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Cited by 24Multiple Sclerosis Research StudiesMindfulness and Compassion InterventionsCancer survivorship and care

Self-concept, illness acceptance and depressive and anxiety symptoms in people with multiple sclerosis.

Open access
Kiropoulos, Litza, Ward, Natalie, Rozenblat, Vanja·2021·Journal of Health Psychology
DOI 10.1177/1359105319871639
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Abstract

Little research has examined the relationship between self-concept and depressive and anxiety symptoms and whether this is moderated by illness acceptance in individuals with multiple sclerosis. Results of an online self-report survey completed by 515 individuals with multiple sclerosis revealed that self-concept was negatively associated with depressive and anxiety symptoms with illness acceptance moderating the association such that individuals with highest self-concept and illness acceptance had the lowest levels of depressive and anxiety symptoms. Findings lend support to psychological interventions that focus on increasing illness acceptance and fostering positive self-concept in individuals with multiple sclerosis.

Integrity signals

Registry

Crossref · 10.1177/1359105319871639

Cites

34 of 34 references verified0 citation errors · 0 not checkable

Statistics

9 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

4 of 22 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Negative self-concept is related to depressive and anxiety symptoms in individuals with MS.

    “Negative self-concept has been found to be related to depressive and anxiety symptoms in individuals with MS (Wright and Kiropoulos, 2017) and to an increase in MS-related symptoms and the progression of the disease (Jopson and Moss-Morris, 2003).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Wright and Kiropoulos, 2017 source

      The Introduction says self-concept has been found to be low in MS populations, and the Discussion links self-concept to intimate relationship quality. Neither passage links negative self-concept to depressive or anxiety symptoms. Searches for depression and anxiety found no such link in the paper's text. (LLM, conf=0.74)

      Experimental — accuracy not yet measured
  • Premisecitation

    Negative associations exist between illness acceptance and measures of depression and anxiety in those with MS.

    “From the research available, negative associations have been found between illness acceptance and measures of depression and anxiety in those with MS (Pakenham and Fleming, 2011;Wright and Kiropoulos, 2017), suggesting that it can be a factor that can be targeted in interventions for depression and anxiety for this group.”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Pakenham and Fleming, 2011 source
    • cites Wright and Kiropoulos, 2017 source

      The Introduction and Discussion link MS illness acceptance to life satisfaction and intimate relationship quality, not to depression or anxiety. Searches for depression and anxiety found references concerning other relationships, but no passage reporting their association with illness acceptance. (LLM, conf=0.77)

      Experimental — accuracy not yet measured
  • Findingown data

    Self-concept was negatively correlated with anxiety symptoms in the sample (r = -.53, p < .001).

    “Consistent with our hypotheses, there was a significant correlation between higher level of self-concept and lower level of depressive, r = -.64,p < .001,and anxiety, r = -.53,p < .001,symptoms.”
    Quote in the paperSubstantial claim
  • Findingown data

    There was a stronger relationship between illness acceptance and depression for participants with low self-concept compared to those with high self-concept.

    “Furthermore, there was a stronger relationship between illness acceptance and depression for participants with low self-concept compared to those with high self-concept.”
    Quote in the paperSubstantial claim
  • Findingown data

    Illness acceptance directly predicted depressive symptoms in the regression (t(514) = -5.02, p < .001).

    “Both self-concept, t(514) = -8.36,p < .001,and illness acceptance, t(514) = -5.02,p < .001,directly predicted depression.”
    Quote in the paperSubstantial claim
  • May combine two claims. 14
  • Classified as probably not a substantial claim. 11
  • The quote only partly states this claim. 1

  • May combine two claims.

    Premisecitation

    Positive self-concept in individuals with MS is associated with lower depressive and anxiety symptom scores, higher levels of illness acceptance and better intimate relationship quality.

