Buffering the Suffering? Investigating the Role of Self-Compassion and other Psychosocial Variables in Individuals with Medically Unexplained Physical Symptoms

Abstract

Medically unexplained physical symptoms (MUPS) occur in the absence of identifiable organic pathology. While specific aetiological factors remain unclear, current biopsychosocial perspectives of MUPS acknowledge the conspicuous influence of various psychosocial factors on this mysterious phenomenon. The recent rise of self-compassion is psychological research has highlighted its beneficial effects across several populations. However, the potential utility of this contemporary ‘third-wave’ concept has not previously been assessed in a MUPS sample. Thus, examining the role of self-compassion alongside other well-established psychosocial correlates of MUPS, will extend and contribute to current understandings of MUPS. This, in turn, may potentially improve the management techniques available for this patient group. This cross-sectional study compared patients with MUPS, patients with a medically explained condition (namely, rheumatoid arthritis (RA)), and healthy controls across a range of psychosocial variables. By doing so, the study aimed to provide further insights into how such variables uniquely contribute to the experiences of MUPS patients. Seventy-two MUPS patients, 64 RA patients, and 59 healthy controls completed a series of questionnaires assessing variables such as symptom burden and interference, symptom acceptance, symptom catastrophizing and hypervigilance, self-compassion, and indices of psychological distress. Analyses revealed significant differences between patient groups and healthy controls across measures of symptom burden and interference, symptom acceptance, symptom catastrophizing and hypervigilance. Further, MUPS patients reported significantly greater levels of symptom burden and interference, symptom catastrophizing (and its component helplessness), as well as symptom hypervigilance, depression, anxiety, and stress. Significant differences between only MUPS patients and healthy controls were also observed in measures relating to affectivity and difficulties in emotion regulation. Self-compassion was negatively correlated with measures of negative psychological states and positively with symptom acceptance and positive affect. The three study groups did not significantly differ in levels of self-compassion. However, self-compassion moderated the relationship between measures of symptom experience (i.e. burden and interference) and psychological distress (specifically, depression and negative affect) amongst those with RA. Post-hoc analyses also indicated that for MUPS patients, self-compassion mediated the relationship between symptom interference and measures of psychological distress (namely, anxiety and stress). These findings provide valuable insights into specific psychosocial factors that uniquely contribute to the experiences of MUPS patients. In particular, given the novel findings pertaining to the mediatory function of self-compassion in MUPS patients, further research directions could include exploring the potential utility of self-compassion as a therapeutic intervention to improve well-being in MUPS patients.