Psychological Resilience and Vulnerability as Mediators Between Adverse Life Events and Fatigue, Motor Dysfunction, and Paresthesia in Multiple Sclerosis

Abstract

Objective Adverse life events have been associated with exacerbating multiple sclerosis (MS) symptoms, but results have been variable, raising the question on the role of other psychological factors. This study examined the role of psychological resilience and vulnerability as mediators between adverse life events on MS symptoms. Methods Participants with MS (N = 1239) were aged 18 to 81 years (mean [SD] = 45.6 [10.4] years), and 84.5% were female. MS symptoms were measured by the modified Fatigue Severity Scale, modified Fatigue Assessment Scale, Motor Dysfunction Assessment Scale, Paraesthesiae Spell Duration Scale, and the Paraesthesiae Cumulative Duration Scale. Psychological measures included the Connor-Davidson Resilience Scale, Resilience Scale for Adults, Psychological Vulnerability Scale, the vulnerability section of the Defence Style Questionnaire, and the Adverse Life Events Assessment Scale. Regression analyses and structural equation modeling were performed. Results Adverse life events during the preceding 60 days were associated with fatigue, motor dysfunction, and paresthesia, but with small effect sizes (β from 0.07 to 0.15; p ≤ .014). A structural equation model by which resilience mediated less and vulnerability more MS symptoms after adverse life events during the preceding 60 days showed a statistically significant fit with the data of a moderate to good degree (p < .001; goodness-of-fit statistic = 0.725; root mean square error of approximation = 0.047). Vulnerability played a markedly larger role than did resilience. Conclusion The results suggest that psychological resilience and vulnerability play mediating roles in the relation between adverse life events and MS symptoms, but other psychological factors also need to be investigated.

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

“…Psychological vulnerability refers to core beliefs and thoughts that people have that can interfere with their daily life and negatively affect their mood. Previous studies showed psychological vulnerability mediating the relationship between adverse life events and MS symptoms ( 38 ). Interestingly, the results of this study showed that people with SPMS showed greater negative core beliefs compared to people with PPMS, which may indicate that the secondary progressive course of disease may make these core beliefs more salient.…”

Impact of resilience, social support, and personality traits in patients with neuroinflammatory diseases during the COVID-19 pandemic

“…Higher psychological resilience has previously been identified as a non-disease-specific factor associated with better physical function in pwMS. ( Klineova et al, 2020 , Swanepoel et al, 2020 ) For example, a recent longitudinal study examining the risk and protective factors for cognitive decline [Reserve against disability in early MS (RADIEMS)] showed that pwMS with greater CD-RISC scores had better objective functional outcomes, including both motor and cognitive indices. ( Klineova et al, 2020 ) When compared to more vulnerable counterparts, pwMS with greater resilience also exhibit less neurological symptoms (paresthesia, motor dysfunction, fatigue) within the 60 days after an adverse life event.…”

“…( Klineova et al, 2020 ) When compared to more vulnerable counterparts, pwMS with greater resilience also exhibit less neurological symptoms (paresthesia, motor dysfunction, fatigue) within the 60 days after an adverse life event. ( Swanepoel et al, 2020 ) Therefore, resilience-targeted interventions may provide benefits to both mental and physical outcomes. ( Pakenham et al, 2018 ) PwMS with greater social support ( e.g., belonging to patient community) have significantly greater resilience and sense of coherence, and use more suitable coping strategies.…”

Determinants of motivated behavior are linked to fatigue and its perturbation by SARS-CoV-2 vaccination

“…In contrast, more short-term changes in fatigue are linked foremost to temporally constrained events such as acute viral infections (Carrat et al, 2008), or environmental factors such as temporary stress (Doerr et al, 2015). As previous research has shown, the effects of acute events on behavioral regulation can differ depending on whether or not they are accompanied by more or less severe baseline conditions (Haeffel et al, 2008; Swanepoel et al, 2020), similar to vulnerability models of diseases (Ingram & Luxton, 2005).…”