    “In contrast, positive self-concept in individuals with MS has been found to be associated with lower depressive and anxiety symptom scores, higher levels of illness acceptance and better intimate relationship quality (Bogart, 2015;Brooks and Matson, 2012;Wright and Kiropoulos, 2017) and better psychological and physical status (Wilski et al., 2016).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Bogart, 2015 source
    • cites Brooks and Matson, 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Wright and Kiropoulos, 2017 source

      The Univariate analyses report significant associations among self-concept, MS illness acceptance and intimate relationship quality; the Discussion also describes self-concept and acceptance as moderately correlated. The Measures and Statistical Analyses do not include depressive or anxiety symptom scores, so this source does not support that part of the claim. Page numbers are unavailable in our copy. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    A tailored 8-week cognitive behavioural therapy programme for depression and anxiety in newly diagnosed MS individuals resulted in significant reductions in depressive and anxiety symptoms and higher levels of illness acceptance.

    “Relatedly, a recent study found significant reductions in levels of depressive and anxiety symptoms and higher levels of illness acceptance in individuals who were newly diagnosed with MS who undertook a tailored 8-week cognitive behavioural therapy programme for depression and anxiety (Kiropoulos et al., 2016).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Kiropoulos et al., 2016 source

  • May combine two claims.

    Findingown data

    Examination of the interaction plot showed a buffering effect: as self-concept and illness acceptance increased, level of depressive symptoms decreased.

    “Examination of the interaction plot showed a buffering effect that as self-concept and illness acceptance increased, level of depressive symptoms decreased.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    At low self-concept, individuals who also had low illness acceptance scored higher on the depression measure compared to individuals with average and high illness acceptance, while this effect was less pronounced for individuals with medium self-concept and even further reduced for those with high self-concept.

    “That is, at low self-concept, individuals who also had low illness acceptance scored higher on the depression measure compared to individuals with average and high illness acceptance, while this effect was less pronounced for individuals with medium self-concept and even further reduced for those with high self-concept.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    At low self-concept, individuals who also had low illness acceptance scored higher on the anxiety measure compared to individuals with average and high illness acceptance, while this effect was less pronounced for individuals with medium self-concept and even further reduced for those with high self-concept.

    “That is, at low self-concept, individuals who also had low illness acceptance scored higher on the anxiety measure compared to individuals with average and high illness acceptance, while this effect was less pronounced for individuals with medium self-concept and even further reduced for those with high self-concept.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A recent meta-analysis found a robust relationship between low self-esteem and depression and anxiety.

    “with a recent meta-analysis finding a robust relationship between low selfesteem and depression and anxiety (Sowislo and Orth, 2013).”
    • Also stated in: § Introduction · boosted
      “In contrast, negative self-concept has been linked strongly to increased risk for major depressive and anxiety disorders, substance abuse and lower quality of life (Pelkonen et al., 2008;Trzesniewski et al., 2006;Vickery et al., 2005), with a recent meta-analysis finding a robust relationship between low selfesteem and depression and anxiety (Sowislo and Orth, 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sowislo and Orth, 2013 source

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). The quote only partly states this claim.

    Study design and conductown data

    The results for anxiety symptoms did not change when level of ambulation was included in the model.

    “These results did not change when level of ambulation was included in the model.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Positive self-concept is viewed as an essential component of mental health.

    “Positive self-concept is viewed as an essential component of mental health (Taylor and Brown, 1988).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Taylor and Brown, 1988 source

  • May combine two claims.

    Study design and conductown data

    Missing data were missing at random and ignorable (Little's test χ2(5378)=1813.03, p=1.00).

    “Little's (1988) test indicated that the missing data were missing at random and ignorable, χ 2 (5378) = 1813.03,p = 1.00.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Little (1988) source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The DASS-42 Depression subscale had Cronbach's α = 0.95 in this study.

    “Cronbach's α for this study is 0.95 for the Depression subscale total score and 0.89 for the Anxiety subscale total score.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Self-esteem is linked to lower levels of depression.

