The relationship among performance of instrumental activities of daily living, self-report of quality of life, and self-awareness of functional status in individuals with multiple sclerosis.

Objective: To investigate the relationship between self-awareness of functional status and performance of Instrumental Activities of Daily Living (IADL), and self-reports of quality of life (QOL) in persons with multiple sclerosis (MS). Design: A between-groups design, using a correlational approach to examine the relationship between self-awareness of functional status, IADL and QOL. Participants: We studied 47 individuals with clinically definite MS and 26 healthy controls (HCs). Measures: The Functional Behavior Profile was completed by both participants and their informants. Participants' scores were subtracted from those of their informants', and the absolute value was used as the self-awareness/concordance score. The Executive Function Performance Test measured IADL performance; QOL was measured with the Functional Assessment of Multiple Sclerosis. Results: MS participants showed lower levels of self-awareness relative to HCs. Significant correlations were observed between performance of IADL, reports of QOL and self-awareness levels of functional status. However, reports of QOL were not significantly correlated with performance of IADL. Conclusions: The positive association between self-awareness of functional status with IADL performance and QOL reports provides support for the role of awareness in rehabilitation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific impairments of emotion perception in multiple sclerosis.

Objective: Multiple sclerosis (MS) often results in demyelination of a network of frontal-subcortical tracts involved in processing emotional information. We investigated the effect of MS on the ability to identify emotional and nonemotional information from static and dynamic stimuli and determined whether difficulties in emotion perception related to quality of life. Method: 32 MS and 33 control participants, matched for age and education, identified emotions and nonemotional information from static images of faces and dynamic videos of people interacting. They also completed cognitive assessment and quality of life ratings. Results: On the static face perception tasks, participants with MS performed more poorly than healthy controls on emotion perception, t(63) = 3.30, p     

Longitudinal predictors of attitudes toward aging among women with multiple sclerosis.

The purpose of the study was to explore the impact of change in functional limitation (FL), controlling for social support (SS), on attitudes toward aging using longitudinal survey data collected over a 7-year period. The 503 women with multiple sclerosis (MS; age, M = 57 years, SD = 10.25) were mostly Anglo (93%) and married (69%). First, the authors identified a quadratic growth model as the best for describing change in FL. Next, they considered SS as a time-varying covariate of FL to assess both within- and between-individual effects of SS on FL over time. Within individuals, higher FL levels were associated with lower SS levels. Between individuals, level of but not change in FL was associated with average SS level. Finally, average SS and response level and change in FL were studied as predictors of attitudes toward aging, accounting for 38% of the variance. Women with higher FL and lower SS scores had more negative views of aging. Negative views of aging among women with MS may have long-term consequences for their health outcomes as well as for the quality of their later years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways between physical activity and quality of life in adults with multiple sclerosis.

Objective: This prospective study examined symptoms of depression, fatigue, pain, self-efficacy, and social support as possible intermediaries in the pathway between changes in physical activity and quality of life (QOL) across a 6-month period in persons with multiple sclerosis (MS). Design and Main Outcome Measures: Adults with a definite diagnosis of MS wore an accelerometer for 7 days and then completed a battery of questionnaires at baseline (n = 292) and 6-months follow-up (n = 276). The data were analyzed using panel analysis and covariance modeling in Mplus 3.0. Results: The initial analysis indicated that change in physical activity was associated with a statistically significant and small residual change in QOL (β = .07). The subsequent analysis indicated that change in physical activity was associated with residual changes in fatigue (γ = ?.17), pain (γ = ?.13), social support (γ = .07), and self-efficacy (γ = .11), and, in turn, changes in fatigue (β = ?.13), pain (β = ?.09), social support (β = .18), and self-efficacy (β = .10) were associated with a residual change in QOL. Conclusion: The observed pattern of relationships supports the possibility that physical activity is indirectly associated with improved QOL through pathways that include fatigue, pain, social support, and self-efficacy in individuals with MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical activity and quality of life in multiple sclerosis: Possible roles of social support, self-efficacy, and functional limitations.

Objective: Quality of life (QOL) is compromised among individuals with multiple sclerosis (MS). Physical activity has been positively associated with QOL, but little is known about the factors that explain and/or confound the relationship in those with MS. On the basis of a social-cognitive perspective and previous research, the authors tested the hypothesis that physical activity would be indirectly associated with QOL through a mediated pathway that included self-efficacy and functional limitations, after controlling for perceived social support. Participants: Participants were 196 individuals with a definite diagnosis of MS living in the Midwest region of the United States who completed a battery of questionnaires and wore a pedometer and accelerometer for a 7-day period. Results: Covariance modeling analyses indicated that physical activity was indirectly associated with QOL through a pathway that included self-efficacy and functional limitations, and the pattern of relationships was independent of the perception of social support. Conclusions: The findings support physical activity as a possible modifiable behavior for mitigating reductions of QOL in those with MS and suggest that a social-cognitive model aids in the understanding of physical activity's relationships with QOL. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Making sense of multiple sclerosis.

