The Impact of Migraine vs. Endometriosis on Self-Esteem, Disease Causality Orientation and Stigma Perceptions in a German Sample of Cis-Women

Background: Chronic pain conditions affect the lives of many people around the world. These diseases include migraine, a neurological disorder where severe headaches are accompanied by nausea, and sensitivity to light and sound, and endometriosis, in which tissue similar to the lining inside the uterus grows in the abdomen, causing pain and inflammation. Both conditions are mainly found in people born female. The psychological impact of these conditions is explored in this online survey. Methods: Migraine patients (n=127) and endometriosis patients (n=82) are surveyed, as well as women who do not have either of the two diseases or associated symptoms (n=88). Self-esteem and disease causality orientation (CO) could be compared between all groups. Experienced vs. internalized stigma and leisure time vs. working time impairment were compared between chronic pain conditions. Results: Individuals with endometriosis and migraine showed lower self-esteem compared to the control group. CO results show that interpreting symptoms as caused by personal weakness was low and equal in the three groups. People with a chronic pain condition interpret symptoms in less cases as disease-caused or coincidence, compared to the control group. For both chronic disease conditions, internalized stigma was higher than reported experienced stigma and impairment on leisure time was higher than impairment on productivity. Discussion: Participants from the control group more often interpret disease symptoms as part of a bad coincidence or as a part of a disease than interpreting symptoms as personal weakness. Self-esteem is lower in both groups with endometriosis or migraine, highlighting the need for psychological interventions accompanying physical disease management plans. The implications of high internalized stigma, compared to lower experienced stigma are discussed as well.