The four self-efficacy trajectories among people with multiple sclerosis: clinical associations and implications
Abstract
Background Longitudinal studies among people with Multiple Sclerosis (pwMS) have shown that self-efficacy is linked to physical, cognitive and psychological functioning.Objectives To determine the distribution of self-efficacy in a large sample of pwMS, examining whether there are distinct groups which show different self-efficacy trajectories over time, and the health status characteristics of any groups identified.Methods Participants completed serial questionnaire packs, including Unidimensional Self-efficacy-MS (USE-MS) scale, for the Trajectories of Outcome in Neurological Conditions-MS (TONiC-MS) study over an average 46-month period. The resulting longitudinal data were analysed by a group-based trajectory model.Results 5887 pwMS were studied: mean age 50.2 years (SD 12.0); 73.6% female; Relapsing Remitting MS (61.8%), Secondary Progressive (22.9%), Primary Progressive (11.1%), Rapidly Evolving Relapsing Remitting MS (4.2%). Four distinct self-efficacy trajectories emerged, with declining, slightly declining, stable or improving self-efficacy, each showing different patterns of health status indicators such as EQ-5D-5L, disability and depression. USE-MS ≤ 18 at baseline detected all participants in the two declining groups.Conclusion Future trials on interventions for self-efficacy should assume a priori that those with low levels of self-efficacy (USE-MS ≤ 18 at baseline) are likely to be on a declining trajectory and may need different interventions from those with stable self-efficacy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Research in MS shows links between higher reported self-efficacy and lower reported disability.
“The results are also in line with the self-efficacy theory (47) which indicates an association of self-efficacy with affective outcomes and research in MS showing links between higher reported self-efficacy and improved MS management (48) and lower reported disability (49).”
From Key demographics and psychological skills associated with adjustment to progressive Multiple Sclerosis early in the diagnosis (2022) · cites this paper as [49]
Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
Self-efficacy: Toward a unifying theory of behavioral change
Bandura, A. (1977) · Psychological Review · doi:10.1037/0033-295x.84.2.191 · Cited by 43,925 · see citing works
Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., Bonsel, G., & Badia, X. (2011) · Quality of Life Research · doi:10.1007/s11136-011-9903-x · Cited by 9,795 · see citing works
Probabilistic Models for Some Intelligence and Attainment Tests
Psychology, M. (1961) · Information and Control · doi:10.1016/s0019-9958(61)80061-2 · Cited by 6,936 · see citing works
Bozdogan, H. (1987) · Psychometrika · doi:10.1007/bf02294361 · Cited by 4,468 · see citing works
Group-Based Modeling of Development
NAGIN, D. (2005) · doi:10.4159/9780674041318 · Cited by 4,164 · see citing works
Group-Based Trajectory Modeling in Clinical Research
Nagin, D. S., & Odgers, C. L. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.121208.131413 · Cited by 2,749 · see citing works
Tennant, A., & Conaghan, P. G. (2007) · Arthritis Care & Research · doi:10.1002/art.23108 · Cited by 1,654 · see citing works
Self-citationValuing health-related quality of life: an EQ-5D-5L value set for England
Devlin, N. J., Shah, K. K., Feng, Y., Mulhern, B., & van Hout, B. (2018) · Health Economics · doi:10.1002/hec.3564 · Cited by 1,356 · see citing works
A Note on a Stata Plugin for Estimating Group-based Trajectory Models
Jones, B. L., & Nagin, D. S. (2013) · Sociological Methods & Research · doi:10.1177/0049124113503141 · Cited by 906 · see citing works
Christensen, K. B., Makransky, G., & Horton, M. (2016) · Applied Psychological Measurement · doi:10.1177/0146621616677520 · Cited by 702 · see citing works
Group-Based Trajectory Modeling: An Overview