    “Research has found that self-esteem, a component of self-concept, is linked to happiness (Cheng and Furnham, 2004), high positive affect and low negative affect (Orth et al., 2012), and to lower levels of depression (Orth et al., 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Orth et al., 2009 source

  • May combine two claims.

    Study design and conductreasoning

    The self-report questionnaires were completed online, and the authenticity of the subjects recruited cannot be validated.

    “Second, the current self-report questionnaires were completed online, and the authenticity of the subjects recruited for this study cannot be validated.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Self-esteem is linked to high positive affect and low negative affect.

    “Research has found that self-esteem, a component of self-concept, is linked to happiness (Cheng and Furnham, 2004), high positive affect and low negative affect (Orth et al., 2012), and to lower levels of depression (Orth et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Orth et al., 2012 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The DASS-42 Anxiety subscale had Cronbach's α = 0.89 in this study.

    “Cronbach's α for this study is 0.95 for the Depression subscale total score and 0.89 for the Anxiety subscale total score.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The majority of participants (87.6%) were females who had at least a diploma as the highest level of education and reported having relapse remitting MS, which may limit the generalisability of the current results.

    “Finally, the majority of participants (87.6%) were females who had at least a diploma as the highest level of education and reported having relapse remitting MS, which may limit the generalisability of the current results obtained.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The TSCS-2 total self-concept score had Cronbach's α = 0.94 in this study.

    “In this study, Cronbach's α for the total self-concept score was 0.94.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Receiving an MS diagnosis and experiencing MS symptoms and progression are associated with depression and anxiety.

    “In addition to the physical consequences, receiving an MS diagnosis and experiencing MS symptoms and progression of the disease have been associated with depression and anxiety (Giordano et al., 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Giordano et al., 2011 source

  • May combine two claims.

    Premisecitation

    Negative self-concept is linked strongly to increased risk for major depressive and anxiety disorders, substance abuse and lower quality of life.

    “In contrast, negative self-concept has been linked strongly to increased risk for major depressive and anxiety disorders, substance abuse and lower quality of life (Pelkonen et al., 2008;Trzesniewski et al., 2006;Vickery et al., 2005), with a recent meta-analysis finding a robust relationship between low selfesteem and depression and anxiety (Sowislo and Orth, 2013).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Pelkonen et al., 2008 source
    • cites Trzesniewski et al., 2006 source
    • cites Vickery et al., 2005 source

  • May combine two claims.

    Premisecitation

    Negative self-concept is related to an increase in MS-related symptoms and the progression of the disease.

    “Negative self-concept has been found to be related to depressive and anxiety symptoms in individuals with MS (Wright and Kiropoulos, 2017) and to an increase in MS-related symptoms and the progression of the disease (Jopson and Moss-Morris, 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Jopson and Moss-Morris, 2003 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The ACHC scale had Cronbach's α = 0.81 for total score in this study.

    “Cronbach's α for the total ACHC score in this study was 0.81.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Self-esteem, a component of self-concept, is linked to happiness.

    “Research has found that self-esteem, a component of self-concept, is linked to happiness (Cheng and Furnham, 2004), high positive affect and low negative affect (Orth et al., 2012), and to lower levels of depression (Orth et al., 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cheng and Furnham, 2004 source

  • May combine two claims.

    Study design and conductnone given

    The study employed a cross-sectional design, which does not allow inferences about causality to be made.

    “First, the study employed a crosssectional design, which does not allow inferences about causality to be made.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Self-concept is associated with subjective well-being of individuals and changes in a person's mood and behaviour.

    “Self-concept has been associated with subjective well-being of individuals and changes in a person's mood and behaviour (Halberstadt et al., 1996).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Halberstadt et al., 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

23 of 23

  • The paper relies on this without support.

    Little research has examined the relationship between self-concept and depressive and anxiety symptoms and whether this is moderated by illness acceptance in individuals with multiple sclerosis.

    “Little research has examined the relationship between self-concept and depressive and anxiety symptoms and whether this is moderated by illness acceptance in individuals with multiple sclerosis.”

