Gratitude mediates quality of life differences between fibromyalgia patients and healthy controls
Despite a growing literature on the benefits of gratitude for adjustment to chronic illness, little is known about gratitude in medical populations compared to healthy populations, or the degree to which potential deficits in gratitude might impact quality of life. The purpose of the present study was to (1) examine levels of gratitude and quality of life in fibromyalgia patients and healthy controls and (2) consider the role of gratitude in explaining quality of life differences between fibromyalgia patients and healthy controls.
Participants were 173 fibromyalgia patients and 81 healthy controls. All participants completed measures of gratitude, quality of life, and socio-demographics.
Although gratitude was positively associated with quality of life, levels of gratitude and quality of life were lower in the fibromyalgia sample relative to the healthy controls. This difference in gratitude partially mediated differences in quality of life between the two groups after controlling for socio-demographic variables.
Our findings suggest that gratitude is a valuable positive psychological trait for quality of life in people with fibromyalgia. Interventions to improve gratitude in this patient population may also bring enhancement in quality of life.
KeywordsGratitude Fibromyalgia Quality of life Adjustment Chronic illness
This research was supported in part by a Grant from the Friedrich Baur Foundation.
Compliance with ethical standards
Conflicts of interest
All authors declare no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Wolfe, F., Clauw, D. J., Fitzcharles, M.-A., Goldenberg, D. L., Katz, R. S., Mease, P., et al. (2010). The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care & Research, 62(5), 600–610. doi: 10.1002/acr.20140.CrossRefGoogle Scholar
- 3.Bernard, A. L., Prince, A., & Edsall, P. (2000). Quality of life issues for fibromyalgia patients. Arthritis Care & Research, 13(1), 42–50. doi: 10.1002/1529-0131(200002)13:1<42:AID-ART7>3.0.CO;2-R.CrossRefGoogle Scholar
- 6.Miró, E., Martínez, M. P., Sánchez, A. I., Prados, G., & Medina, A. (2011). When is pain related to emotional distress and daily functioning in fibromyalgia syndrome? The mediating roles of self-efficacy and sleep quality. British Journal of Health Psychology, 16(4), 799–814. doi: 10.1111/j.2044-8287.2011.02016.x.CrossRefPubMedGoogle Scholar
- 8.Janssens, K. A. M., Zijlema, W. L., Joustra, M. L., & Rosmalen, J. G. M. (2015). Mood and anxiety disorders in chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome: Results from the lifelines cohort study. Psychosomatic Medicine, 77(4), 449–457. doi: 10.1097/psy.0000000000000161.CrossRefPubMedGoogle Scholar
- 9.Soriano-Maldonado, A., Amris, K., Ortega, F. B., Segura-Jiménez, V., Estévez-López, F., Álvarez-Gallardo, I. C., et al. (2015). Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia. Quality of Life Research, 24(12), 2951–2957. doi: 10.1007/s11136-015-1045-0.CrossRefPubMedGoogle Scholar
- 30.Gandek, B., Ware, J. E., Aaronson, N. K., Apolone, G., Bjorner, J. B., Brazier, J. E., et al. (1998). Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51(11), 1171–1178.CrossRefPubMedGoogle Scholar
- 32.Ware, J. E., Kosinski, M., & Keller, S. D. (1995). SF-12: How to Score the SF-12 Physical and Mental Health Summary Scales. Boston, MA: The Health Institute, New England Medical Center.Google Scholar
- 33.Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric Theory. New York: McGraw Hill.Google Scholar
- 36.Wu, A. D., Li, Z., & Zumbo, B. D. (2007). Decoding the meaning of factorial invariance and updating the practice of multi-group confirmatory factor analysis: A demonstration with TIMSS data. Practical Assessment, Research and Evaluation, 12(3), 1–26.Google Scholar
- 38.Kline, R. B. (2005). Principles and Practice of Structural Equation Modeling (2ed.). New York: The Guilford Press.Google Scholar
- 39.Little, T. D., Card, N. A., Bovaird, J. A., Preacher, K. J., & Crandall, C. S. (2007). Structural equation modeling of mediation and moderation with contextual factors. In T. D. Little, J. A. Bovaird, & N. A. Card (Eds.), Modeling contextual effects in longitudinal studies (pp. 207–230). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.Google Scholar
- 42.Kline, R. B. (2015). Principles and practice of structural equation modeling. New York: Guilford Publications.Google Scholar
- 43.Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003). Evaluating the fit of structural equation models: Tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8(2), 23–74.Google Scholar
- 44.Latorre-Román, P. A., Martínez-Amat, A., Martínez-López, E., Moral, Á., Santos, M. A., & Hita-Contreras, F. (2014). Validation and psychometric properties of the Spanish version of the Quality of Life Scale (QOLS) in patients with fibromyalgia. Rheumatology International, 34(4), 543–549.CrossRefPubMedGoogle Scholar
- 50.Kool, M. B., van Middendorp, H., Lumley, M. A., Bijlsma, J. W., & Geenen, R. (2013). Social support and invalidation by others contribute uniquely to the understanding of physical and mental health of patients with rheumatic diseases. Journal of Health Psychology, 18(1), 86–95.CrossRefPubMedGoogle Scholar