Is personality profile a relevant determinant of fatigue in multiple sclerosis?

Construction and validation of a nomogram for predicting fatigue in climacteric women

OBJECTIVE

The aim was to develop and validate a nomogram for evaluating the risk of fatigue in climacteric women and to assess its clinical application value.

METHODS

Clinical information was collected from 402 climacteric women who visited a tertiary hospital in Shanghai between November 2023 and April 2024. Network analysis methods were utilized to analyze the core symptom (fatigue). The study participants were then randomly divided into training and validation cohorts in a 7:3 ratio. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for fatigue in climacteric women. A nomogram prediction model was established based on these independent risk factors. The predictive performance of the model was evaluated using the concordance index, area under the curve, receiver operating characteristic curve, Hosmer-Lemeshow test, and calibration curve analysis. Additionally, decision curve analysis was performed to assess the model's performance in clinical applications.

RESULTS

Fatigue is identified as the core symptom in climacteric women. Educational level, chronic diseases, and depression status are independent influencing factors for fatigue in menopausal women. The area under the curve for the training cohort and validation cohort are 0.813 (95% CI, 0.743-0.884) and 0.759 (95% CI, 0.637-0.879), respectively, indicating that the model possesses good discriminative ability. The calibration curve shows good consistency between the predicted probabilities and actual probabilities in both the training and validation cohorts. Additionally, the P values for the Hosmer-Lemeshow test in the training and validation sets are 0.233 and 0.197, respectively, indicating good model calibration. Finally, the decision curve analysis curve demonstrates that the model has good clinical utility.

CONCLUSIONS

A simple nomogram based on three independent factors (educational level, chronic diseases, and depression status) can aid in clinically predicting the risk of fatigue in climacteric women.

Personality matters: Exploring the associations of personality traits with mood and somatic symptoms in multiple sclerosis

BACKGROUND

Research suggest that personality traits influence the mood and somatic symptoms in various different clinical populations. Neuroticism, extraversion, conscientiousness, openness to experience, and agreeableness have been identified as potential predictors of mood and somatic symptoms. However, the literature on personality traits and symptom outcomes in multiple sclerosis (MS) is limited, highlighting the necessity for more in-depth research.

OBJECTIVE

This Cross-sectional study aimed to investigate the association between personality traits and symptomatology in individuals with MS using two separate studies and different personality assessment tools- the NEO Five-Factor Inventory (NEO-FFI) and the Ten Item Personality Inventory (TIPI).

METHODS

Participants completed surveys assessing mood and somatic symptoms. Linear regression analyses were performed to examine the associations between personality traits and MS symptoms controlling for demographic variables.

RESULTS

.The analyses were performed on data from 63 individuals with MS for Study 1 (assessing the NEO-FFI) and 1183 individuals with MS for Study 2 (assessing the TIPI), respectively. Neuroticism was consistently associated with more somatic and mood symptoms in both sample (medium to large effect sizes; β = -0.05 to β = 0.60) Extraversion and conscientiousness were associated with fewer symptoms in Study 2.

CONCLUSIONS

This study highlights the importance of considering personality factors in understanding and managing symptoms in MS. However, further research is needed to understand the causal relationships between personality and symptom outcomes in MS.

Personality Traits and Fatigue in Multiple Sclerosis: A Narrative Review

(1) Background: Multiple sclerosis (MS) is a chronic neurodegenerative autoimmune disease. Fatigue is a prevalent and debilitating symptom that significantly impacts the quality of life of these patients. A relationship between personality traits and fatigue in MS has been hypothesized but not clearly defined. (2) Methods: A literature search was carried out from databases up to April 2023 for studies correlating personality traits and fatigue in patients suffering from MS. (3) Results: A total of ten articles was included; most of the studies depict a neuroticism-fatigue correlation; however, they were not consistent in terms of the fatigue, personality, and covariate assessments. (4) Conclusions: The clinical and methodological heterogeneity of the included studies prevented us from drawing any firm conclusion on the link between personality traits and fatigue in MS. Several models of personality and different fatigue assessments have been found. Despite this, a common pathway shows that the neuroticism trait or similar personality patterns has a role in fatigue diagnosis. This may be a useful target to improve the quality of life and enhance the modification of the disease treatment results. Further homogeneous and longitudinal studies are needed.

