Control beliefs, coping and emotions: Exploring relationships to explain fibromyalgia health outcomes

In order to explain relevant health status dimensions in fibromyalgia syndrome (FMS), this ex post facto study explores relationships between control beliefs, illness-focused coping and emotions. The study additionally sought to clarify the role of coping and emotions as potential mediators in the relationship between control beliefs and perceived health outcomes. Structural equation modelling was employed. A total of 315 FMS patients of various primary care and rheumatology centres participated in the study, and completed measures of health status, control beliefs, coping, anxiety and depression. Analyses revealed that control belief constructs that contain the competence element (self-efficacy and perceived health competence) have a direct effect on all health status areas examined. The findings also suggested the mediating role of emotions between competence beliefs and both physical and psychosocial impact, while illness-coping behaviour significantly mediates the relationship between self-efficacy and physical impact. Control beliefs and emotions are central elements in explaining the overall impact of FMS. Therapeutic efforts should emphasize increasing competence beliefs in order to produce meaningful improvement in FMS emotional distress and health outcomes. These findings contribute to understand further how relevant psychosocial factors may influence adaptation by FMS patients.