Investigating the Effect of Stressful Life Events and PTSD Experience on Fibromyalgia Symptom Severity: The Mediating Role of Social Support and Coping Strategies

Abstract

The present study aimed to examine the effect of stressful life events and PTSD on fibromyalgia symptom severity, considering the mediating role of social support and coping strategies. This cross-sectional correlational study was conducted on patients with fibromyalgia in Isfahan, from whom 1,930 participants were selected using a census sampling method. Data were collected using standardized questionnaires assessing stressful life events, PTSD, perceived social support, and coping strategies. Statistical analyses included descriptive statistics, Pearson correlation coefficients, and structural equation modeling (SEM) using AMOS version 26, with model fit indices evaluated. Results indicated that stressful life events, PTSD, age, and gender had significant positive direct effects on fibromyalgia severity (P<0.001), whereas socioeconomic status showed a significant negative effect (P<0.001). Maladaptive coping strategies had a significant positive effect, while emotion-focused coping showed a significant negative effect on symptom severity (P<0.001). Social support demonstrated significant direct and indirect negative effects. The SEM model exhibited good fit, confirming the mediating roles of social support and coping strategies. The findings suggest that fibromyalgia symptom severity is influenced by psychological and social factors, with social support and coping strategies playing crucial roles in moderating the effects of stress and PTSD; therefore, multidimensional interventions targeting stress reduction, enhancement of social support, and improvement of coping strategies may be effective in managing this disorder.