Investigating Relationships Among Interoceptive Awareness, Emotional Susceptibility, and Fatigue in Persons With Multiple Sclerosis

BACKGROUND

Fatigue is a particularly debilitating symptom for people with multiple sclerosis (MS). Although personality traits and MS have been studied, interoception and emotional susceptibility and their links to fatigue have not yet been explored.

METHODS

Study participants provided demographic information and completed standardized patient-reported outcomes of walking function, physical activity, subjective fatigue, interoceptive awareness, and emotional susceptibility. A subset of participants participated in semistructured interviews discussing fatigue, body sensations, emotions, and their effects on exercise. Quantitative data were analyzed using multiple regression. Qualitative data were analyzed using thematic analysis.

RESULTS

Mean ± SD Fatigue Severity Scale scores (5.0 ± 1.3) indicated that fatigue was a problematic symptom. Mean ± SD Multidimensional Assessment of Interoceptive Awareness, Version 2 (2.8 ± 0.6) and Emotional Susceptibility Scale (3.0 ± 1.0) scores indicated lower levels of interoceptive awareness and emotional susceptibility. Quantitative data indicated no relationship between fatigue and interoceptive awareness (β = -0.20; P = .88) and emotional susceptibility (β = 0.03; P = .83), and neither were these related to physical activity (β = -0.07; P = .64). Qualitative themes indicated strong fatigue experiences involving the whole body and individual limbs, anger and frustration, and effects on physical activity.

CONCLUSIONS

Physically active people with MS report strong sensations of fatigue closely linked to frustration and helplessness. There was agreement between qualitative and quantitative assessments of fatigue but dissonance regarding interoceptive awareness and physical activity. The practice of clinicians, particularly those involved with facilitating or planning physical activity for persons with MS, would benefit from these findings about fatigue.

Clinical correlates of state and trait anxiety in multiple sclerosis

BACKGROUND

Anxiety represents one of the most prevalent psychiatric symptoms in multiple sclerosis (MS), impacting the overall disease burden and quality of life. This psychopathological feature can be expressed as state (S-ANX) and trait (T-ANX) anxiety, but few studies specifically evaluated these two components in MS. The present study was aimed at investigating the prevalence and specific correlates of S-ANX and T-ANX in a cohort of people with MS (PwMS).

METHODS

88 in- and out-patients with MS were consecutively recruited. S-ANX and T-ANX were evaluated with the two subscales of the State and Trait Anxiety Inventory. Bivariate analyses were performed to compare PwMS who displayed clinically significant S-ANX and T-ANX and those who did not. Two logistic regression models were run in order to identify variables significantly associated with S-ANX and T-ANX.

RESULTS

S-ANX and T-ANX presented a prevalence of 42% and 45.5%, respectively. S-ANX was more frequent in subjects hospitalized due to recent MS onset. PwMS and S-ANX more frequently had a recent relapse, as well as evidence of disease activity on brain magnetic resonance imaging. Subjects with T-ANX were more often females and displayed higher severity of fatigue. Depressive features at the Beck Depression Inventory were more severe in both S-ANX and T-ANX subjects. PwMS with S-ANX reported a higher prevalence of T-ANX and vice versa. At the logistic regressions, depression severity displayed a significant association with S-ANX and T-ANX. We also detected positive associations between S-ANX and inpatient status, as well as between T-ANX and female sex.

CONCLUSION

Both S-ANX and T-ANX are highly prevalent features in PwMS. These two components of anxiety should be adequately identified and discriminated in the clinical practice. The higher severity of depression in PwMS with clinically significant anxiety should not be neglected.

