The impact of social support and invalidation on the severity of somatic symptoms in women with fibromyalgia

Abstract

The current study examines the association of perceived social support and invalidation with the severity of somatic symptoms in women with fibromyalgia, using a patient-based research methodology. The model used in this research proposes that fibromyalgia is rooted in an imbalance between the ‘threat’ system and the ‘soothing’ system, as described by Gilbert´s affect regulation model (Gilbert, 2005). This study focused on the social side of this model. Literature reveals the positive impacts of social support on health and well-being for patients, and a relation between social support and perceived pain severity. Research also indicates the potency of negative impact by invalidation, a social threat, in predicting well-being. In the current study, patients with enduring physical symptoms had identified all factors that threaten or soothe them. In the current study 64 women with fibromyalgia participated (mean age 47, ranging from 22 to 65). They completed the Patient Health Questionnaire-15 to establish the severity of their symptoms. Through regression analysis it was examined whether the importance placed in social support as a soother, and the importance placed in invalidation as a threat is associated with the severity if somatic symptoms. Relationship status was significantly correlated with social support (p= .03) and entered as a covariate. The regression analysis showed that neither social support nor invalidation nor the interaction between the two significantly predicted PHQ-15 values (F =1.565, p =.22, R2 adj.=.0254). This may be due to forced sorting procedure. Participants had to sort 5 piles for the value they placed in each soother and threat: if a participant regarded all soothers as equally soothing, she still had to hierarchically sort them on a scale of 1 to 5, from least to most soothing (or threatening, for threats). This may have caused a distorted view of the importance that participants placed in the social support or invalidation statements. Furthermore, participants who were in a relationship (51 participants) put higher importance in social support than did participants who were single (13 participants), with 69.33% of singles in in ‘high’ versus 92.16% of those in a relationship. This perhaps caused the sample size for low social support to become too small to generate an effect, because no good comparison could be made between low importance social support and high importance in social support. More research on the way that social support or invalidation shapes the disease experience is necessary to understand the impact of the value that people with fibromyalgia themselves place in social support and invalidation.