Positive Affect Moderates Walking's Impact on Depression in Fibromyalgia Patients

Abstract

Background: Depression and pain have a dependent and complex relationship that increase pain-related barriers related to physical activity in patients with chronic pain. Moreover, positive affect and pain acceptance may also contribute to the development of lasting physical and cognitive resources that can support the maintenance of exercise behavior.

Aim: The aim of this study was to examine the impact of psychosocial variables (commitment to physical activity (walking), positive affect) on depression and activity acceptance among patients with Fibromyalgia (FM).

Design: Cross-sectional correlational study.

Method: Commitment to physical activity (walking), positive affect, depression and activity acceptance were evaluated in 132 FM women. Two models were tested to analyze mediation and moderated mediation effects.

Results: The mediating role of depression between walking and activity acceptance was corroborated regarding the subjective measure of walking. The moderated mediation model found that the effect of walking on activity acceptance was mediated by depression at medium (value: .19; ß = 2.50, [95% CI = 1.19/4.05]) and high levels (value: 9.87; ß =4.46, p < .001, [95% CI = 2.34/6.86]) of positive affect. The indirect effect of walking on activity acceptance via depression was stronger in individuals with higher positive affect.

Conclusions: Different levels of positive affect played a contextual role when trying to prevent the effect of depression on activity acceptance in women that walked.

Clinical implications: Positive affect is a key variable to prevent the effects of depression on activity acceptance in FM women that walk with the goal to exercise. Interventions from positive psychology, cognitive behavioural therapy and acceptance and commitment therapy can be very useful in this context.