Personality and fatigue: meta-analysis of seven prospective studies

The present study examined the cross-sectional and longitudinal associations between the five major personality traits and fatigue. Participants were adults aged 16-104 years old (N > 40,000 at baseline) from the Health and Retirement Study, the National Social Life, Health, and Aging Project, the Wisconsin Longitudinal Study graduate and sibling samples, the National Health and Aging Trends Survey, the Longitudinal Internet Studies for the Social Sciences and the English Longitudinal Study of Ageing. Personality traits, fatigue, demographic factors, and other covariates were assessed at baseline, and fatigue was assessed again 5-20 years later. Across all samples, higher neuroticism was related to a higher risk of concurrent (meta-analytic OR = 1.73, 95% CI 1.62-1.86) and incident (OR = 1.38, 95% CI 1.29-1.48) fatigue. Higher extraversion, openness, agreeableness, and conscientiousness were associated with a lower likelihood of concurrent (meta-analytic OR range 0.67-0.86) and incident (meta-analytic OR range 0.80-0.92) fatigue. Self-rated health and physical inactivity partially accounted for these associations. There was little evidence that age or gender moderated these associations. This study provides consistent evidence that personality is related to fatigue. Higher neuroticism and lower extraversion, openness, agreeableness, and conscientiousness are risk factors for fatigue.

Personality traits of patients with multiple sclerosis and their correlation with anxiety and depression levels: A cross‐sectional case–control study

Objective

Multiple sclerosis is a chronic demyelinating disease of the central nervous system that can cause severe disability and impair the quality of life (QoL).

Methods

In the current cross‐sectional, case–control study, we investigated personality traits, anxiety and depression levels, in 101 patients in the case group and 202 individuals as a control group. The personality traits of the participants were collected via the Neuroticism‐Extraversion‐Openness Five‐Factor Inventory (NEO‐FFI) questionnaire. We evaluated the level of anxiety and depression based on the Hospital Anxiety and Depression Scale questionnaire.

Results

Our study showed in patients with disease duration above 1 year, the rates of agreement (29.78), anxiety (8.83), and depression level (6.39) were significantly higher than the control group (27.19, 6.47, and 4.97, respectively). Although patients with disease duration below 1 year showed a higher level of agreement and conscientiousness (29.65 and 34.35, respectively) than controls (26.6 and 30.86, respectively). The level of anxiety and depression in patients with a disability index above 4.5 was significantly higher than patients with a disability index below 1. Patients with a disability index below 1 showed a higher rate of extraversion and agreement and conscientiousness (31.47, 31.53, and 35.07, respectively) than controls (25.5, 26.23, and 3033, respectively). In addition, patients with a disability index above 4.5 showed a higher level of agreement (35.64), conscientiousness (35.5), anxiety (9.64), and depression (7.5) than controls (25.96, 30.71, 6.96, and 4.71, respectively).

Conclusions

In conclusion, anxiety and depression levels were much higher among MS patients compared with controls and the severity of these conditions correlate with the score of the disability index. Therefore, a complete comprehension of these conditions by the neurologist could be vital in improving patients’ QoL and increasing compliance and adherence to pharmacological therapy.

Personality traits of patients with multiple sclerosis and their correlation with anxiety and depression levels: A cross-sectional case-control study

OBJECTIVE

Multiple sclerosis is a chronic demyelinating disease of the central nervous system that can cause severe disability and impair the quality of life (QoL).

METHODS

In the current cross-sectional, case-control study, we investigated personality traits, anxiety and depression levels, in 101 patients in the case group and 202 individuals as a control group. The personality traits of the participants were collected via the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) questionnaire. We evaluated the level of anxiety and depression based on the Hospital Anxiety and Depression Scale questionnaire.

