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.