Dr Monica Falautano

Psychologist. Psychotherapist. 

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Not only depression and anxiety in Multiple Sclerosis (MS)

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Illness perceptions, coping strategies and well-being among Persons with Multiple Sclerosis (PwMS).

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Psychologist and psychotherapist at Psychological and Neuropsychological Service – Neurological Department - San Raffaele Hospital, Milano  - Italy

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MS could pose high challenges to patients’ adjustment due to its largely unpredictable progression, growing physical and cognitive impairment and lack of a specific treatment. Illness perception play a key role in adjustment as it influence the ways individuals cope with health threats [1].

A multicenter study, 680 PwMS from eight MS centers in Italy, conducted over the past three years, analyzed the mediation of coping strategies and social support between illness perceptions and well-being of PwMS and the adaptive and maladaptive coping mechanisms considering positive and negative well-being indicators. 

To obtain information from the PwMS were used: the Revised Illness Perception Questionnaire [2] to evaluate illness beliefs; the Brief COPE [3] to assess problem-focused, emotion-focused, and avoidance coping strategies; the Multidimensional Scale of Perceived Social Support [4]; the Satisfaction with Life Scale [5] and the Beck Depression Inventory II [6] to investigate positive and negative well-being indicators, respectively.

The study results show how perceived social support was related to higher life satisfaction and lower depression, and it emerged as a significant mediator for both well-being indicators. Emotional representations were negatively related to life satisfaction and positively to depression through lower social support. Emotion-focused coping uniquely mediated the relation between illness beliefs and life satisfaction. Identity, personal and treatment control, coherence, and psychological causes were related to higher use of this strategy which in turn was associated to higher life satisfaction. Avoidance uniquely mediated the relation between illness beliefs and depression.

This results highlight how illness beliefs are related to PwMS’ well-being directly and indirectly through coping strategies and social support. Overlapping and unique pathways were detected for positive and negative indicators of well-being, suggesting the need to broaden the focus of psychological intervention and clinical care for the comprehensive promotion of PwMS’ illness adjustment and well-being [7] .

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1. Leventhal, H., Nerenz, D. R., & Steele, D. J. (1984). Illness perceptions and coping with health threats. In A. Baum, S. E. Taylor, & J. E. Singer (Eds.), Handbook of psychology and health:Social psychological aspects of health (Vol. 4, pp. 219-252). Hillsdale, NJ: Erlbaum.

2. Moss-Morris, R., Weinman, J., Petrie, K.J., Horne, R., Cameron, L.D., & Buick, D. (2002). The Revised Illness Perception Questionnaire (IPQ-R). Psychology and Health, 17, 1-16.

3. Carver, C.S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100.

4. Zimet, G.D., Dahlem, N.W., Zimet, S.G. & Farley, G.K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30-41.

5. Diener, E., Emmons, R., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment,49, 71-75.

6. Beck, A.T,. & Brown, G.K. (1996). Beck depression inventory-II manual. San Antonio, TX: Psychological Corporation.

7. Bassi, M., Falautano M, Cilia S., Goretti B, et al. Illness Perception and Well-Being Among Persons with Multiple Sclerosis and Their Caregivers. J Clin Psychol Med Settings. 2016 Mar;23(1):33-52.