Objective: In this study, the aim was to examine the dimensional structure of a multi-item measure of sense making in people with multiple sclerosis (MS) and to investigate relations between sense making and both positive and negative adjustment outcomes. Method: Participants were 408 persons with MS and 232 caregivers. Questionnaires were completed at the initial assessment (Time 1) and 12 months later (Time 2). Results: Factor analysis of the Sense Making Scale (SMS) revealed 6 psychometrically sound factors: Redefined Life Purpose, Acceptance, Spiritual Perspective, Luck, Changed Values and Priorities, and Causal Attribution. Results of regression analyses indicated that the Time 2 SMS factors accounted for significant amounts of variance in each of the Time 2 adjustment outcomes (life satisfaction, positive states of mind, anxiety, depression, caregiver adjustment rating of the care receiver), after controlling for Time 1 adjustment and relevant demographic and illness variables. Conclusions: Findings delineate the dimensional structure of sense making in MS and the differential links between sense making dimensions and adjustment and have implications for the measurement of sense making. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal analysis of cognitive dysfunction, coping, and depression in multiple sclerosis.

Using a longitudinal design, the authors examined coping and cognitive functioning in the development of depression in individuals with multiple sclerosis (MS). Coping style was evaluated in 2 conceptually distinct roles: as moderator and mediator of the impact of cognitive dysfunction on depression. Using indices derived from the COPE (C. S. Carver, M. F. Scheier, & J. K. Weintraub, 1989), the authors operationalized coping in 3 ways—as active, avoidant, and an index accounting for relative levels of both. Coping both moderated and partially mediated the relationship between cognitive dysfunction and depression. Moderation results suggest that the relationship between cognitive dysfunction and depression is dependent on coping style—adaptive coping protects individuals from experiencing depression related to their cognitive deficits; however, when individuals use maladaptive coping, cognitive dysfunction puts them at risk for depression. Mediational results suggest that cognitive dysfunction leads to depression partially due to cognitive dysfunction’s effects on coping. That is, cognitive deficits may impair individuals’ ability to use adaptive coping strategies, leaving them more likely to use maladaptive strategies. Clinical and theoretical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships among sexual satisfaction, marital quality, and marital instability at midlife.

Sexual satisfaction, marital quality, and marital instability have been studied over the life course of couples in many previous studies, but less in relation to each other. On the basis of the longitudinal data from 283 married couples, the authors used autoregressive models in this study to examine the causal sequences among these 3 constructs for husbands and wives separately. Results of cross-lagged models, for both husbands and wives, provided support for the causal sequences that proceed from sexual satisfaction to marital quality, from sexual satisfaction to marital instability, and from marital quality to marital instability. Initially higher levels of sexual satisfaction resulted in an increase in marital quality, which in turn led to a decrease in marital instability over time. Effects of sexual satisfaction on marital instability appear to have been mediated through marital quality. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Child maltreatment history among newlywed couples: A longitudinal study of marital outcomes and mediating pathways.

Participants included 202 newlywed couples who reported retrospectively about child maltreatment experiences (sexual abuse, physical abuse, psychological abuse, and neglect) and whose marital functioning was assessed 3 times over a 2-year period. Decreased marital satisfaction at T1 was predicted by childhood physical abuse, psychological abuse, and neglect for husbands; only neglect predicted lower satisfaction for wives. Increased maltreatment of various types was also related to T1 difficulties with marital trust and partner aggression. Dyadic growth curve analyses showed that the marital difficulties reported at T1 tended to remain over the course of the study. Further, in several instances, maltreatment exerted an increasingly detrimental influence on marital functioning over time, particularly for husbands. Examination of possible mediators between maltreatment and reductions in marital satisfaction revealed pathways through decreased sexual activity, increased psychological aggression, and increased trauma symptoms reported by husbands. These findings suggest that clinicians should consider how an adult’s history of child maltreatment may contribute to current marital dysfunction. The authors also identify possible targets for intervention when working with this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexuality and intimacy following radical prostatectomy: Patient and partner perspectives.