RESULTS

Our study showed in patients with disease duration above 1 year, the rates of agreement (29.78), anxiety (8.83), and depression level (6.39) were significantly higher than the control group (27.19, 6.47, and 4.97, respectively). Although patients with disease duration below 1 year showed a higher level of agreement and conscientiousness (29.65 and 34.35, respectively) than controls (26.6 and 30.86, respectively). The level of anxiety and depression in patients with a disability index above 4.5 was significantly higher than patients with a disability index below 1. Patients with a disability index below 1 showed a higher rate of extraversion and agreement and conscientiousness (31.47, 31.53, and 35.07, respectively) than controls (25.5, 26.23, and 3033, respectively). In addition, patients with a disability index above 4.5 showed a higher level of agreement (35.64), conscientiousness (35.5), anxiety (9.64), and depression (7.5) than controls (25.96, 30.71, 6.96, and 4.71, respectively).

CONCLUSIONS

In conclusion, anxiety and depression levels were much higher among MS patients compared with controls and the severity of these conditions correlate with the score of the disability index. Therefore, a complete comprehension of these conditions by the neurologist could be vital in improving patients' QoL and increasing compliance and adherence to pharmacological therapy.

Fatigue, Depression, and Anxiety Among Ambulating Multiple Sclerosis Patients

Background

Multiple sclerosis (MS) is an inflammatory disease associated with adverse effects: including depression, anxiety, fatigue, which may affect physical activity and the quality of life (QoL) among patients with MS (pwMS).

Objective

This study aims to assess the prevalence of depression, anxiety, and fatigue among pwMS who have no physical disability in Saudi Arabia, and demonstrate any correlation between these factors and physical activity as well as the QoL.

Methods

A cross-sectional study was conducted in the Neuroimmunology outpatient clinics in King Fahad Medical City (KFMC) and King Saud University Medical City (KSUMC) in Riyadh City, KSA. The Arabic version of the Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression levels. The HADS scores were then categorized into three levels according to the total points: normal (0–7 points), borderline (7–10 points), and anxiety/depression (11 – 21 points). The Arabic version of the Fatigue Severity Scale (FSS) was used to measure fatigue (cut-off point ≥5). The physical activity was measured by the Arabic version of the short form of the International Physical Activity Questionnaire (IPAQ), which measure time spent walking, moderate- and vigorous-intensity physical activity of at least 10 minutes duration. The QoL was also measured by the Arabic version of the EuroQOL five-dimensional (EQ-5D-3L) instrument (i.e., mobility, self-care, usual activities, pain/discomfort, and anxiety/depression).

Results

A total of 323 pwMS participated in this study, 83 had scores that indicated anxiety (25.7%) and 44 had depression (13.6%). The majority of patients had scores with the normal range of depression and anxiety (70% and 57% respectively). The mean of EuroQol Group visual analogue scale (EQ-VAS) score was 80.43 (SD=19.8). 156 (48.3%) out of 323 pwMS reported fatigue while the remainder had no fatigue (n=167, 51.7%). The results indicate that only 143 patients (44.3%) had participated in vigorous physical activity during the last 70 days, with a median of 3 days per week (IQR= 5–3) and a median of 60 minutes per day 0 (Interquartile range: IQR = 60–30). Only 149 patients (49.2%) had patricpated in moderate physical activities during the previous week with a median of 3 days per week (IQR = 5–3) and a median of 40 minutes per day (IQR = 60–30). 194 patients had participated in walking activities (60.0%) with a median of 5 days per week (IQR = 7–3) and a median of 45 minutes per day (IQR = 60–30). The results revealed that fatigue was positively correlated with depression (r = 0.407, p-value < 0.001) and anxiety (r = 0.289, p-value < 0.001).

Conclusion

The current study shows depression, anxiety, and fatigue tend to be correlated and clustered together among pwMS in our cohort. However, fatigue is not associated with the intensity of physical activity undertaken. The results of this study are important for the improvement of the clinical management of MS patients.

