A substantial amount of people with a rheumatic disease perceive invalidation consisting of lack of understanding and discounting (negative social responses). To get insight into the potential buffering role of self-efficacy and pain acceptance against invalidation, this cross-sectional study examined associations between these variables. Spanish speaking people (N = 1153, 91% female, mean age 45 ± 11 years) with one or multiple rheumatic diseases completed online the Illness Invalidation Inventory, the Chronic Pain Acceptance Questionnaire, and the Chronic Disease Self-Efficacy Scale. Higher self-efficacy (t = - 4.80, p = < 0.001) and pain acceptance (t = - 7.99, p = < 0.001) were additively associated with discounting. Higher self-efficacy (t = - 5.41, p = < 0.001) and pain acceptance (t = - 5.71, p = < 0.001) were also additively associated with lack of understanding. The combined occurrence of high self-efficacy and high acceptance was associated most clearly with lower lack of understanding (interaction: t = - 2.12, p = 0.034). The findings suggest the usefulness of examining whether interventions aimed at increasing self-efficacy and pain acceptance can help people with rheumatic diseases for whom invalidation is a considerable burden.
Keywords: Acceptance; Acceptance and commitment therapy; Invalidation; Psychological adjustment; Rheumatic diseases; Self-efficacy.