S-79
Clinical and Experimental Rheumatology 2020
1
Department of Clinical Psychology,
National Distance Education University
(UNED), Madrid;
2
Rheumatology Unit, Rehabilitation
Institute, University General Hospital
Gregorio Marañón, Madrid, Spain;
3
Gasteiner Heilstollen Hospital, Bad
Gastein-Böckstein, Austria;
4
Katholieke University Leuven, Belgium;
5
Department of Psychology, Luther
College, Decorah, IA, USA.
Miguel A. Vallejo, PhD
Laura Vallejo-Slocker, MSc
Javier Rivera, MD, PhD
Martin Offenbächer, MD
Jessie Dezutter, PhD
Loren Toussaint, PhD
Please address correspondence to:
Miguel A. Vallejo,
Department of Clinical Psychology,
National Distance Education
University (UNED),
Juan del Rosal, 10,
28040 Madrid, Spain.
E-mail: mvallejo@psi.uned.es
Received on January 26, 2020; accepted
in revised form on February 6, 2020.
Clin Exp Rheumatol 2020; 38 (Suppl. 123):
S79-S85.
© Copyright CliniCal and
ExpErimEntal rhEumatology 2020.
Key words: forgiveness, fbromyalgia,
acceptance, catastrophising, coping
Funding: this study was funded by the
Ministerio de Economía y Competitividad
(MINECO), Proyectos I+D+I (Retos),
Spanish Government under the Grant
PSI2017-85447-R. It was also in part
funded by the Instituto de la Mujer,
Ministerio de Sanidad, Servicios Sociales
e Igualdad, Spanish Government under
grant 2011-INV-00232.
Competing interests: none declared.
ABSTRACT
Objective. Forgiveness infuences
health through numerous mechanisms,
but commonly it is thought to reduce
stress, increase healthy behaviour, and
promote social support, thereby posi-
tively impacting health and wellbeing.
Self-forgiveness has been given con-
siderable attention in relation to health
and wellbeing. Fibromyalgia (FM)
patients had lower forgiveness of oth-
ers and self-forgiveness as compared
to controls. The aim of this study is to
explore the relationship of self-forgive-
ness (FS) with the impact and sever-
ity of FM, acceptance, catastrophising,
and coping.
Methods. We evaluated 228 FM female
patients who completed the Mauger
Forgiveness Scale, the Combined In-
dex of Severity in Fibromyalgia (ICAF)
survey, the Chronic Pain Acceptance
Questionnaire (CPAQ), and the Pain
Catastrophising Scale (PCS).
Results. High self-forgiveness is re-
lated to high levels of active coping
(r=.41) and acceptation (r=.38), and
low self-forgiveness is related to emo-
tional negative factors and catastro-
phising (r=-.56). Two factors (physi-
cal and emotional) were obtained.
Lower FS is an emotional factor with
negative emotion, catastrophising and
a defcit in active coping. A decision-
tree analysis showed a frst node with
ICAF Emotional scores and a second
level with CPAQ and PCS scores as
predictors.
Conclusion. A notable lack of FS in-
dicates a problem (distress and cata-
strophising) with the health aspects
related to this syndrome. Acceptance
could require a low negative emotional
status. People with high FS were likely
to increase acceptation as the positive
component of acceptance in FS. This
fnding does not indicate an interest in
maintaining problematic behaviours.
Introduction
Forgiveness is a multidimensional
construct with diverse connections to
health and wellbeing in both patients
and general populations (1). Forgive-
ness can be conceptualised in multiple
ways, but two common approaches
are to consider, i.e. forgiveness of oth-
ers and self-forgiveness (2). Forgive-
ness is commonly described as a trait
or characteristic of an individual that
is relatively stable across time and
situations (3). Forgiveness infuences
health through numerous mechanisms,
but commonly it is thought to reduce
stress, increase healthy behaviour, and
promote social support thereby posi-
tively impacting health and wellbeing.
Self-forgiveness has been given con-
siderable attention and it appears that
it may be as, if not more, important as
forgiving others in relation to health
and wellbeing (4). Indeed, self-forgive-
ness has been related to multiple health
behaviours and outcomes, such as anx-
iety (5), depression (6), coping factors,
and health behaviours (7), as well as,
conditions such as eating disorders and
alcoholism, and chronic problems such
as pain or cancer (8).
Fibromyalgia (FM) is a syndrome of
unknown aetiology characterised by
widespread pain, fatigue, sleep altera-
tions, and decline in physical function-
ing (9). Special importance is given
to emotional factors related to FM,
mainly mood disturbances, anxiety and
stress (10). Individuals suffering from
FM need to adapt to a chronic condi-
tion that exerts an overwhelming infu-
ence on their lives (11).
Recently, Offenbäecher et al. (12)
compared a sample of FM patients and
normal controls and showed that FM
patients had lower forgiveness of oth-
ers and self-forgiveness as compared to
controls. Specifcally, when compared
with forgiveness of others, self-forgive-
Self-forgiveness in fbromyalgia patients and its
relationship with acceptance, catastrophising and coping
M.A. Vallejo
1
, L. Vallejo-Slocker
1
, J. Rivera
2
,
M. Offenbächer
3
, J. Dezutter
4
, L. Toussaint
5