Psychological well- being, negative affectivity, and functional impairment in fibromyalgia. Psychotherapy and Psychosomatics

Background: Psychological Well Being (PWB) is likely to be important in understanding psychological responses to chronic physical illnesses. This study aimed to examine PWB, operationalized according to Ryff’s model, in fibromyalgia (FM) and its relationship with ill-being and disability, when controlling for several confounds. Methods: 48 fibromyalgic female outpatients were compared to 48 female healthy controls recruited from the general population. Measures of PWB, assessed using the Ryff’s six-subscale model, negative affectivity, and functional impairment were obtained from standardised, selfadministered rating scales. Statistical analyses focused on between-groups differences and multiple stepwise regression analyses to predict ill-being and disability. Results: Cases showed higher depression symptoms and more difficulties in daily living than controls. Unexpectedly, cases and controls did not differ in anxiety or in PWB. Functional Impairment and anxiety predicted depression in FM females, while Environmental Mastery and Purpose in Life predicted depression among healthy controls. Three PWB dimensions predicted functional impairment (i.e., Positive Relationships and Purpose in Life) or anxiety (i.e., Selfacceptance) in FM females. Conclusions: The causal models explaining ill-being and/or difficulties in daily living in healthy females cannot be generalized to females with FM. Indeed, although Purpose in Life emerges as an important protective factor either in cases and in controls, the relationship of this domain with depression seems mediated by disability in cases and direct in controls. Moreover, in FM subjects, social support and also Self-Acceptance seem to buffer the effects of the adversity on ill-being.