Humor styles and well-being of women with endometriosis during the COVID-19 pandemic

Women with endometriosis frequently report worse psychological distress, pain, and quality of life than healthy women. However, not all women with endometriosis fare poorly, suggesting that coping resources may moderate the relation of endometriosis with adjustment. Thus, we examined the relation of adaptive and maladaptive humor styles with mental and physical health outcomes among women with endometriosis during the COVID-19 pandemic. Forty-eight US women completed online surveys February-September 2021 during times when COVID positivity rates remained high (>5 %) and social distancing measures were in effect. Self-enhancing humor was uniquely associated with greater purpose in life and positive affect, and with less negative affect and endometriosis stress. Self-defeating humor was uniquely associated with greater negative affect, depressive symptoms, and endometriosis pain, and with marginally worse healthy diet adherence. Positive reappraisal indirectly mediated the relations of self-enhancing humor with healthy diet and exercise adherence, and social support indirectly mediated the relation of self-enhancing humor with fewer depressive symptoms. Self-enhancing humor was linked with better, and self-defeating humor with worse, adjustment to endometriosis. Positive reappraisal and social support emerged as possible mediators of these associations. Further exploration of behavioral pathways linking humor styles with health outcomes is needed.