Multiple sclerosis: Empirical literature for the clinical health psychologist
Abstract
This article reviews the empirical literature related to clinical health psychology in multiple sclerosis (MS). MS is a disease in which the immune system attacks the central nervous system. As such, the interactions between medical and psychological variables are complex, and potentially of considerable importance to patients. Common neuropsychological and psychological problems associated with MS and their etiologies are reviewed. The effects of stress and depression on MS exacerbation are discussed, including clinical, immune, endocrine, and neuroimaging findings. The types of coping common in MS and their effects on adjustment are discussed. The empirical literature on psychological and neuropsychological intervention is reviewed. The small literature on caregiving in MS is also summarized.
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Studies comparing multiple sclerosis patients with patients suffering from another degenerative deficiency (arthritis) have not established a specific link between anxiety symptoms and multiple sclerosis.
“Des travaux ayant comparé des patients atteints de sclérose en plaques avec des patients souffrant d'une autre déficience dégénérative (arthrite) n'ont toutefois pas permis d'établir un lien spécifique entre les symptômes anxieux et la sclérose en plaques [32,33].”
From Prise en charge des troubles anxieux dans le cadre d'atteintes neurologiques (2004) · cites this paper as [32]
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“…can produce a wide variety of symptoms, including impaired motor function or feeling in limbs, debilitating fatigue, pain, loss of bowel or bladder control, sexual dysfunction, blindness due to optic neuritis, impaired cognitive functioning and emotional symptoms (Goodkin 1992; Mohr and Cox 2001).”
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“There were higher levels of anxiety than depression in this sample; whereas most research reports the reverse (Korostil & Feinstein, 2007; Mohr & Cox, 2001).”
ResultSomer, E., Golan, D., Dishon, S., Cuzin-Disegni, L., Lavi, I., & Miller, A. (2010) · Multiple Sclerosis · doi:10.1177/1352458509358714 · Cited by 26 · see citing works
REVIEW OF INTERVENTION STUDIES ON DEPRESSION IN PERSONS WITH MULTIPLE SCLEROSIS
Walker, I., & Gonzalez, E. (2007) · Issues in Mental Health Nursing · doi:10.1080/01612840701344480 · Cited by 25 · see citing works
“…United States, women are diagnosed with the disease more frequently than men: A ratio of approximately 3:1 in young adults (Hauser & Goodkin, 2001; Mohr & Cox, 2001; National Multiple Sclerosis Society [NMSS], 2000; Noonan, Kathman, & White, 2002; Paty & Ebers, 1998) approaches 2:1 in older…”
BackgroundBruce, J. M., & Arnett, P. (2005) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617705050629 · Cited by 25 · see citing works
Internet-based treatment for depression in multiple sclerosis: A randomized controlled trial
Boeschoten, R., Dekker, J., Uitdehaag, B., Beekman, A., Hoogendoorn, A., Collette, E., Cuijpers, P., Nieuwenhuis, M. M., & van Oppen, P. (2017) · Multiple Sclerosis · doi:10.1177/1352458516671820 · Cited by 24 · see citing works
Mohr, D. C., Epstein, L. A., Luks, T. L., Goodkin, D. E., Cox, D., Goldberg, A., Chin, C. T., & Nelson, S. J. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.6.1017 · Cited by 25 · see citing works
Self-citationCharles Bonnet Syndrome: Visual Hallucination and Multiple Sclerosis
Alao, A. O., & Hanrahan, B. (2003) · International Journal of Psychiatry in Medicine · doi:10.2190/0nuq-y5q9-ta6h-rjhh · Cited by 24
“These include euphoria, depression, and personality changes [1].”
BackgroundInfluentialPain and affective memory biases interact to predict depressive symptoms in multiple sclerosis
Bruce, J. M., Polen, D., & Arnett, P. (2007) · Multiple Sclerosis · doi:10.1177/1352458506070229 · Cited by 23 · see citing works
“Depression and pain are common among patients with MS [2,9].”
BackgroundAbbas, J., Aqeel, M., Zhang, W.-H., Aman, J., & Zahra, F. (2018) · International Journal of Human Rights in Healthcare · doi:10.1108/ijhrh-11-2017-0071 · Cited by 21 · see citing works
Depression in Multiple Sclerosis: Reactive or Endogenous?
Holden, K. E., & Isaac, C. (2011) · Clinical Neuropsychologist · doi:10.1080/13854046.2011.564208 · Cited by 20 · see citing works
“However, Mohr and Cox ( 2001 ) propose that all studies have been too small to produce reliable results.”
