Body appreciation as a protective factor in women with fibromyalgia: an examination of associations between pain perception, social comparison and psychological distress.

OBJECTIVES: While symptoms of fibromyalgia (FM) and psychological distress are directly linked, indirect effects are also apparent. The aim of the present study was to develop an explanatory model for the effect of FM on women's psychological distress and identify possible protective and risk factors. METHODS: This study comprised of total of 293 women aged 20-68 (M= 34.3, SD = 12.1), of which 141 were women with FM and 152 healthy peers (HP), who completed questionnaires regarding demographic characteristics, anxiety (GAD-7), depression (PHQ-9), body appreciation (BAS-2), social comparison strategies, and pain assessment (SF-MPQ). RESULTS: FM patients demonstrated higher psychological distress, i.e., depression and anxiety and lower body appreciation. Body appreciation significantly correlated with social comparison coping strategies. Body appreciation and social comparison strategies mediated the link between FM and psychological distress. Among FM patients, body appreciation moderated the links between pain intensity and aspects of social comparison strategies, thus explaining the link between pain intensity and psychological distress. CONCLUSIONS: Women with FM demonstrated higher levels of anxiety and depression symptoms and lower body appreciation compared to HP. The unique role of body appreciation in moderating the indirect link between pain and psychological distress appears to be protective.