Most research on adjustment following radical prostatectomy has focused on limited assessments of urinary and erectile functioning. In this study, the authors provided a more comprehensive assessment of sexuality from 134 radical prostatectomy patients and their partners and determined the extent to which various components of sexuality are associated with psychosocial adjustment. Measures of sexuality and intimacy modestly predicted patients' emotional distress and quality of life (QoL), with body image and dyadic adjustment playing the most important roles after controlling for medical variables, general physical functioning, and optimistic outlook. Urinary incontinence and other sexuality variables were not unique predictors. In contrast, partner ratings of sexual satisfaction played a more important role in predicting their QoL. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress and memory bias interact to predict depression in multiple sclerosis.

This study is an investigation of the moderating effect of cognitive schema on the relationship between stress and depression in individuals with multiple sclerosis (MS). In the study, the authors employed a performance-based measure of affective memory bias and a self-report measure of everyday stress to assess both direct and interactive effects of cognitive schema and stress on depression in individuals with MS. The specific hypotheses were that high stress would be more highly associated with depression if an individual also demonstrated a bias for negative information, but that a bias for positive information may buffer against the effects of stress on depression. Results supported the hypotheses, demonstrating a significant effect of the interaction and differential effects of stress based on the direction of memory bias. Implications for understanding depression in MS are discussed, as well as dominant theories of adult depression in the general population. The results are also discussed as a potential contradiction to A. T. Beck's (1967, 1976) developmental hypothesis of cognitive schemas. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Retrieval practice improves memory in multiple sclerosis: Clinical application of the testing effect.

The testing effect is a robust cognitive phenomenon by which memory retrieval on a test improves subsequent recall more than restudying. Also known as retrieval practice, the testing effect has been studied almost exclusively in healthy undergraduates. The current study investigated whether retrieval practice during testing leads to better delayed recall than restudy among persons with multiple sclerosis (MS), a neurologic disease associated with memory dysfunction. In a within-subjects design, 32 persons with MS and 16 demographically matched healthy controls (HC) studied 48 verbal paired associates (VPA) divided across 3 learning conditions: massed restudy (MR), spaced restudy (SR), and spaced testing (ST). Delayed VPA cued recall was measured after 45 min. There was a large main effect of learning condition (ηp2 = .54, p     

Correlates of pain interference in multiple sclerosis.

Objectives: To describe pain interference and explore its associations with several indexes of health and psychosocial functioning among veterans with multiple sclerosis (MS). Study Design: Cohort study linking computerized medical records and survey questionnaire. Participants: Four hundred fifty-one veterans with MS. Outcome Measures: Pain Effects Scale, Patient Health Questionnaire, Modified Social Support Survey, items from the Short Form Health Survey and the North American Research Consortium on MS Registry Survey (NARCOMS) Performance Scales. Results: Participants reported a moderate level of overall pain interference. Increased fatigue, poorer general health, and greater depression symptom severity each were significantly associated with higher levels of pain interference. Conclusions: Pain interference in MS is associated with a variety of other clinically meaningful indexes of functioning. Pain in MS should be treated aggressively to minimize functional impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cortical atrophy and personality in multiple sclerosis.

Although the cognitive disorder of multiple sclerosis (MS) is well characterized, little is known about personality changes that may occur in this disease. There are reliable personality tests available for research in neurological disease, based on the well-known Five Factor Model. Preliminary research suggests that cognitively impaired MS patients exhibit elevation in Neuroticism, and diminution in Extraversion, Agreeableness, and Conscientiousness, as do patients with Alzheimer's disease. We predicted that these characteristics would be associated with lower neocortical volume. We studied 44 patients using brain MRI and the NEO Five-Factor Inventory. Regression models controlling for T2 lesion volume, depression, and cognitive dysfunction revealed significant correlation between cortical atrophy and reduction in Extraversion and Conscientiousness. Discrepancies between patient- and informant-reports were found, and overreporting of high Openness and Conscientiousness among patients was associated with lower neocortical volume. A final regression model accounting for depression, cognitive function, and personality accounted for 38% of the variance in neocortical volume. These findings suggest that cortical atrophy in MS is associated with adverse impact on personality, although longitudinal research is needed to test this hypothesis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting relationship and life satisfaction from personality in nationally representative samples from three countries: The relative importance of actor, partner, and similarity effects.

Three very large, nationally representative samples of married couples were used to examine the relative importance of 3 types of personality effects on relationship and life satisfaction: actor effects, partner effects, and similarity effects. Using data sets from Australia (N = 5,278), the United Kingdom (N = 6,554), and Germany (N = 11,418) provided an opportunity to test whether effects replicated across samples. Actor effects accounted for approximately 6% of the variance in relationship satisfaction and between 10% and 15% of the variance in life satisfaction. Partner effects (which were largest for Agreeableness, Conscientiousness, and Emotional Stability) accounted for between 1% and 3% of the variance in relationship satisfaction and between 1% and 2% of the variance in life satisfaction. Couple similarity consistently explained less than .5% of the variance in life and relationship satisfaction after controlling for actor and partner effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response variability is associated with self-reported cognitive fatigue in multiple sclerosis.

