Examining the impact of target, illness, and observer characteristics on perceptions of women with fibromyalgia and rheumatoid arthritis

Abstract

Aim: To examine the impact of the attractiveness, visible disability cue, and diagnostic ambiguity stereotypes on perceptions of women with Rheumatoid Arthritis (RA) and Fibromyalgia (FM) and the role of observers' Pain Experience and Attributional Style (AS) in moderating perceptions. Inclusion of these variables within a single study adds to our understanding of existing attributional theories regarding judgements about people with chronic pain (i.e., Weiner, 1980). Method: Sixty-six observers with differing levels of Pain Experience and either a Supportive or Unsupportive AS viewed photographs of 8 women of varying levels of attractiveness paired with a diagnosis of RA or FM and pictured with or without a cane. Observers rated each woman on Pain/Disability, Personality, and Responsibility for her pain condition, as well as their feelings of Anger and Sympathy/Desire to Help. Multivariate and univariate ANOV As were used to analyze the data. Results: The visible disability cue impacted the largest number of judgements: It added legitimacy to the targets' pain condition (higher perceived Pain/Disability) but also led to more negative views of the targets' Personality and Responsibility, and to higher levels of Anger. As anticipated the "'What is Beautiful is Good/Healthy" stereotypes exerted their expected effects on perceptions of Pain/Disability and Personality, but the strength of the effects declined when a visible disability cue or medical evidence were present. The ambiguity stereotype only had a direct effect on ratings of Anger and Personality and these ratings appeared to be linked to one another (more Anger/less positive view of Personality when there was no medical evidence). Lastly, observer characteristics played a minimal role in moderating the impact of the stereotypes (Pain Experience moderated the impact of the visible disability cue for Pain/Disability only) but they were the only variables to directly influence rating of Sympathy/Desire to Help (higher Sympathy/Desire to Help associated with a Supportive AS and more Pain Experience). Conclusions: The findings highlight the complexity of the attributional process and have implications for existing attributional theories of chronic pain and the potential impact of stereotypes/observer characteristics on the interactions between patients with pain and health care practitioners/loved ones on patient outcomes.