Social comparison processes and catastrophising in fibromyalgia: A path analysis

Social Determinants and Consequences of Pain: Toward Multilevel, Intersectional, and Life Course Perspectives

Despite wide endorsement of a biopsychosocial framework for pain, social aspects of pain remain rarely addressed in the context of pain prevention and management. In this review, we aim to 1) examine the broad scope of social determinants and consequences of pain and their interactions across multiple levels of organization, and 2) provide a framework synthesizing existing concepts and potential areas for future work on social aspects of pain, drawing upon socioecological, intersectional, and life course approaches. Integrating interdisciplinary theory and evidence, we outline pathways through which multilevel social factors and pain may affect each other over time. We also provide a brief summary of intrapersonal aspects of pain, which are thought to operate at the interface between individuals and the social context. Progressing from micro- to macrolevel factors, we illustrate how social determinants of pain can directly or indirectly contribute to pain experiences, expression, risk, prognosis, and impact across populations. We consider 1) at the interpersonal level, the roles of social comparison, social relatedness, social support, social exclusion, empathy, and interpersonal conflict; 2) at the group or community level, the roles of intimacy groups, task groups, social categories, and loose associations; and 3) at the societal level, the roles of political, economic, and cultural systems, as well as their policies and practices. We present examples of multilevel consequences of pain across these levels and discuss opportunities to reduce the burden and inequities of pain by expanding multilevel social approaches in pain research and practice. PERSPECTIVE: Despite wide endorsement of a biopsychosocial framework for pain, social aspects of pain are often unclearly defined, hindering their use in pain prevention, management, and research. We summarize the scope of social aspects of pain and provide a framework synthesizing existing concepts and potential areas for future work.

Selection of social comparison standards in cardiac patients with and without experienced defibrillator shock

Patients with an implantable cardioverter-defibrillator (ICD) often report psychological distress. Literature suggests that patients with physical disease often compare their well-being and coping to fellow patients. However, we lack knowledge on social comparison among patients with ICD. In this study, we examined psychological distress and social comparison selection in patients with (ICD+) and without experienced ICD shocks (ICD-). We theorized that relative to ICD- patients, those with ICD+ display higher levels of psychological distress and thereby compare more frequently with fellow patients with more severe disease, but better disease coping and try to identify more strongly with these standards to improve their own coping. We recruited 92 patients with (ICD+, n = 38) and without an experienced ICD shock (ICD-, n = 54), who selected one of four comparison standards varying in disease severity and coping capacity. Relative to ICD-, ICD+ patients reported higher levels of device-related distress, but there were no significant differences in anxiety, depression, or quality of life. ICD+ patients selected more often comparison standards with poor coping and, irrespective of standard choice, displayed more negative mood following comparison. Our results show that ICD+ patients tend to perform unfavorable comparisons to fellow patients, which might explain higher psychological distress and worse coping. These findings warrant further research into social comparison as a relevant coping mechanism in ICD patients.

Impact of social comparison on perceived online academic futility: A perspective from parents

In response to the wide-ranging concern of online academic futility, the current study aimed to explore the independent variables and mediating variable from a novel perspective of parents during COVID-19. Based on the social comparison theory and the control-value theory of achievement emotions, social comparison and tutoring anxiety were incorporated into an integrated model as predictors and mediator, respectively. A total of 300 parents completed an online survey. The results of the structural equation modeling indicated that upward social comparison and downward social comparison were both positively related to tutoring anxiety, which in turn positively predicted perceived online academic futility. Notably, tutoring anxiety played a significant mediating role in the association between different social comparison and perceived online academic futility. These results highlight the consistent predictive effect of upward social comparison and downward social comparison on perceived online academic futility, shedding light on the roles of tutoring anxiety in explaining the relationship from parental perspectives.

