The network and core dimensions of individual emotion regulation competency in late adolescence: A study based on longitudinal network analysis.

Fibromyalgia is a condition presenting with characteristic chronic widespread pain, often associated with unrefreshing sleep and cognitive difficulties (). The mechanisms and aetiology of fibromyalgia remain largely unknown (; ) despite it being a commonly seen condition with a worldwide prevalence of 1.8% (). Fibromyalgia is associated with a substantial impact on patients’ quality of life as well as significant economic costs for patients and healthcare systems (; ). Diagnosis of fibromyalgia is symptom-based and is given according to internationally recognized diagnostic criteria developed by the American College of Rheumatology (ACR; ). Previous studies have shown that many patients fulfilling the diagnostic criteria for fibromyalgia do not receive a diagnostic label (; ). Diagnostic labels are given by healthcare professionals (HCP) to patients depending on the presentations of specific signs and symptoms (). In addition to facilitating the start of management, diagnostic labels create a space for patients to understand and articulate their own personal identity, influencing their relationships, interactions with HCPs and their position in the community (). Literature shows that this process is not as straightforward for patients with symptom-based diagnoses such as fibromyalgia. Fibromyalgia is a contested and stigmatized diagnosis with many physicians offering different opinions about its validity and legitimacy (; ). Therefore, individuals might consequently experience a denial of legitimacy of their experiences, disempowerment and social isolation (; ; ; ). Previous qualitative studies of patients with fibromyalgia have explored the personal experiences and challenges of living with the symptoms of this condition (; ). Such challenges include complex doctor-patient relationships, negative impacts on health journeys, navigating different treatment options, and the need for self-empowerment (; ). Moreover, another study found that individuals resist marginalization following a fibromyalgia diagnosis by redefining life goals and actively negotiating their identity (). However, limited research explored whether receipt of the fibromyalgia diagnostic label leads to specific challenges independently from the challenges of the symptoms of fibromyalgia. In a recent systematic review that studied the impacts of receiving a diagnosis of a functional disorder, including fibromyalgia (), only few studies investigated the impact of having a diagnostic label of fibromyalgia independently from the impact of the symptoms. In these studies patients reported experiences of stigmatizing encounters after receiving the fibromyalgia diagnostic label (; ). Other influences, such as impacts on individual identity and social and societal challenges, remain relatively unexplored in relation to the diagnostic label. This qualitative study aims to provide in depth insights into personal experiences of receiving a diagnostic label of fibromyalgia on identity, relationships, and life in general.