Rheumatoid arthritis and object relations

The purpose of this study was to explore the object relations of Rheumatoid Arthritis (RA) patients in addition to examining the association, if any, of Alexithymia and RA for these patients. The sample was comprised of 50 subjects (20 RA, 10 UC, and 20 NP or Non-psychosomatic controls). Two-and three-group comparisons were made, using Analysis of Variance, Discriminate Analysis, and non-parametric Tests (Chi-Square and Fisher's Exact Probability Test). The results show that hypothesis 1 was only partially confirmed since only 3 Westen Object Relations Scales – the Capacity for Emotional Investment and Moral Standards (El), Complexity of Representations of People (CR) , and Affect-tone of Relationship Paradigms (AT) – showed statistically significant differences for RA and NP controls. The BORI Subscales failed to distinguish the 3 groups. Furthermore, RA and UC subjects differed at a statistically significant level on Affect-tone of Relationship Paradigms. The RAs turned out to be a bimodal group consisting of a less differentiated (below average) subgroup and a more differentiated (average or above) Object Relations subgroup on all 3 Westen Scales (CR, EX, and AT). The less differentiated RA subgroup may benefit more from psychotherapy since they may be more vulnerable to psychological stress. Further, only Affect-tone distinguished the 3 groups at a statistically significant level. The RA group was more heterogeneous and tended to score the lowest of the 3 groups on this variable (60% of the RAs scored below average as compared to 20% UCs and 10% NP controls.) These results suggest that there seems there seems to be no specific pattern of object relations for all psychosomatic-autoimmune patients, that RA patients differ from non-psychosomatic controls in object relations, and that, within the RA group, some subjects are more and others are less differentiated in terms of object relations. Hypothesis 2 was rejected since RA did not differ statistically from the NP subjects. However, in the three-group-comparison, the RAs were the least and the UCs the most alexithymic subjects of all 3 groups. These results indicate that not all psychosomatic-autoimmune patients are alexithymic and that alexithymia is not the problem of RA patients.