Illness Invalidation and Demoralization in Endometriosis: Does Self-Compassion Help?

Mia Levin, Vashna Singh, Brenda G. Stewart, Sherman, Kerry
In: Women's Reproductive Health · 2025 · vol. 13(2) , pp. 468–482 · doi:10.1080/23293691.2025.2598036 · W4417537121
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This study investigated the relationship between illness invalidation, demoralization, and self-compassion in women with endometriosis.

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This cross-sectional study investigated whether self-compassion moderates the relationship between illness invalidation and demoralization among 177 participants diagnosed with endometriosis. Using online surveys to measure these psychological constructs, the researchers found that while illness invalidation from family, healthcare providers, and employers was strongly associated with higher levels of demoralization, self-compassion did not significantly buffer this negative effect. The authors note that these results highlight a critical need for targeted psychoeducation and communication skills interventions to address social and dyadic contexts where patients feel dismissed. This paper is centrally about endometriosis, focusing on the psychosocial burden of the disease and the role of self-compassion in coping with illness invalidation.

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Abstract In endometriosis, helplessness and hopelessness (demoralization) and having one’s illness dismissed by others (illness invalidation) are reported qualitatively. Selfcompassion may protect against such adverse psychological outcomes. We investigated whether the association between illness invalidation and demoralization is moderated by self-compassion. Participants (n=177) completed an online survey: Demoralization Scale II, Illness Invalidation Inventory, Self-Compassion ScaleSF. Regression analyses confirmed an association between illness invalidation, self-compassion and demoralization, with no moderating effect. Illness invalidation from family, healthcare professionals, and the workplace was greatest. These findings suggest the need for targeted psychoeducation and communication skills interventions to increase awareness in social and dyadic contexts. Authorship Contributions CRediT: Mia Levin: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draft, Writing – review & editing; Vashna Singh: Data curation, Investigation, Methodology, Writing – original draft, Writing – review & editing; Brenda Stewart: Data curation, Investigation, Methodology, Writing – original draft, Writing – review & editing; Kerry A. Sherman: Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Supervision, Writing – original draft, Writing – review & editing. Disclosure Statement No potential conflict of interest was reported by the author(s). Attestation Statements Data generated from this study have not been previously published. Data will be made available to the editors of the journal pre and/or post publication for review or query upon request. The appropriate checklist for this study design was followed (STROBE checklist: cross-sectional studies; Supplementary File 1). Data Availability Statement Data that support these findings may be made available on request to the corresponding authors.

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Condition tags

endometriosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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