Exploring the role of shame and self-compassion on the link between fibromyalgia symptoms and depression: Insights from mediation and moderation analyses

Publication date

2026

Authors

Fortuna,  Judite
Pinto,  Ana M.
da Silva,  José A. P.
Geenen, R.ORCID 0000-0002-6615-6708ISNI 0000000397139908
Castilho,  Paula

Editors

Advisors

Supervisors

Document Type

Article
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License

cc_by

Abstract

The intricacies of the fibromyalgia-depression link accentuate the need to further explore underlying psychosocial mechanisms. External shame resulting from fibromyalgia?s nature and associated impairment may increase the risk for depression. We explored whether being supportive and compassionate toward one?s perceived shortcomings would potentially weaken this association. This cross-sectional study comprised 138 women with fibromyalgia. Participants were recruited via patient associations and invited to complete an online survey. Descriptive, correlational, mediation and moderation analyses were performed to test the driving hypotheses. Both mediation and moderation analyses accounted for approximately 40% of the variance in depressive symptoms. Fibromyalgia severity was directly and indirectly? through external shame? associated with depressive symptoms. The shame-depressive symptoms link was weaker in participants with greater self-compassion skills. Findings point to the importance of shame and self-compassion and the need to address them in research and clinical contexts.

Keywords

compassionate self-responding, depressive symptoms, fibromyalgia, mediation/moderation, shame, Applied Psychology

Citation

Fortuna, J, Pinto, A M, da Silva, J A P, Geenen, R & Castilho, P 2026, 'Exploring the role of shame and self-compassion on the link between fibromyalgia symptoms and depression : Insights from mediation and moderation analyses', Journal of Health Psychology, vol. 31, no. 1, pp. 52-68. https://doi.org/10.1177/13591053251331286