Patients' Lived Experience in a Multicomponent Intervention for Fibromyalgia Syndrome in Primary Care: A Qualitative Interview Study

Fibromyalgia syndrome (FMS) disrupts patients' biopsychosocial spheres. A multicomponent intervention (MCI) program, which combined health education, cognitive behavioral therapy, and physical activity, was conducted in South Catalonia's primary care centers with the aim of improving symptom self-management and quality of life. A qualitative interview study was carried out to understand patients' lived experiences during the intervention program. Sampled purposively, 10 patients were interviewed via phone calls and face-to-face. The encounters were audio-recorded, verbatim transcribed, and analyzed through thematic analysis. As a result, four themes emerged: legitimizing fibromyalgia through the MCI, the MCI as a socializing experience, learning how to live with FMS through the MCI, and room for improving the MCI. Participants agreed on the program being an insightful experience that promoted illness knowledge and acceptance and that improved their coping skills and symptom self-management. The inclusion of additional psychological guidance, expressive psychological group therapy, and providing relatives with information were proposed for enhancing the program. Our findings have contributed to gaining insight into the subjective impact of the MCI and identifying new therapeutic targets to tailor the program to patients' needs, which will hopefully increase its effectiveness and improve their quality of life.

Social Comparison and Stress Appraisal in Women with Chronic Illness

(1) Background: The present study examined how social comparison orientation, stress appraisal and different social comparison strategies interact in women facing chronic illness. (2) Methods: Assessments were conducted by a trained professional in face-to face semistructured interviews (n = 179 women with chronic illness). Main outcome measures included social comparison scales and a stress appraisal questionnaire. The mediation model, by a bootstrapping procedure, was used to analyze the interaction among variables. (3) Results: Regarding the relationships among variables studied, they were related to each other except for a downward contrast, which allowed us to propose our hypothetical mediation model. Results showed that stress appraisal fully mediates between social comparison orientation and social comparison strategies except for the upward identification strategy. (4) Conclusions: Our results suggest that uncertainty, feelings of threat and low control over one’s illness or, in general, stress appraisal, had an important mediating effects over social comparison processes in patients with chronic illnesses. Therefore, by understanding the stress appraisal process, and the variables that might modify it, we could improve the use of social comparison as a favorable coping strategy.

Affective Consequences of Social Comparisons by Women With Breast Cancer: An Experiment

Objective

People with severe illness often meet and compare themselves with other patients. Some of these comparison standards do well, others do poorly. Such comparisons could have positive as well as negative consequences depending on whether people identify or contrast from the standard. In the present study, we examine whether patients with breast cancer can benefit from comparisons by engaging in favorable comparison processes.

Design

102 women diagnosed with breast cancer were randomly assigned to read a (fictitious) self-report from a well or poorly adjusted breast cancer patient.

Main Outcome Measures

Participants reported their affective reaction (mood, anxiety, depression) and specified their comparison process (identification or contrast).

Results

In general, participants engaged in favorable comparison processes by contrasting predominantly with poorly adjusted patients, and identifying with well-adjusted ones.

Participants’ Mood Assimilated to the Standard

Participants reported more positive mood after having been exposed to the well-adjusted than the poorly adjusted standard.

Anxiety and Depression Varied With the Type of Comparison Process

It was lower the more they avoided unfavorable comparisons (contrasting with the well-adjusted patient and identifying with the poorly adjusted one).

Conclusion

Patients adjust their comparison processes to the standard to experience favorable comparisons. Especially avoiding unfavorable comparison processes reduces the risk of negative consequences after encountering other patients. Thus, patients may profit from comparisons as long as they engage in the right process.

Consequences of Chronic Non-Cancer Pain in adulthood. Scoping Review

OBJECTIVE

To examine and map the consequences of chronic pain in adulthood.

METHOD

Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included

RESULTS

Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning.

CONCLUSIONS

This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.

Profiles of Women With Fibromyalgia and Social Comparison Processes

Background

Due to uncertainty regarding chronic pain in Fibromyalgia (FM) patients, there has been a growing interest in social comparison and its influence on emotional responses.

Aims

to analyze profiles in FM patients according to pain perception, social comparison strategies and anxiety and depression.

Methods

The sample consisted of 131 FM outpatients (Mean age: 50.15, SD = 11.1). Two scales were used: the Social Comparison Illness Scale and the Hospital Anxiety and Depression Scale.

Results

Two profiles were found by cluster analysis (K-means method): one (66%) with a higher level of pain perception, anxiety and depression and greater use of upward contrast and downward identification social comparison; and another (34%) with lower levels of pain perception, anxiety and depression and greater use of upward identification and downward contrast.

Conclusion

These profiles underline the interest in social comparison strategies and their role in FM.