The role of coping in adjustment to multiple sclerosis-related adaptive demands

Abstract

In general, coping research has faded to examine coping and spec@ illness-related stressors, and with respect to multiple sclerosis (MS), there is a lack of research into cqping with this disease. In this s t d y , stress and coping theory was used to evaluate the role of appraisal and coping strategies in the adjustment to illness-related stressors in M S patients. A total of 134 M S patients and their carers were interviewed and completed self-administered scales. Predictors included illness, M S problems, appraisal and coping variables. Adjustment outcomes included depression, global distress, social adjustment, and global health status. Hierarchical regression analyses indicated that illness variables were related to depression and social adjustment. Number of MS problems, appraisal and coping were related to most adjustment measures. Overall, findings supported the hypotheses that threat appraisals and emotion-focused coping would be related w poorer adjustment and that problem-focused coping would be related to better adjustment. There was only weak support for the hypothesis that the relationship between adjustment and both appraisal and coping would vary according to the type of illness-related stressor. Findings support the utility of a stress and coping model of adaptation to MS.

Mood and self-esteem of persons with multiple sclerosis following an exacerbation

“…For example, Jean et al [10] found that persons with MS who used more emotion-focused coping strategies (e.g., denial, hoping the problem would just go away) were more likely to experience psychological distress than those who used problem-focused coping strategies (e.g., developing strategies to deal with the situation). Similar results were obtained by both Pakenham [11] and Pakenham et al [12]. Furthermore, Hicky and Greene [13] indicated that these findings applied for both men and women with MS. After an exacerbation of an illness, it would be expected from Folkman and Lazarus' [14] theory that the person would experience this as an uncontrollable event and so be more likely to utilize emotion-focused coping, as opposed to problem-focused coping.…”

“…Particularly for the exacerbation group, it was expected that the coping strategies adopted by respondents would predict mood and self-esteem over time. Most previous studies have examined the cross-sectional relationships between coping and adjustment, and so the level of stability in the adjustment variable could not be partialled out in the analyses [10,12]. However, Pakenham [11] did find that better psychological adjustment over a 12-month period among persons with MS was predicted by high levels of problem-focused coping and low levels of emotionfocused coping at Time 1.…”

Depression and multiple sclerosis: Review of a lethal combination

“…In cross-sectional surveys, emotion-focused coping has been related to lower self-esteem [41], global distress [42][43][44], and depression [13,15,[45][46]. Similar results were found in studies that examined the relationship between coping styles and depression over time [47][48].…”

Multiple sclerosis: Empirical literature for the clinical health psychologist

“…Consistent with research from other chronic illnesses, both cross-sectional and longitudinal studies in MS have found that passive, avoidant, emotion-focused coping strategies (e.g., wishful thinking, self-blame, avoidance) are related to poorer adjustment and lower levels of QOL (Aikens et al, 1997;Buelow, 1991;Mohr et al, 1997a;O'Brien, 1993b;Pakenham, 1999;Pakenham et al, 1997).…”