This study investigated primary and secondary stressors of distress in rheumatoid arthritis patients and partners, analysing data of 61 couples. Patients' disability was found to be a primary stressor of their distress. In addition, it also had an indirect effect on partners' distress through partners' primary stressor, perceived burden. Marital quality and negative transactions can be considered joint secondary stressors for partners, not for patients. An indication of an indirect effect of marital quality on patients' distress was found, through partners' burden. Using a multilevel model, which takes into account the dependence between patients' and partners' distress, 36% of the variance in patients' distress could be explained, whereas 68% of partners' distress variance was explained. More knowledge on how patient and partner influence each other's distress is needed to develop psychosocial interventions that will help patients and partners minimize their psychological distress and prevent deterioration of their marital quality.