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Thesis

Coping and adjustment in people with multiple sclerosis: Integration of the literature and ramifications for psychological treatment

26 July 1999

Abstract

This thesis reviews the literature on stress, coping, and adjustment in people with multiple sclerosis (MS). The literature is grouped into five major sections. First, studies focusing on the relationship between stress and MS exacerbations are reviewed. The most important finding is that the intensity, but not overall number, of stressful life events contributes to the occurrence of exacerbations. Second, the effects of disease uncertainty and uncontrollability are discussed. No clear effects of disease uncertainty or uncontrollability are identified in the literature. Third, research into the psychological symptoms of people with MS is reviewed. Depression is by far the most common psychological symptom associated with MS. Fourth, studies examining self-esteem and self-concept in MS patients are summarized. It appears that self-concept tends to improve over time in MS patients unless a high level of physical restriction is experienced. Finally, the fifth section summarizes the studies that focus on adaptation in people with MS. The most significant finding in this area is that contact with healthy people and social support' tend to improve adaptation in MS patients. Following the review, the research in this area is critiqued and suggestions for improving future research are discussed. Treatments for MS patients which consist mainly of group based interventions which target depressive symptoms as well as improving adaptation are recommended in view. of the research on the needs of people with MS.


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