BackgroundA wireless body measurement system to study fatigue in multiple sclerosis
Yu, F., Bilberg, A., Stenager, E., Rabotti, C., Zhang, B.-B., & Mischi, M. (2012) · Physiological Measurement · doi:10.1088/0967-3334/33/12/2033 · Cited by 18 · see citing works
Wireless medical sensor measurements of fatigue in patients with multiple sclerosis
Fei, Y., Bilberg, A., & Stenager, E. (2010) · 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology · doi:10.1109/iembs.2010.5627530 · Cited by 18 · see citing works
“The effects of MS can include a wide range of unpleasant and debilitating symptoms, such as loss of function or sensation in the limbs, loss of bowel or bladder control, sexual dysfunction, blindness, loss of balance, pain, cognitive dysfunction, emotional changes, and fatigue [ 2 ].”
BackgroundBowden, G. T., & Toothill (2010) · British Journal of Occupational Therapy · doi:10.1177/03080226140770s802 · Cited by 18 · see citing works
An exploration of anger phenomenology in multiple sclerosis
Nocentini, U., Tedeschi, G., Migliaccio, R., Dinacci, D., Lavorgna, L., Bonavita, S., Bresciamorra, V., Comanducci, G., Coniglio, G., Livrea, P., et al. (2009) · European Journal of Neurology · doi:10.1111/j.1468-1331.2009.02727.x · Cited by 18 · see citing works
“Although anger can have negative outcomes on self-esteem, evaluation by others, interpersonal relationships [9], and physical health [10], it has not been sufficiently studied in MS patients [11].”
BackgroundLes troubles de l’humeur et des émotions dans la sclérose en plaques : une revue de la littérature
Montel, S., & Bungener, C. (2007) · Revue Neurologique · doi:10.1016/s0035-3787(07)90352-5 · Cited by 17 · see citing works
Young, E. E., Sieve, A. N., Vichaya, E., Carcoba, L. M., Young, C., Ambrus, A., Storts, R., Welsh, C., & Meagher, M. (2010) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2010.01.015 · Cited by 16 · see citing works
“In addition, exposure to environmental factors, such as stressful life events (Ackerman et al., 2002, 2003; Brown et al., 2006a,b; Buljevac et al., 2003; Mohr et al., 2000; Mohr and Cox, 2001) or life-threatening situations (Grant et al.”
BackgroundClinical Practice Guidelines for the Detection and Treatment of Depression in Multiple Sclerosis
McIntosh, G. E., Liu, E. S., Allan, M., & Grech, L. (2023) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000200154 · Cited by 28 · see citing works
Body image in multiple sclerosis patients: a descriptive review
Cara, M. D., Buono, V. L., Corallo, F., Cannistraci, C., Rifici, C., Sessa, E., D'Aleo, G., Bramanti, P., & Marino, S. (2019) · Neurological Sciences · doi:10.1007/s10072-019-3722-1 · Cited by 15 · see citing works
“er with the presence of possible sexual dysfunction, pain, and depression [36], may adversely affect the structure of the body image [37], which includes satisfaction with appearance, concern for one’s own body and the social well-being [38].”
BackgroundSieve, A. N., Steelman, A., Young, C., Storts, R., Welsh, T. H., Welsh, C., & Meagher, M. (2006) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2006.04.020 · Cited by 15 · see citing works
“Additionally, longitudinal studies find stress to increase the chances of exacerbation of MS (Mohr and Cox, 2001; Ackerman et al., 2003).”
BackgroundInfluentialSwanepoel, I., van Staden, W., & Fletcher, L. (2019) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000770 · Cited by 13 · see citing works
“These features delimit generalizability of the results, although they are consistent with results in previous studies, with a similar preponderance of sex (1,64) and subtype (15,16,20,42,54).”
ResultChildhood-Onset Multiple Sclerosis and Mood Disorders: A Case Study
McCann, K. K., Farmer, J., & Patel, N. (2004) · Child Neuropsychology: A Journal of Normal and Abnormal Development in Childhood and Adolescence · doi:10.1080/09297040490911113 · Cited by 13
“Behavioral and emotional problems in children with MS are likely to be multiply determined (Dennis, 2000; Mohr & Cox, 2001).”
