The roles of cognition and mood in psychosocial adjustment to multiple sclerosis
Multiple sclerosis (MS), a common, chronic autoimmune demyelinating disease, is characterized by diagnostic uncertainty and unpredictability in symptom manifestation. Approximately 85 percent of patients initially present symptoms of MS consistent with a relapsing-remitting (RR) course, and often experience disrupted cognitive functioning. In addition, because RR MS is unpredictable and variable, it is commonly associated with decreased psychosocial adjustment and increased emotional disturbance. At present, little is established in the MS literature regarding the concurrent roles of cognition and mood in the process of adjustment to the disease. As such, the present study sought to explore relationships between aspects of cognitive functioning and reported psychosocial adjustment in patients with RR MS. The moderating role of mood on the relationships between cognition and psychosocial adjustment was also explored. Results indicated that immediate memory/attention, working memory, sustained attention, and cognitive flexibility were significantly related to reported psychosocial adjustment to RR MS. Performance on these variables, in addition to verbal abstract reasoning, also contributed to the prediction of level of psychosocial adjustment when the effects of depressed mood were controlled. In sum, despite limitations (e.g., small sample size), current findings yielded promising information regarding the associations between cognitive functioning and adjustment, as well as factors that can affect such associations (e.g., depressed mood). MS is generally diagnosed early in life and adopts a variable symptom course. Thus, future research should continue to address the relationships among cognitive functioning, psychosocial adjustment, and mood state to assist individuals with MS in maintaining quality of life over time. Such knowledge will be valuable as both medical and psychological treatment protocols and support systems for this disease continue to be developed and refined.