The association of personality traits with poststroke fatigue in daily life: An exploratory experience sampling method and cross-sectional study

Fatigue is a frequently occurring and persistent symptom after stroke. Many biological, psychosocial, and behavioural factors are associated with poststroke fatigue, but research into associations with personality traits is relatively sparse. In this study, we explored whether personality traits were related to poststroke fatigue measured with conventional fatigue questionnaires as well as experience sampling methodology (ESM). Twenty-four individuals with stroke completed 10 daily questionnaires about momentary (here-and-now) fatigue for six consecutive days using the mHealth ESM application PsyMate^TM. Further, they completed questionnaires assessing personality (NEO-FFI and LOR-T) and fatigue (FSS). Results showed that higher extraversion (ß = -.44, SE = .12, p = .001; 95% CI = -.67-.19) and optimism (ß = -.18, SE = .06, p = .007; 95% CI = -.30-.05) were associated with lower momentary fatigue. No association was found between neuroticism and momentary fatigue, but higher neuroticism (r = 0.531, p = .008, 95% CI = .160-.759; r = .574, p = .003, 95% CI = .245-.767) was associated with higher scores on the retrospective FSS scales. We conclude that personality traits differentially influence poststroke fatigue, but this also depends on the way fatigue is measured (with retrospective or with momentary measures). When functional gains are not in line with expected progress during the rehabilitation treatment of fatigue, it may be appropriate to take into account how person characteristics are related to momentary fatigue.

Fatigue in patients with chronic disease: results from the population-based Lifelines Cohort Study

(1) To evaluate the prevalence of severe and chronic fatigue in subjects with and without chronic disease; (2) to assess to which extent multi-morbidity contributes to severe and chronic fatigue; and (3) to identify predisposing and associated factors for severe and chronic fatigue and whether these are disease-specific, trans-diagnostic, or generic. The Dutch Lifelines cohort was used, including 78,363 subjects with (n = 31,039, 53 ± 12 years, 33% male) and without (n = 47,324, 48 ± 12 years, 46% male) ≥ 1 of 23 chronic diseases. Fatigue was assessed with the Checklist Individual Strength-Fatigue. Compared to participants without a chronic disease, a higher proportion of participants with ≥ 1 chronic disease were severely (23% versus 15%, p < 0.001) and chronically (17% versus 10%, p < 0.001) fatigued. The odds of having severe fatigue (OR [95% CI]) increased from 1.6 [1.5–1.7] with one chronic disease to 5.5 [4.5–6.7] with four chronic diseases; for chronic fatigue from 1.5 [1.5–1.6] to 4.9 [3.9–6.1]. Multiple trans-diagnostic predisposing and associated factors of fatigue were found, explaining 26% of variance in fatigue in chronic disease. Severe and chronic fatigue are highly prevalent in chronic diseases. Multi-morbidity increases the odds of having severe and chronic fatigue. Several trans-diagnostic factors were associated with fatigue, providing a rationale for a trans-diagnostic approach.

How personality traits affect functional outcomes in patients with multiple sclerosis: A scoping review on a poorly understood topic

Personality is an important variable when explaining individual differences in disease acceptance, coping styles and psychological well-being. Personality changes, such as social inadequacy, disinhibition, apathy, emotional lability, and impulsivity, have been reported in many patients with multiple sclerosis (MS). This review sought to assess the role of personality traits in people with MS, focusing on how this may affect the patient's outcome. Studies were identified by searching on PubMed, Web Of Science and Cochrane databases. Our review shows that the personality traits commonly found in MS are often dysfunctional. In particular, it has been suggested that people with MS present with lower levels of conscientiousness, extraversion and agreeableness, as well as higher levels of neuroticism than healthy controls. These personality traits negatively affect cognitive domains, mood, and psychological well-being. As personality may affect the clinical manifestations and disabilities of patients with MS, personality assessment should be an integral part of the management of the disease, in order to achieve better functional outcomes.

Identifying the relevant determinants of MS related fatigue: The role of the clinical indicators of disease and personality

BACKGROUND AND OBJECTIVE

Research on the factors contributing to multiple sclerosis (MS) related fatigue are far from conclusive. Some studies put forward that clinical aspects of the disease give rise to this symptom whilst others emphasize the effects of psychological factors on its etiology. This study investigated the relationship between clinical aspects of MS and personality with MS fatigue.