BackgroundMethodResultInfluentialQuality of life and mental health in multiple sclerosis patients during the COVID-19 Pandemic
Rodríguez-Agudelo, Y., Nava-Adán, J., Paz-Rodríguez, F., Abundes-Corona, A., Flores-Rivera, J., & Corona, T. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.104487 · Cited by 12 · see citing works
Prevalence and Correlates of Body Image Dissatisfaction in Patients with Multiple Sclerosis.
Stevens, S. D., Thompson, N., & Sullivan, A. (2019) · International Journal of MS Care · doi:10.7224/1537-2073.2018-066 · Cited by 12 · see citing works
Experiences of persons with multiple sclerosis with rehabilitation—a qualitative interview study
Ghaidar, D., Sippel, A., Riemann-Lorenz, K., Kofahl, C., Morrison, R., Kleiter, I., Schmidt, S., Dettmers, C., Schulz, H., & Heesen, C. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08150-8 · Cited by 10 · see citing works
“The psychological consequences following the diagnosis of MS can be devastating, and consequently depression is frequent in pwMS [26].”
BackgroundCox, D., Mohr, D., & Epstein, L. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80042-7 · Cited by 10 · see citing works
Self-citationManagement of psychosocial adjustment among people with multiple sclerosis: a critical analysis
Guerra, S. (2013) · British Journal of Neuroscience Nursing · doi:10.12968/bjnn.2013.9.2.89 · Cited by 9 · see citing works
Kiropoulos, L., Kilpatrick, T., Kalincek, T., Cherulov, L., Mcdonald, E., Wijeratne, T., Threader, J., Rozenblat, V., Simpson-O’Brien, N., van der Walt, A., et al. (2020) · Trials · doi:10.1186/s13063-019-4018-8 · Cited by 8 · see citing works
The impact of pain on the quality of life of people with multiple sclerosis: A community survey
Douglas, C., Wollin, J., & Windsor, C. (2009) · International Journal of MS Care · doi:10.7224/1537-2073-11.3.127 · Cited by 8 · see citing works
Üstündağ, S., Yeşilbalkan, Ö. U., & Kabay, S. C. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.105342 · Cited by 5 · see citing works
Bijoux-Leist, J., & Leist, T. (2022) · Health Psychology and Behavioral Medicine · doi:10.1080/21642850.2022.2050373 · Cited by 7 · see citing works
“…the unpredictability of its clinical course are often accompanied by depression (Randolph, Arnett, & Freske, 2004; McNulty, Livneh, & Wilson, 2004; Mohr & Cox, 2001; Turner, Williams, Bowen, Kivlahan, & Haselkorn, 2006), anxiety (Burns, Siddique, Fokuo, & Mohr, 2010; Maurelli et al., 1992; Montel…”
Predicting medication adherence in multiple sclerosis using telephone-based home monitoring.
Turner, A., Roubinov, D. S., Atkins, D. C., & Haselkorn, J. (2016) · Disability and Health Journal · doi:10.1016/j.dhjo.2015.08.008 · Cited by 7 · see citing works
Psychological Consultation Services at a Multiple Sclerosis Clinic
Stepleman, L., Jump, R., Shelton, S. F., & Hughes, M. D. (2009) · International Journal of MS Care · doi:10.7224/1537-2073-11.4.180 · Cited by 6 · see citing works
[Facial emotion recognition, theory of mind and empathy in multiple sclerosis].
Ayache, S., Chalah, M. A., Kuempfel, T., Padberg, F., Lefaucheur, J., & Palm, U. (2017) · Fortschritte der Neurologie Psychiatrie · doi:10.1055/s-0043-118846 · Cited by 5 · see citing works
- Authors
- Mohr, D. C., & Cox, D.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Mohr, David C.
- ORCID
- Mohr, David C.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2001-04
- Volume
- 57
- Issue
- 4
- Pages
- 479-499
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2112201125
- Cited by
- 176
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 3 · 2022: 7 · 2021: 5 · 2020: 6 · 2019: 6 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 4 · 2014: 13 · 2013: 7 · 2012: 9
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01-MH59708, R01MH059708)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- multiple sclerosis, neuropsychological problems, mental illness, stress, depression, disease exacerbation, immune system, endocrine system, neuroimaging, coping, psychological adjustment, psychological intervention, neuropsychological intervention, caregiving
- MeSH terms
- Adaptation, Psychological, Adult, Anger, Central Nervous System, Depression, Female, Humans, Male, Mental Health, Middle Aged, Multiple Sclerosis, Psychotherapy, Stress, Psychological, Cognitive Behavioral Therapy, Caregivers
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