Storying endometriosis: Examining relationships between narrative identity, mental health, and pain

•Narrative identity predicted mental health in 120 women with painful endometriosis.•Themes of agency and communion predicted mental health beyond pain and neuroticism.•Interpreting endometriosis as central to identity was related to more pain symptoms. We examined whether narratives related to mental health and pain in 120 women with endometriosis. Participants wrote narratives about endometriosis, rated the narratives on centrality to identity and positive and negative self-change, and completed measures of depressive symptoms, life-satisfaction, pain intensity and pain symptoms. Narratives were content-coded for themes of agency and communion. Higher centrality to identity, more negative self-change, and lower agency and communion were related to poorer mental health. Higher centrality to identity was associated with more pain symptoms. Narrative measures predicted mental health beyond pain intensity, pain symptoms, and neuroticism. The results indicate that how women with endometriosis narrate their illness is connected to mental health.