Social Media Connectedness in Fibromyalgia

Perceived shared experiences were assessed via online survey by asking participants the question, "In the past week, how much did you feel like you are not the only person living with your struggles?" Participants provided responses using a 7-item Likert scale ranging from 1 ("Definitely not the only one") to 7 ("Completely the only one"), such that lower scores were indicative of an increased sense of shared experiences and higher scores were indicative of a decreased sense of shared experiences. This survey was administered weekly during the trial.

Hopefulness and hopelessness were assessed via online survey by asking participants the question, "In the past week, how much do you feel like the problems you are currently facing might get better in the future?" Participants provided responses using a 7-item Likert scale ranging from 1 ("Not at all") to 7 ("Definitely"), such that higher scores were indicative of increased feelings of hopefulness and lower scores were indicative of increased feelings of hopelessness. This survey was administered weekly during the trial.

Validation and feelings of being understood were assessed via online survey by asking participants the question, "In the past week, how understood did you feel by others?" Participants provided responses using a 7-item Likert scale ranging from 1 ("Not at all understood") to 7 ("Definitely understood"), such that higher scores were indicative of increased feelings of validation and understanding and lower scores were indicative of decreased feelings of validation and understanding. This survey was administered weekly during the trial.

Suicidal ideation was assessed via online survey by asking participants the question, "In the past week, how often did you have thoughts of not wanting to be alive or of hurting yourself in some way?" Participants provided responses using a 7-item Likert scale ranging from 1 ("I didn't have these thoughts at all") to 7 ("Every day"), such that higher scores were indicative of increased thoughts of suicidal ideation and lower scores were indicative of decreased thoughts of suicidal ideation. Milestone surveys were administered at weeks 6, 12, and 18. Scores were summarized by study arm.

Depression was assessed using the 9-item Patient Health Questionnaire (PHQ-9). The PHQ-9 is a standard measurement tool used for screening, diagnosing, monitoring and measuring the severity of depression. Participants were asked how often they had been bothered by symptoms like depressed mood, trouble sleeping, or low energy over the past two weeks. Each question is scored on a 4-point scale ranging from 0 ("Not at all") to 3 ("Nearly every day"), for an overall possible scoring range of 0-27, such that higher scores were indicative of increased depressive symptoms. Milestone surveys were administered at weeks 6, 12, and 18. Scores were summarized by study arm.

Anxiety was assessed using the 7-item Generalized Anxiety Disorder-7 (GAD-7) scale. The GAD-7 is a self-assessment tool used to screen for and asses the severity of anxiety. Participants were asked how often they had been bothered by common symptoms of anxiety over the prior two week period. Each question is scored on a 4-point scale ranging from 0 ("Not at all") to 3 ("Nearly every day"), for an overall possible scoring range of 0-21, such that higher scores were indicative of increased anxiety symptoms. Milestone surveys were administered at weeks 6, 12, and 18. Scores were summarized by study arm.

Functional impairment was assessed via online survey by asking participants the question, "In the past week, how often did your fibromyalgia symptoms get in the way of your goals?" Participants provided responses using a 7-item Likert scale ranging from 1 ("Not at all") to 7 ("Every day"), such that higher scores were indicative of increased functional impairment and lower scores were indicative of decreased functional impairment. Milestone surveys were administered at weeks 6, 12, and 18. Scores were summarized by study arm.

Perceived burdensomeness and Thwarted belongingness were assessed using the 15-item Interpersonal Needs Questionnaire (INQ-15). The INQ-15 is a widely used clinical assessment tool designed to evaluate two psychological constructs linked to suicide ideation: perceived burden and thwarted belonging. Perceived burdensomeness subscale items (questions 1-6) were rated on a scale ranging from 1 ("Not at all true") to 7 ("Very true"), yielding a range of 6-42. Thwarted belongingness subscale items (questions 7-15) were rated on a scale ranging from 1 ("Not at all true") to 7 ("Very true"), yielding a range of 9-63. A total perceive burden score was calculated by combining the two subscales, yielding an overall scoring range of 15-99, such that higher scores are indicative of increased perceived burden and thwarted belonging. Milestone surveys were administered at weeks 6, 12, and 18. Scores were summarized by study arm.

PTSD was assessed using the Short PTSD Rating Interview (SPRINT). SPRINT is an 8-item clinical assessment tool designed to quickly evaluate the core symptoms and severity of PTSD (intrusion, avoidance, numbing, arousal) along with somatic malaise, stress vulnerability, and role and social functional impairment. Participants provide responses to each of the 8 items based on their experiences over the past week using a 5-point scale ranging from 0 ("Not at all") to 4 ("Very much"), for an overall possible score of 0-32, such that higher scores are indicative of increased severity of PTSD symptoms. Milestone surveys were administered at weeks 6, 12, and 18. Scores were summarized by study arm.