Do online peer support groups for fibromyalgia convey psychological flexibility? A qualitative analysis of Facebook support groups’ discussion content

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University of New Brunswick


Background: Fibromyalgia (FM) is a debilitating, often stigmatized disorder of unknown origins characterized by chronic widespread pain, fatigue, sleep difficulties, cognitive dysfunction, and mood symptoms. Patients anecdotally describe online peer support groups (OPSGs) as invaluable sources of information and support but others have expressed concern OPSGs may have iatrogenic effects. Although three studies have examined pre-social media FM OPSGs, limited information about their discussion content and potential utility as a mental health resource is available. Method: Accordingly, the current project endeavoured to explore what is discussed in contemporary OPSGs (Study 1) and whether this content aligns with a recommended psychological treatment for FM (Study 2). In Study 1, discussion content from three Facebook FM OPSGs was inductively examined using Thematic Analysis. In Study 2, the content was re-examined deductively using the psychological flexibility/inflexibility model underlying Acceptance and Commitment Therapy (ACT). Results: In Study 1, two themes depicting why group members participated in the OPSG (trying to understand FM, seeking/offering emotional support) and six themes underlying the reasons members seek informational and emotional support (fighting FM, learning to live with FM, struggling with identity, distressing thoughts and feelings, judgment, empowerment-seeking) were identified. Results of Study 2 indicated the OPSGs’ discussion content aligned more frequently and saliently with ACT’s psychological inflexibility pillars rather than the psychological flexibility pillars, suggesting the discussions are often ACT-incongruent. Conclusions: This research enhances our understanding of why persons with FM often utilize OPSGs while concurrently highlighting key areas of need including psychological health that are likely being insufficiently addressed offline by existing health resources. Although patients’ efforts to address these needs including emotional and psychological distress via OPSGs exemplifies their resourcefulness and tenacity, the content encountered online may not consistently align with the principles of ACT, an evidenced based psychological treatment for chronic pain. Clinically, these results suggest FM OPSGs provide validation, acceptance, and other aspects of foundational emotional support but may not be equipped to address more significant psychological problems.



SOCIAL SCIENCES::Social sciences::Psychology