Nagin, D. S. (2014) · Annals of Nutrition and Metabolism · doi:10.1159/000360229 · Cited by 700 · see citing works
Rehm, J., Üstün, T. B., Saxena, S., Nelson, C. B., Chatterji, S., Ivis, F., & Adlaf, E. (1999) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.61 · Cited by 287 · see citing works
Group-based Trajectory Modeling Extended to Account for Nonrandom Participant Attrition
Haviland, A. M., Jones, B. L., & Nagin, D. S. (2011) · Sociological Methods & Research · doi:10.1177/0049124111400041 · Cited by 221 · see citing works
Using Latent Class Analysis to Identify Hidden Clinical Phenotypes
Mori, M., Krumholz, H. M., & Allore, H. G. (2020) · JAMA · doi:10.1001/jama.2020.2278 · Cited by 208 · see citing works
The use of the Visual Analogue Scale (VAS) in rehabilitation outcomes
Kersten, P., Küçükdeveci, A. A., & Tennant, A. H. (2012) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-0999 · Cited by 150 · see citing works
Self-citationTrojan, D., Arnold, D. L., Collet, J., Shapiro, S., Bar‐Or, A., Robinson, A. R., Cruguel, J.-P. L., Ducruet, T., Narayanan, S., Arcelin, K., et al. (2007) · Multiple Sclerosis Journal · doi:10.1177/1352458507077175 · Cited by 129 · see citing works
Self-efficacy predicts self-reported health status in multiple sclerosis
Riazi, A., Thompson, A. J., & Hobart, J. C. (2004) · Multiple Sclerosis Journal · doi:10.1191/1352458504ms986oa · Cited by 127 · see citing works
Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets
Mulhern, B. J., Feng, Y., Shah, K. K., Janssen, M. F., Herdman, M., van Hout, B., & Devlin, N. J. (2018) · PharmacoEconomics · doi:10.1007/s40273-018-0628-3 · Cited by 116 · see citing works
Wilski, M., & Tasiemski, T. (2015) · Acta Neurologica Scandinavica · doi:10.1111/ane.12465 · Cited by 109 · see citing works
An introduction to Rasch analysis for Psychiatric practice and research
da Rocha, N. S., Chachamovich, E., Fleck, M. P. D. A., & Tennant, A. (2012) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2012.09.014 · Cited by 100 · see citing works
Self-citationMotl, R. W., McAuley, E., Wynn, D. R., Sandroff, B. M., & Suh, Y. (2012) · Quality of Life Research · doi:10.1007/s11136-012-0149-z · Cited by 88 · see citing works
Motl, R. W., McAuley, E., & Sandroff, B. M. (2013) · Physical Therapy · doi:10.2522/ptj.20120479 · Cited by 74 · see citing works
Schmitt, M. M., Goverover, Y., DeLuca, J., & Chiaravalloti, N. (2014) · Rehabilitation Psychology · doi:10.1037/a0035288 · Cited by 70 · see citing works
Wynne, S. C., Patel, S., Barker, R. E., Jones, S. E., Walsh, J. A., Kon, S. S. C., Cairn, J., Loebinger, M. R., Wilson, R., Man, W. D., et al. (2020) · Chronic Respiratory Disease · doi:10.1177/1479973120933292 · Cited by 66 · see citing works
Quality of life in multiple sclerosis is dominated by fatigue, disability and self-efficacy
Young, C. A., Mills, R. J., Rog, D. J., Sharrack, B., Majeed, T., Constantinescu, C. S., Kalra, S., Harrower, T., Santander, H., Courtald, G., et al. (2021) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2021.117437 · Cited by 65 · see citing works
Self-citationSuh, Y., Weikert, M., Dlugonski, D., Balantrapu, S., & Motl, R. W. (2011) · Behavioral Medicine · doi:10.1080/08964289.2011.603768 · Cited by 49 · see citing works
Hu, X., Jing, M., Zhang, M., Yang, P., & Yan, X. (2020) · Health and Quality of Life Outcomes · doi:10.1186/s12955-020-01578-8 · Cited by 43 · see citing works
Young, C., Mills, R. J., Woolmore, J., Hawkins, C., & Tennant, A. (2012) · Multiple Sclerosis Journal · doi:10.1177/1352458512436592 · Cited by 40 · see citing works
Self-citationKaufmann, M., Salmen, A., Barin, L., Puhan, M. A., Calabrese, P., Kamm, C. P., Gobbi, C., Kühle, J., Manjaly, Z., Ajdacic‐Gross, V., et al. (2020) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2020.102148 · Cited by 40 · see citing works
Guicciardi, M., Carta, M., Pau, M., & Cocco, E. E. (2019) · Behavioral Sciences · doi:10.3390/bs9120121 · Cited by 36 · see citing works
