RESUMEN
PURPOSE/OBJECTIVE: The ability to tolerate uncertainty about the future may be foundational to positive psychological adjustment. Conversely, intolerance of uncertainty (IU) has been shown to be a vulnerability factor for anxiety and depression. One stressor with a very high degree of uncertainty about the future is a new diagnosis of multiple sclerosis (MS). However, few psychological interventions in MS have directly targeted IU. Research Method/Design: Forty-eight participants with early MS and moderate levels of distress were randomized to receive either 6 sessions of a brief psychological intervention designed to improve the ability to tolerate uncertainty (n = 23) or treatment as usual (TAU; n = 25). Measures of mood, IU, and MS acceptance were administered at baseline and about 8 weeks later. Intervention effects were tested via linear regression controlling for baseline levels. RESULTS: Participants were primarily Caucasian (85%) women (73%) and had lived with an MS diagnosis for an average of 376.3 days. Groups did not differ at baseline on most demographic or outcome variables. The intervention was well-tolerated, and most participants (82.6%) completed all 6 sessions and reported benefit. Postintervention, those in the intervention group demonstrated lower levels of IU and more MS acceptance relative to the TAU group. There was no effect of the intervention on global anxiety. Decreases in IU were associated with increases in MS acceptance (r = -.63). Effect sizes for these changes were moderate. CONCLUSIONS/IMPLICATIONS: These pilot results demonstrate that IU is responsive to a brief psychological intervention, and improvement with IU is associated with positive psychological outcomes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Asunto(s)
Actitud Frente a la Salud , Terapia Cognitivo-Conductual/métodos , Ajuste Emocional , Esclerosis Múltiple/psicología , Incertidumbre , Adulto , Femenino , Humanos , Masculino , Proyectos PilotoRESUMEN
OBJECTIVES: To investigate the longitudinal relationships between social support and subsequent mental health outcomes in individuals with multiple sclerosis (MS), and to examine resilience as a mediator between social support and subsequent mental health outcomes in this population. DESIGN: Observational, longitudinal cohort study. Participants were assessed at 4 time points over 12 months in the context of a previously reported randomized controlled trial. SETTING: Telephone-based measures administered to community-based participants. PARTICIPANTS: Individuals (N=163) with MS and 1 or more of the following symptoms: depression, fatigue, and pain. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mental health outcomes included (1) depressive symptomatology, assessed using the Patient Health Questionnaire-9; (2) anxious symptomatology, assessed using the short form of the Emotional Distress-Anxiety Scale from the Patient-Reported Outcomes Measurement Information System; and (3) general mental health status, assessed using the Mental Component Summary score from the Short Form-8 Health Survey. Resilience was assessed using the Connor-Davidson Resilience Scale. RESULTS: At any given time, social support from significant others, family members, and friends was significantly associated with subsequent mental health outcomes for all 3 measures assessed (all P values <.05). Resilience measured concomitantly with social support significantly mediated the relationships between social support and subsequent mental health outcomes. After controlling for resilience, most of the direct relationships between social support and mental health outcomes were no longer significant. CONCLUSIONS: There are significant longitudinal relationships between social support, resilience, and mental health outcomes for people with MS. Given the mediating role of resilience in supporting better mental health outcomes, future clinical research and practice may benefit from an emphasis on resilience-focused psychological interventions.