STABILITY AND DETERMINANTS OF PSYCHOSOCIAL WELL-BEING IN MULTIPLE-SCLEROSIS

Illness intrusiveness - illness-induced life style disruptions - was h ypothesized to compromise psychosocial well-being in multiple sclerosi s (MS) by (a) interfering with continued involvements in valued activi ties and interests and (b) decreasing personal control over important life domains. Three categories of illness-related variables were hypot hesized to contribute to increased illness intrusiveness: burden of il lness (i. e., direct physical action and effects of disease), function al deficits (i.e., operational deficits in discrete functional systems ), and physical disabilities (i.e., limitations to the integrated perf ormance of more complex functions). Measures of illness intrusiveness, personal control, psychosocial well-being and illness-related variabl es were obtained from 94 people with MS on three occasions over 18 mon ths. Surprisingly, all disease and psychosocial variables were highly stable. Hierarchical multiple regression analyses, controlling for rec ent stressful life events, supported the proposed model. Regression an alyses also indicated that each of the hypothesized determinants was s ignificantly and uniquely related to the perception of illness intrusi veness. Approximately two-thirds of participants appeared to achieve a positive psychosocial adjustment to MS. However, the remaining one-th ird reported elevated levels of emotional distress.