Beyond the Boundaries of Disease—Significant Post-traumatic Growth in Multiple Sclerosis Patients and Caregivers

Abstract

Despite the negative repercussions of a chronic disease, multiple sclerosis (MS) might also lead to positive consequences. This longitudinal study explored post-traumatic growth in MS patients and attempted to identify possible determinants. Post-traumatic growth of 260 patients and their caregivers was compared. A subset of 209 patients and caregivers were evaluated at baseline. Patients filled in the Posttraumatic Growth Inventory and General Health Questionnaire at three different times over a 36-month follow-up period. Patient post-traumatic growth significantly increased over the follow-up period (p < 0.001) with large effect sizes on almost every subscale. Higher score on the Expanded Disability Status Scale, higher pain severity, female gender, and higher anxiety were positive predictors of post-traumatic growth, while more interference of pain, higher level of education, and more social dysfunction were negative predictors. Post-traumatic growth did not differ significantly between patients and caregivers. Our results showed significant positive intrapsychic changes of MS patients over a 36-month follow-up period up to 12 years from diagnosis. The potential influence of clinical, demographic, and mental health variables underlines the need for a personalized approach to be able to understand and sustain these processes. Comparable post-traumatic growth levels in patient-caregiver dyads at baseline suggest interdependently driven cognitive processes stabilizing well-being. Future research is recommended for further insight into the underlying cognitive processes.

Coping Strategies Furthering Post-Traumatic Growth in Multiple Sclerosis: A Longitudinal Study

“…However, there is a lack of studies exploring these associations over a longer period. Longitudinal data indicate an increasing progression of PTG in MS and corroborate the influence of clinical, demographic, and mental health variables with small to medium effect sizes [19]. When studying personal benefit finding, an improvement tendency over time was also observed suggesting that substantial improvement of personal growth appears later in MS adaptation [17].…”

Coping Strategies and Posttraumatic Growth Following Transient Ischemic Attack: A Qualitative Study

“…As described above, previous studies indicated that PTG in the context of neurological disorders may increase over time [ 16 , 17 ]. Since one-third of the patients in our study had suffered a previous TIA and 11.8% had suffered a previous ischemic stroke before the current TIA, it can be assumed that in these patients PTG might have developed already before the current TIA.…”

“…A higher level of PTG was found in the latter group, which indicates that PTG after traumatic brain injury is not only a common phenomenon but also seems to increase over time [ 16 ]. A recent study by Gil-Gonzales et al analyzed the longitudinal course of PTG in a group of patients with multiple sclerosis [ 17 ]. It was shown that the level of PTG increased over a follow-up period of 36 months; furthermore, the positive psychological changes were still present 12 years after the initial diagnosis [ 17 ].…”

“…A recent study by Gil-Gonzales et al analyzed the longitudinal course of PTG in a group of patients with multiple sclerosis [ 17 ]. It was shown that the level of PTG increased over a follow-up period of 36 months; furthermore, the positive psychological changes were still present 12 years after the initial diagnosis [ 17 ]. In this context, a higher pain severity, female gender, and higher levels of anxiety could be demonstrated as positive predictors of PTG in multiple sclerosis [ 17 ].…”

“…It was shown that the level of PTG increased over a follow-up period of 36 months; furthermore, the positive psychological changes were still present 12 years after the initial diagnosis [ 17 ]. In this context, a higher pain severity, female gender, and higher levels of anxiety could be demonstrated as positive predictors of PTG in multiple sclerosis [ 17 ]. However, the phenomenon of PTG does not appear to be specific to neurological disorders; in a 2016 study, the occurrence of PTG in patients after traumatic brain injury was compared to patients after myocardial infarction and similar levels were found in both disease entities [ 18 ].…”