Fibromyalgia Impact and Suicidal Behavior: Effects of Stress and Self-Compassion

Fibromyalgia, a chronic illness characterized by widespread muscle pain, tenderness, joint stiffness, and fatigue, affects 3-6% of the world’s population. Symptoms of fibromyalgia impact the ability to complete daily activities, such as cooking, cleaning or employment, possibly leading to greater perceived stress and, in turn, to engagement in suicidal behavior. For persons with fibromyalgia, pressure to complete previous routines, and emergence of frustration at the inability to do so, may result in the experience of being overwhelmed by stressors. Further, persons with fibromyalgia are at greater risk for both mental health difficulties and suicidal behavior than persons in the general population; for example, depressive symptoms, including self-blame, are three times more common. However, not all individuals with fibromyalgia experience overwhelming distress or engage in suicidal behaviors, perhaps due to the presence of individual-level protective factors. One such factor is self-compassion, which is composed of self-kindness, common humanity, and mindfulness. Positive emotions directed toward the self may buffer against illness-related stressors and feelings of inadequacy and loss associated with impact of disease and functional impairment, thereby decreasing suicide risk. At the bivariate level, we hypothesized that fibromyalgia impact would be positively related to stress and suicidal behaviors, and that self-compassion would be negatively related to all of these variables. At the multivariate level, we hypothesized that stress would mediate the relation between fibromyalgia impact and suicidal behaviors, and that self-compassion would moderate this mediation effect such that greater self-compassion would weaken the linkages between impairment and stress, impairment and suicidal behavior, and stress and suicidal behavior. Our sample of individuals with fibromyalgia (N=508) were primarily White (91.8%; n=383) and female (95.7%; n=401), and completed self-report measures including: Fibromyalgia Impact Questionnaire-Revised, Depression Anxiety Stress Scales, Self-Compassion Scale-Short Form, and Suicide Behaviors Questionnaire-Revised. Bivariate correlations and multivariate analyses, per Hayes (2013), were conducted covarying age, sex, and ethnicity. In bivariate correlations, fibromyalgia impact was positively related to stress and suicidal behaviors and negatively related to self-compassion (p Supporting hypotheses, our results suggest that self-compassion may protect against the development of stress related to fibromyalgia impact and subsequent risk for suicidal behaviors, and may have clinical implications. Therapeutic interventions focused on alleviating stress (e.g., meditation, stress inoculation therapy) and promoting self-compassion (e.g. mindful self-compassion training, positive self-talk) could ameliorate the perceived impact of fibromyalgia-related stressors and, thus, risk for engagement in suicidal behaviors