  • The paper relies on this without support.

    Limited research has been conducted to explore the factors that may explain the variation in levels of depression and anxiety between individuals with MS.

    “While rates of depression and anxiety have been established within an MS population, limited research has been conducted to explore the factors that may explain the variation in levels of depression and anxiety between individuals with MS.”
2 of 2

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • p-value fits an unstated one-tailed test: t(514) = -3.12,p = .001

    Minor

    The paper reports p = .001 here; recomputing from the test statistic and its degrees of freedom gives p = .002 (two-tailed). The reported value is what a one-tailed test gives, but the paper does not say near this result that a one-tailed test was used.

    Reported p = .001 · recomputed p = .002

1 of 1

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upt(514) = -3.12reported p = .001 · recomputed p = .002

    “t(514) = -3.12,p = .001”

  • Consistentχ²(5378) = 1813.03reported p = 1 · recomputed p = 1.000

    “χ 2 (5378) = 1813.03,p = 1.00”

  • ConsistentF(3, 511) = 160.04reported p < .001 · recomputed p < .001

    “F(3, 511) = 160.04,p < .001”

  • Consistentt(514) = -8.36reported p < .001 · recomputed p < .001

    “t(514) = -8.36,p < .001”

  • Consistentt(514) = -5.02reported p < .001 · recomputed p < .001

    “t(514) = -5.02,p < .001”

  • Consistentt(514) = 4.01reported p < .001 · recomputed p < .001

    “t(514) = 4.01, p < .001”

  • ConsistentF(3, 511) = 79.94reported p < .001 · recomputed p < .001

    “F(3, 511) = 79.94,p < .001”

  • Consistentt(514) = -5.62reported p < .001 · recomputed p < .001

    “t(514) = -5.62,p < .001”

  • Consistentt(514) = 2.57reported p = .01 · recomputed p = .010

    “t(514) = 2.57, p = .010”

9 of 9

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Age range differs between the text and Table 1

    Minor

    The results describe the youngest participant as 18, while Table 1 gives a minimum age of 16.

  • Social self-concept SD exceeds its possible range

    Minor

    Table 1 reports a standard deviation of 96.53 for scores ranging only from 18 to 55. A standard deviation that large is impossible for values within that range.

  • Regression coefficient tests use inconsistent degrees of freedom

    Minor

    The depression model reports 511 residual degrees of freedom, but its coefficient tests use 514. The same mismatch occurs in the anxiety model; coefficient tests for these models should use the residual degrees of freedom.

  • Self-concept-anxiety correlation differs from Table 2

    Minor

    The results text reports a correlation of −.53, whereas Table 2 reports −.54 for TSCS-2 and DASS-A.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. Fitts WH, 1996, Tennessee Self-Concept Scale, TSCS: 2 (2nd edn)
  2. Halberstadt JB, 1996, Striving and Feeling: Interactions among Goals, Affect, and Self-Regulation, 123

Cited by

Sorted by citations

Related

Authors
Kiropoulos, L., Ward, N., & Rozenblat, V.
Affiliations
The University of Melbourne (AU)
Corresponding author
Kiropoulos, Litza
ORCID
Venue
Journal of Health Psychology
Publisher
SAGE Publications
Published
2019-08-24
Volume
26
Issue
8
Pages
1197-1206
ISSN
  • 1359-1053 (ISSN-L)
  • 1461-7277
DOI
10.1177/1359105319871639
OpenAlex
W2969679775
Cited by
24
References
30
Citations by year
2026: 5 · 2025: 3 · 2024: 8 · 2023: 2 · 2022: 1 · 2021: 5
FWCI
1.10
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Health Psychology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
multiple sclerosis, self-concept, acceptance of illness, depressive symptoms, anxiety symptoms, moderation, psychological intervention, chronic disease
MeSH terms
Anxiety, Depression, Humans, Multiple Sclerosis, Surveys and Questionnaires, Self Concept

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

Cited sources are checked by gpt-6-sol.

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.

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