PTOTSLPSurveyJournal of rehabilitation medicine2022

Facing Invalidation: A Further Challenge when Living with Chronic Widespread Pain.

Pirjo Järemo, Maria Arman, Björn Gerdle and 1 others

PMID 35274146

WHAT IT FOUND

Patients with chronic widespread pain reported frequent invalidation, particularly from social services and medical professionals.

Higher levels of discounting and lack of understanding were associated with worse mental health and more anxiety or depression, but not with physical health status.

Key findings

01Patients reported the highest levels of invalidation (both discounting and lack of understanding) from social services, followed by medical professionals, while spouse interactions were rated as least invalidating.

02Experiences of invalidation from spouse, family, and work were significantly associated with worse self-reported mental health, whereas no correlations were found between invalidation and physical health status.

03The presence of anxiety symptoms was associated with experiencing more discounting from work and social services, and depressive symptoms were associated with discounting from spouse and family.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The study had a low response rate (46%), which may affect the representativeness of the sample. The cross-sectional design prevents determining whether invalidation causes poor mental health or if patients with poor mental health perceive more invalidation. The sample was drawn from a specialist centre, so findings may not apply to patients with CWP in primary care. The SF-36 mental health measure may not capture specific aspects of suffering related to social invalidation.

Declared interests

The authors declared no conflicts of interest. The study was approved by the Regional Ethics Review Board in Stockholm.

The easy way to misread this

Do not assume that invalidation affects physical function or pain severity directly. The study found no correlation between invalidation scores and physical health status (PCS) or pain severity (BP), meaning the impact observed was specifically on mental health and symptoms of anxiety and depression.

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