Social Support and Subjective Health in Fibromyalgia: Self-Compassion as a Mediator

Psychological Distress in Women with Fibromyalgia: The Roles of Body Appreciation, Self-Compassion, and Self-Criticism

BACKGROUND

While past research detected a direct link between symptoms of fibromyalgia (FM) and psychological distress, body appreciation was suggested as a viable mediator of this link. The aim of the present study was to further develop an explanatory model for the effect of FM on women's psychological distress and identify possible protective and risk factors. Specifically, it was hypothesized that self-compassion would moderate the indirect effect of body appreciation and self-criticism on psychological distress in women with FM.

METHOD

This study comprised a total of 293 women, aged 20-68 (M = 34.8, SD = 12.3), of whom 146 were women with FM and 147 were heathy controls. All the women completed questionnaires regarding demographic characteristics, depression (PHQ-9), anxiety (GAD-7), self-criticism (DEQ-SC), body appreciation (BAS2), and the self-compassion scale (SCS).

RESULTS

A moderated serial mediation model demonstrated lower body appreciation in participants with FM compared to controls. These lower levels of body appreciation, together with lower levels of self-compassion, were associated with greater self-criticism and, consequently, higher levels of psychological distress.

CONCLUSIONS

The results emphasize the role of self-compassion as a protective mechanism against psychological distress among women with FM. Future studies should further investigate the effect of self-compassion-focused interventions on patients with FM.

Evaluating the Interaction Between Pain Intensity and Resilience on the Impact of Pain in the Lives of People With Fibromyalgia

OBJECTIVE

Recent theoretical models posit that resilience acts as a resource/mechanism opposing pain catastrophizing and other vulnerability sources against pain adaptation. The aim of this study was to investigate the relationship between resilience, pain, and functionality in people living with fibromyalgia (FM).

MATERIALS AND METHODS

We conducted a cross-sectional online survey of people participating in Brazilian fibromyalgia virtual support groups on Facebook in May 2018. Resilience was evaluated by the Connor-Davidson Resilience Scale. Average pain and the degree of interference of pain in the lives of participants (DIPLP) were assessed using the Brief Pain Inventory. The association between these 3 variables was evaluated through multivariable robust linear regression with adjustment for 21 potential confounders.

RESULTS

We included 2176 participants with FM. Resilience was associated with a decreased DIPLP (β: -0.38, 95% CI: -0.54 to -0.22, P <0.001) but not with average pain scores (β: -0.01, 95% CI: -0.18 to 0.16, P =0.93). A significant interaction between resilience and average levels of pain on the DIPLP was observed so that resilience showed a much stronger protective association among participants with average null-to-mild pain than among those with moderate and severe pain levels.

DISCUSSION

Our results provide evidence against beliefs that the pain of people with FM is related to low psychological resilience and shed light on the complex interrelationships between resilience, pain, and functionality. This research signals both the relevance and limits of resilience in the management of FM. Future studies evaluating behavioral interventions for FM should consider how those interventions interact with baseline pain levels and resilience.

Healthcare discrimination and treatment adherence among sexual and gender minority individuals living with chronic illness: the mediating effects of anticipated discrimination and depressive symptoms

Background: Sexual and gender minority (SGM) individuals are at increased risk for an array of chronic illness due to minority stress. Up to 70% of SGM individuals report healthcare discrimination, which may cause additional challenges for SGM people living with chronic illness including avoiding necessary healthcare. The extant literature highlights how healthcare discrimination is associated with depressive symptoms and treatment nonadherence. However, there is limited evidence on the underlying mechanisms between healthcare discrimination and treatment adherence among SGM people living with chronic illness.Methods: Among a sample of SGM individuals living with chronic illness (n = 149) recruited from social media, the current study examined the mediating roles of anticipated discrimination and depressive symptoms on the relation between healthcare discrimination and treatment adherence in a serial mediation model.Results: We found that healthcare discrimination was associated with greater anticipated discrimination, increased depressive symptoms, and, in turn, poorer treatment adherence. Conclusion: These findings highlight the association between minority stress and both depressive symptoms and treatment adherence among SGM individuals living with chronic illness. Addressing institutional discrimination and the consequences of minority stress may improve treatment adherence among SGM individuals living with chronic illness.

Oxidative Stress in Fibromyalgia: From Pathology to Treatment

Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain associated with sleep problems, fatigue, depression, and anxiety. The persistence of pain, impairment of cognitive function, and negative impact on the psychological state have caused a detrimental effect on the patients' quality of life. However, to date, the treatment and mechanisms of this disease are yet to be established. Oxidative stress might play a critical role in FM pathophysiology. Increased levels of prooxidative factors such as nitric oxide, lipid peroxidation, and mitophagy can cause pain sensitization in fibromyalgia. Numerous studies have supported the hypothesis of beneficial antioxidative effects in FM. Due to the lack of effective therapy for fibromyalgia, many treatments are sought to reduce pain and fatigue and improve patients' quality of life. This manuscript discusses the impact of various antioxidative procedures that can diminish fibromyalgia symptoms, such as hyperbaric oxygen therapy, modification of dietary habits, and physical activity.