The effect of executive function on stress, depression, anxiety, and quality of life in multiple sclerosis

Abstract

The experience of cognitive deficits and emotional dysfunction are prevalent in people with multiple sclerosis (PwMS), although research examining their interaction has provided inconsistent findings. The current study examined the ability of executive function to predict psychosocial adjustment in PwMS. One hundred and seven PwMS underwent cognitive assessment and completed measures of stress, depression, anxiety, and quality of life (QoL). There was limited support for a relationship. There was no relationship between objective cognitive tasks and state or trait anxiety, mental health QoL, overall QoL, or stress frequency. The only relationship with depression was found when the Beck Depression Inventory Fast-Screen was used, with a task of planning when the timing element was removed. A measure of error rates on a task of cognitive flexibility predicted physical health QoL, and severity, but not frequency, of stress was predicted by a task of working memory. The results of this study highlight the need for further research into the relationship between cognitive deficits and psychosocial adjustment because of the conflicting findings between studies and call for a common measurement framework for future investigation.

Anxiety in multiple sclerosis is related to depressive symptoms and cognitive complaints

“…ing and anxiety in the final analyses. The importance of coping in quality of life and in anxiety is stated in multiple MS studies 18,24,49. Our study confirms this pattern and is the first MS study on anxiety that includes demographic, disease-related and psychological variables in a multivariable analysis, including comprehensive cognitive functioning.…”

“…The importance of coping in quality of life and in anxiety is stated in multiple MS studies. 18,24,49 More specifically, a greater reliance on emotion-focused coping strategies is related to poor psychosocial adjustment, depression and anxiety. 49 Lack of correlations between these disease-related variables, together with the strong relation between anxiety, depression and cognitive complaints, can possibly be explained by coping as a moderating variable.…”

“…18 The association between disease-related factors and anxiety shows mixed results across studies. 20,23,24 Finally, anxiety is related to subjective cognitive complaints, rather than with objective neuropsychological measurements. 13,15,18 However, relapsing-remitting MS (RRMS) is associated with more anxiety in comparison with primary progressive (PPMS) and secondary progressive (SPMS) forms of MS. 19 This seems counterintuitive, since RRMS patients have generally lower neurological disability and are more likely to receive immunotherapy.…”

“…21,22 Yet, other studies have not found a correlation with general cognitive functioning, memory, attention and executive functioning. 20,23,24 Finally, anxiety is related to subjective cognitive complaints, rather than with objective neuropsychological measurements. 25 Studies on anxiety and depression in MS have generally found significant correlations between the two.…”

Understanding and Treating Cognitive Function Deficits in Multiple Sclerosis

“…Cognitive behavioral therapy, as aerobic work out, and education programs are promising psychosocial interventions to improve coping and lessen cognitive symptoms [6]. There is a need for better ways of diagnosing and treating cognitive problems not only in MS but also in other neurodegenerative disorders and aging [7]. Early recognition, assessment and treatment are important because cognitive changes can significantly affect a patient's quality of life and are the primary cause of early departure from the work force.…”