(1) Background: The present study examined how social comparison orientation, stress appraisal and different social comparison strategies interact in women facing chronic illness. (2) Methods: Assessments were conducted by a trained professional in face-to face semistructured interviews (n = 179 women with chronic illness). Main outcome measures included social comparison scales and a stress appraisal questionnaire. The mediation model, by a bootstrapping procedure, was used to analyze the interaction among variables. (3) Results: Regarding the relationships among variables studied, they were related to each other except for a downward contrast, which allowed us to propose our hypothetical mediation model. Results showed that stress appraisal fully mediates between social comparison orientation and social comparison strategies except for the upward identification strategy. (4) Conclusions: Our results suggest that uncertainty, feelings of threat and low control over one's illness or, in general, stress appraisal, had an important mediating effects over social comparison processes in patients with chronic illnesses. Therefore, by understanding the stress appraisal process, and the variables that might modify it, we could improve the use of social comparison as a favorable coping strategy.
Keywords: chronic illness; social comparison; stress; women.