Onset Symptom Clusters in Multiple Sclerosis: Characteristics, Comorbidities, and Risk Factors
Ajdacic‐Gross, V., Steinemann, N., Horváth, G., Rodgers, S., Kaufmann, M., Xu, Y., Kamm, C. P., Kesselring, J., Manjaly, Z., Zecca, C., et al. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.693440 · Cited by 30 · see citing works
Wollin, J. A., Spencer, N., McDonald, E., Fulcher, G., Bourne, M., & Simmons, R. D. (2013) · International Journal of MS Care · doi:10.7224/1537-2073.2012-032 · Cited by 28 · see citing works
Self-efficacy and Walking Performance in Persons With Multiple Sclerosis
Motl, R. W., Balto, J. M., Ensari, I., & Hubbard, E. A. (2017) · Neurology Report · doi:10.1097/npt.0000000000000172 · Cited by 24 · see citing works
Factors affecting the trajectory of health-related quality of life in COPD patients
Yoo, J. Y., Kim, Y. S., Kim, S. S., Lee, H., Park, C. G., Oh, E. G., & Oh, Y. (2016) · The International Journal of Tuberculosis and Lung Disease · doi:10.5588/ijtld.15.0504 · Cited by 23 · see citing works
Malaju, M. T., Alene, G. D., & Azale, T. (2022) · BMJ Global Health · doi:10.1136/bmjgh-2021-007483 · Cited by 23 · see citing works
Kamal, M., Tamana, S. K., Smithson, L., Ding, L., Lau, A., Chikuma, J., Mariasine, J., Lefebvre, D. L., Subbarao, P., Becker, A. B., et al. (2018) · Sleep Medicine · doi:10.1016/j.sleep.2018.04.008 · Cited by 19 · see citing works
Bejer, A., Ćwirlej-Sozańska, A. B., Wiśniowska-Szurlej, A., Wilmowska-Pietruszyńska, A., Spałek, R., Alessandro de, S. I. R. E., & Sozański, B. (2021) · Quality of Life Research · doi:10.1007/s11136-021-02806-4 · Cited by 19 · see citing works
Multiple sclerosis and employment: Associations of psychological factors and work instability
Wicks, C. R., Ward, K., Stroud, A., Tennant, A., & Ford, H. L. (2016) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-2142 · Cited by 18 · see citing works
Self-citationLo, L. M. P., Taylor, B. V., Winzenberg, T. M., Palmer, A. J., Blizzard, L., Hussain, M. A., & van der Mei, I. A. F. (2021) · European Journal of Neurology · doi:10.1111/ene.14887 · Cited by 16 · see citing works
Jongen, P. J., van Mastrigt, G. A. P. G., Heerings, M. A. P., Visser, L. H., Ruimschotel, R. P., Hussaarts, A., Duyverman, L., Valkenburg-Vissers, J., Cornelissen, J., Bos, M., et al. (2019) · PLoS ONE · doi:10.1371/journal.pone.0223482 · Cited by 14 · see citing works
Psychological determinants of job retention in multiple sclerosis
Ford, H. L., Wicks, C. R., Stroud, A., & Tennant, A. (2018) · Multiple Sclerosis Journal · doi:10.1177/1352458518754362 · Cited by 12 · see citing works
Self-citationSelf-efficacy and Physical and Cognitive Function in Older Adults with Multiple Sclerosis
Bollaert, R. E., & Motl, R. W. (2018) · International Journal of MS Care · doi:10.7224/1537-2073.2018-001 · Cited by 12 · see citing works
Self-Efficacy and Walking Performance Across the Lifespan Among Adults With Multiple Sclerosis
Sikes, E. M., Cederberg, K. L. J., Baird, J. F., Sandroff, B. M., & Motl, R. W. (2019) · Neurodegenerative Disease Management · doi:10.2217/nmt-2019-0007 · Cited by 12 · see citing works
Jongen, P. J., Lemmens, W. A. J. G., Hoogervorst, E. L. J., & Donders, R. (2017) · Health and Quality of Life Outcomes · doi:10.1186/s12955-017-0622-z · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Healthier living with MS: The key role of self-efficacy and emotion regulation
Dehghan, M., Sharifi, P., Hasani, J., Young, C. A., & Langdon, D. W. (2023) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2023.104608 · Cited by 7 · see citing works
Self-citationBogosian, A., Day, F., Norton, S., Silber, E., Sakel, M., Sharrack, B., & Moss-Morris, R. (2022) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2022.966133 · Cited by 5 · see citing works
“Frontiers in Rehabilitation Sciences 08 indicates an association of self-efficacy with affective outcomes and research in MS showing links between higher reported self-efficacy and improved MS management (48) and lower reported disability (49).”
