The bidirectional effect of stress and functionality in multiple sclerosis and the interaction role of anxiety, coping and social support

• Published in: Journal of psychosomatic research 2023-07, Vol.170, p.111375-111375, Article 111375
• Main Authors: Briones-Buixassa, Laia, Montañés-Masias, Brenda, Milà-Villaroel, Raimon, Arrufat, Francesc X., Aragonès, Josep Mª., Norton, Sam, Bort-Roig, Judit, Moss-Morris, Rona
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological - physiology; Adult; Aged; Anxiety; Anxiety - etiology; Anxiety - physiopathology; Anxiety - psychology; Coping; Coping Skills; Ecological Momentary Assessment; Female; Functionality; Humans; Male; Middle Aged; Mindfulness; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - physiopathology; Multiple Sclerosis - psychology; Regression Analysis; Social Support; Stress; Stress, Psychological - etiology; Stress, Psychological - physiopathology; Stress, Psychological - psychology
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2023.111375

The present study aims to analyse the bidirectional hypothesis between stress and multiple sclerosis with several measures of stress, impairment and functionality, considering also the interaction role of stress-related psychosocial factors such as anxiety, coping and social support. A one-year follow-up was conducted with 26 people with multiple sclerosis. Participants reported i) at baseline, anxiety (State-Trait Anxiety Inventory), and social support (Multidimensional Scale of Perceived Social Support); ii) daily, Ecological Momentary Assessment through self-reported diaries of stressful events and coping strategies; iii) monthly, the perceived stress (Perceived Stress Scale), iv) trimonthly, the self-reported functionality (Functionality Assessment in multiple sclerosis) and v) at baseline and at the end, neurologist rated impairment (Expanded Disability Status Scale). Mixed-effect regression models were conducted. The bidirectional hypothesis was confirmed with perceived stress and self-reported functionality, which were negatively related in both directions. Coping and anxiety showed an interaction effect: active coping increased functionality only with high levels of stress, and high-trait anxiety showed lower functionality whereas low-trait anxiety showed higher functionality but only with low stress levels. People with multiple sclerosis may benefit from different types of psychological therapies, from gold-standard therapies like Cognitive Behavioural Therapy to third-waves therapies like Dialectical Behaviour Therapy or mindfulness, that focus on dealing with stress and affective symptoms, adjusting to the disease, and to improving their overall quality of life. More research is needed in this field under the biopsychosocial model. •The stress-Multiple Sclerosis (MS) relationship is controversial, with low evidence.•The bidirectional hypothesis was confirmed through ecological momentary assessments.•Active coping was adaptive with high stress, but counterproductive with low stress.•Low-trait anxiety was related to a higher functionality only with low stress levels.•Research is needed in gold standard and third-wave therapies (mindfulness) for pwMS.