Cognitive fatigue is a common, often debilitating symptom of multiple sclerosis (MS). Although MS patients frequently report that fatigue negatively affects cognitive functioning, most studies have found little evidence for a direct relationship between self-reported cognitive fatigue and traditional measures of neuropsychological functioning. The purpose of the present study was to examine the association between self-reported cognitive fatigue and a measure of response time variability (RTV). MS patients demonstrated significantly higher RTV than controls, and RTV was highly correlated with self-reported cognitive fatigue among relapsing-remitting and secondary progressive MS patients. Results highlight the need to implement newer methods to further elucidate the relationship between cognitive fatigue and neuropsychological functioning in MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital relations among former prisoners of war: Contribution of posttraumatic stress disorder, aggression, and sexual satisfaction.

In this study, the authors examined the marital adjustment, spousal aggression, and sexual satisfaction of prisoners of war (POWs) 3 decades after their release. More specifically, the authors examined the extent to which impaired marital relations among former POWs are an outcome of their captivity or of the posttraumatic stress disorder (PTSD) that some of them developed. The authors compared 25 former POWs with PTSD, 85 former POWs without PTSD, and 104 control veterans. The findings reveal that the marital problems of former POWs are more related to PTSD than to their captivity. PTSD is related to decreased marital satisfaction, increased verbal aggression, and heightened sexual dissatisfaction among former POWs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived family support, acculturation, and life satisfaction in mexican american youth: A mixed-methods exploration.

In this article, the authors describe a mixed-methods study designed to explore perceived family support, acculturation, and life satisfaction among 266 Mexican American adolescents. Specifically, the authors conducted a thematic analysis of open-ended responses to a question about life satisfaction to understand participants' perceptions of factors that contributed to their overall satisfaction with life. The authors also conducted hierarchical regression analyses to investigate the independent and interactive contributions of perceived support from family and Mexican and Anglo acculturation orientations on life satisfaction. Convergence of mixed-methods findings demonstrated that perceived family support and Mexican orientation were significant predictors of life satisfaction in these adolescents. Implications, limitations, and directions for further research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of an intensive psychosocial intervention for children of parents with multiple sclerosis.

Objective: To evaluate an intervention for children of parents with multiple sclerosis (MS). It was hypothesized that the intervention would increase knowledge of MS, approach coping, and social support and decrease avoidant coping and stress appraisals. It was expected that these changes would reduce the adverse impacts of caregiving and produce better adjustment. Method: Twenty children (9-14 years) who had a parent with MS attended a 6-day camp intervention. These children completed questionnaires at pre- and postintervention and at 3-month follow-up; their parents with MS (N = 14) completed questionnaires at preintervention and at follow-up. Results: After the intervention, children reported significant decreases in distress, stress appraisals, caregiving compulsion, and activity restrictions and increases in social support and knowledge of MS. Parental data confirmed the increase in the children's knowledge of MS, and overall, qualitative data supported the quantitative findings. Qualitative data showed that the intervention had indirect effects on some parents and families. Conclusions: Findings offer preliminary support for the use of a stress- and coping-based intervention for supporting children and their families with parental MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between cognitive deficits and everyday functional activities in multiple sclerosis.

Considerable evidence indicates that cognitive dysfunction and impairments in everyday life activities are common in multiple sclerosis (MS). However, the relationship between these cognitive and functional deficits has not been thoroughly investigated. The purpose of this study was to examine the role of cognitive dysfunction in the functional status of individuals with MS. Participants were 74 adults with MS and 35 healthy comparison participants (HCs) who underwent neuropsychological testing and completed the Executive Functions Performance Test (EFPT; Baum, Morrison, Hahn, & Edwards, 2003), an objective measure of everyday life activities. Between-groups comparisons and correlational analyses were conducted to examine the relationship between cognition and functional capacity. Significant differences in EFPT performance were revealed between individuals with MS with and without cognitive impairment and HCs. In individuals with MS, performance on cognitive constructs was related to performance on the EFPT. Furthermore, a linear regression model comprised of indices of cognitive functioning explained a significant portion of the variance in everyday life activities. Findings suggest that individuals with and without cognitive impairment differ in functional status and that aspects of cognition are predictive of functional status in MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)