BackgroundSelf-citationLv, Q., Chang, H., Wang, Y., Xu, X., Liu, J., He, Y., Fu, L., Lin, M. F., Gao, X., Zang, X., et al. (2025) · BMC Nursing · doi:10.1186/s12912-025-02995-0 · Cited by 6 · see citing works
Sun, B., Wang, J., Xiao, H., Wang, Y., & Wang, J. (2026) · PLoS ONE · doi:10.1371/journal.pone.0339591 · Cited by 2 · see citing works
What would improve MS clinic services for cognition? – A stakeholder panel and survey exploration
Langdon, D. W., Coutts, M., McGuigan, C., Morrow, B., Peryer, G., & Young, C. A. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.103930 · Cited by 2 · see citing works
Self-citationDani, T., Antar, A. D., Kratz, A. L., & Banović, N. (2026) · ACM Transactions on Computing for Healthcare · doi:10.1145/3797885 · Cited by 1 · see citing works
The Benefits of a United Kingdom Multiple Sclerosis Register
Middleton, R. (2024) · doi:10.23889/suthesis.65409
Dang, P. L., Krug, I., & Kiropoulos, L. A. (2026) · Cognitive Therapy and Research · doi:10.1007/s10608-026-10722-5
Sharifi, P., Dehghan, M., & Shahgholian, M. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.106549
A Process-based Approach to Psychological Distress in People with Early Multiple Sclerosis
Lakshmikanth, S., Sudhir, P. M., Desai, G., & Netravathi, M. (2026) · Indian journal of clinical psychology · doi:10.4103/ijcp.ijcp_19_26
- Authors
- Young, C. A., Mills, R., Langdon, D., Sharrack, B., Majeed, T., Kalra, S., Footitt, D., Rog, D., Harrower, T., Nicholas, R., Woolmore, J., Thorpe, J., Hanemann, C. O., Ford, H., Paling, D., Ellis, C., Palace, J., Constantinescu, C., & Tennant, A.
- Affiliations
- University of Liverpool (GB)
- Royal Holloway University of London (GB)
- NIHR Sheffield Biomedical Research Centre (GB)
- Lancashire Teaching Hospitals NHS Foundation Trust (GB)
- University Hospitals of North Midlands NHS Trust (GB)
- North Cumbria Integrated Care NHS Foundation Trust (GB)
- Salford Royal NHS Foundation Trust (GB)
- Imperial College Healthcare NHS Trust (GB)
- Queen Elizabeth Hospital Birmingham (GB)
- Peninsula College of Medicine and Dentistry (GB)
- Leeds Teaching Hospitals NHS Trust (GB)
- Darent Valley Hospital (GB)
- University of Nottingham (GB)
- University of Leeds (GB)
- Corresponding author
- Young, Carolyn A.
- ORCID
- Venue
- Journal of the Neurological Sciences
- Publisher
- Elsevier BV
- Published
- 2022-05
- Volume
- 436
- Pages
- 120188
- ISSN
- 0022-510X (ISSN-L)
- OpenAlex
- W4213235386
- Cited by
- 10
- References
- 45
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 2
- FWCI
- 0.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of the Neurological Sciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Teva Pharmaceutical Industries
- Novartis
- Sanofi Genzyme
- Roche
- Multiple Sclerosis Society (62)
- Merck
- Biogen
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- multiple sclerosis, self-efficacy, group-based trajectory modeling, relapsing-remitting multiple sclerosis, secondary progressive multiple sclerosis, primary progressive multiple sclerosis, disability, depression, health-related quality of life, EQ-5D-5L
- MeSH terms
- Female, Humans, Longitudinal Studies, Male, Middle Aged, Multiple Sclerosis, Surveys and Questionnaires, Self Efficacy, Multiple Sclerosis, Relapsing-Remitting
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
