Key demographics and psychological skills associated with adjustment to progressive Multiple Sclerosis early in the diagnosis

Angeliki Bogosian; Fern Day; Sam Norton; Eli Silber; Mohamed Sakel; Basil Sharrack; Rona Moss-Morris

doi:10.3389/fresc.2022.966133

Key demographics and psychological skills associated with adjustment to progressive Multiple Sclerosis early in the diagnosis

Front Rehabil Sci. 2022 Aug 29:3:966133. doi: 10.3389/fresc.2022.966133. eCollection 2022.

Authors

Angeliki Bogosian¹, Fern Day¹, Sam Norton², Eli Silber³, Mohamed Sakel⁴, Basil Sharrack⁵, Rona Moss-Morris²

Affiliations

¹ School of Health and Psychological Sciences, University of London, London, United Kingdom.
² Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
³ Department of Neurology, King's College Hospital, London, United Kingdom.
⁴ Department of Neurorehabilitation, East Kent Hospitals University NHS Foundation Trust, Kent, United Kingdom.
⁵ Department of Neuroscience and NIHR Neurosciences Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust and University of Sheffield, Sheffield, United Kingdom.

Abstract

Background/purpose: Being diagnosed with a progressive type of multiple sclerosis (MS) has been associated with worse psychological outcomes compared to relapsing-remitting type. Previous studies of adjustment to MS have primarily focused on relapsing-remitting type MS. The present study aims to examine psychological adjustment for people newly diagnosed with progressive multiple sclerosis.

Methods: This was a multicenter cross-sectional survey of 189 people newly diagnosed with progressive MS. A composite measure of psychological adjustment was created from questionnaires measuring psychological distress, positive affect, perceived-stress, life satisfaction and self-concept. Predictor variables included coping strategies, social support, relationship with partner, psychological vulnerability, MS-related beliefs, and responses to symptoms. Data were analysed using a regularised regression model to indicate which group of all variables are associated with adjustment.

Results: People who were older (b = 0.17(0.07), p = 0.02), in employment (b = 0.40 (0.17), p = 0.01), and with lower illness severity (b = -0.24 (0.08), p = 0.001) showed better adjustment. Based on a Lasso regression, the most important psychological and demographic variables associated with lower adjustment (out-of-sample cross-validation R ²= 62.6%) were lower MS self-efficacy and higher avoidance, cognitive vulnerability, embarrassment avoidance, conflict, helplessness, and secondary progressive MS type.

Conclusions and implications: Helping newly diagnosed people to find ways to tolerate anxiety-causing situations by encouraging acceptance may help people adjust to progressive MS by lowering their avoidance. Further, building confidence in managing the illness and addressing relationship issues are key focus areas in psychological interventions for people with progressive multiple sclerosis.

Keywords: adjustment; management; model; multiple sclerosis; progressive; psychosocial factors; quantitative research.