Illness invalidation and psychological distress in adults with chronic physical health symptoms

Objectives: Illness invalidation is a term used to describe when someone's illness experience is delegitimised by another person in the social environment. This study investigated whether illness invalidation was associated with psychological distress in Australian adults managing symptoms of chronic physical health conditions (CPHCs), and whether illness factors were related to levels of illness invalidation experienced. Methods: In 2022, a large cross-sectional online survey was conducted on adults managing symptoms of CPHCs (e.g., chronic pain, fatigue). Participants self-reported demographic and illness information, health-related self-efficacy, psychological distress, and illness invalidation using validated scales. Results: The sample data revealed (N = 1610) that illness invalidation was experienced across many symptom categories. Hierarchical regressions indicated that discounting from family members, medical professionals, and the spouse/partner, as well as lack of understanding from family members, was significantly and uniquely associated with psychological distress while controlling for adjustment-related factors. Adults with multiple CPHCs, longer symptom durations and suspected/unconfirmed CPHC diagnoses experienced higher illness invalidation. Conclusions: Illness invalidation, particularly discounting, is common in people managing symptoms of CPHCs and appears to be uniquely associated with psychological distress. Future research should attend to illness invalidation in adjustment and reducing invalidating experiences for people with CPHCs.