The Role of Subjective Well-Being in the Relationship Between Illness Invalidation, Acceptance, and Functioning in Fibromyalgia

Abstract

Fibromyalgia (FM) is a chronic, widespread pain disorder that severely impairs daily functioning and well-being. Beyond physical symptoms, social and cognitive factors such as illness invalidation and difficulties in acceptance may further hinder adaptation. This study examined whether positive mental health and subjective well-being mediate the relationship between these factors and functioning in women with FM. A total of 148 women aged 20–65 completed self-report measures of the study variables. Preliminary correlation analyses showed that positive mental health was unrelated to invalidation and was therefore excluded from the mediation model. Mediation analyses revealed that higher illness invalidation and greater difficulties in illness acceptance were associated with lower subjective well-being, which in turn related to poorer functioning. These findings highlight the central role of subjective well-being in linking psychosocial factors to functioning in women with FM. Illness invalidation, acceptance difficulties, and subjective well-being itself emerged as key therapeutic targets, underscoring the importance of integrated, acceptance-based, and patient-centered interventions that foster well-being and support adaptive functioning despite persistent symptoms.