METHOD

A total of 201 participants with MS of which 48 (23.9%) males and 153 (76.1%) females took part in this online study. Questionnaires were populated measuring clinical features of the disease (disease duration, type of MS, Expanded Disability Status Scale - EDSS), personality traits, and MS-related fatigue. Data was analyzed by hierarchical regression analyses.

RESULTS

Personality traits accounted for a greater variance in MS fatigue (R² = .482, p < .01) than clinical aspects of the disease, these results were conclusive after controlling for the sociodemographic variables and depression. Temperament explained in total 10.5% variance of fatigue and character an additional 4.0 %. High Harm avoidance (HA) (β = .229, p < .01) and low Self-directedness (SD) (β = -.217, p < .01) directly predicted fatigue. Also, temperament was shown to indirectly affect fatigue, through character. High HA and high Novelty-seeking (NS) through low SD predicted fatigue. The association between clinical features and fatigue was not observed unless paired with personality traits. EDSS in conjunction with HA and Secondary - progressive MS (SPMS) coupled with SD negatively affected fatigue levels.

CONCLUSION

Personality traits directly and indirectly predicted MS-related fatigue. Furthermore, the impact of clinical indicators of disease on fatigue would not be observed unless these features occurred together with particular personality traits.

Fatigue in Multiple Sclerosis is related to relapses, autonomic dysfunctions and introversion: A quasi-experimental study

BACKGROUND

Fatigue in Multiple Sclerosis (MS) might be partially due to inflammatory processes. If so, relapses should increase the fatigue level.

METHODS

Two groups of MS patients participated in this study. One suffered from a relapse and was treated by Methylprednisolone. The other group experienced a deterioration of their neurological condition but no relapse and received neurological rehabilitation. We assessed fatigue before admission, at admission and after discharge (t1, t2, t3). Furthermore, autonomic dysfunctions, depressive mood, apathy and extraversion were assessed at admission. Changes in fatigue were analysed with ANCOVAs and fatigue levels were analysed with regression analyses using clinical data and scores for depressive mood, apathy, extraversion and autonomic dysfunctions.

RESULTS

Only patients suffering from a relapse showed a significant increment in fatigue from t1 to t2. Regression analyses revealed that autonomic dysfunctions and introversion best explained the fatigue level.

CONCLUSIONS

This study shows that a relapse is accompanied by an increase in MS-related fatigue. Moreover, autonomic dysfunctions and introversion, more than depression and apathy, play a major role in the explanation of MS-related fatigue. This finding represents additional evidence for the relationship between inflammation, vagal afferent signaling, autonomic dysfunctions, introversion and the feeling of MS-related fatigue.

Salivary IL-1ß as an Objective Measure for Fatigue in Multiple Sclerosis?

Background: The causes of fatigue in multiple sclerosis (MS) and other inflammatory disorders are not well understood. One possible cause that might explain fatigue in inflammatory disorders appears to be the immunological process itself, triggering neural activity that is experienced as fatigue.

Objectives: To investigate whether salivary IL-1ß concentration, associated with systemic inflammation, is related to subjective fatigue in MS.

Methods: 116 MS patients (62 relapsing remitting MS, 54 secondary progressive MS) and 51 healthy controls participated in this study. Salivary concentration of IL-1ß was determined using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Fatigue was assessed using various fatigue scales. We compared IL-1ß concentration between groups and performed regression analyses to investigate which variables best predict fatigue scores.

Results: We found that the IL-1ß concentration best predicts fatigue scores in relapsing remitting MS patients, even though the IL-1ß concentration did not differ significantly between relapsing remitting MS patients and healthy controls. Secondary progressive MS patients showed a somewhat elevated IL-1ß concentration compared to relapsing remitting MS patients and healthy controls. Furthermore, disease modifying treatment had a significant effect on the IL-1ß concentration, with treated patients showing a lower IL-1ß concentration than non-treated patients.

Conclusions: The present study points to a significant relation between the proinflammatory cytokine IL-1ß and fatigue in relapsing remitting MS patients. It also suggests a potential effect of disease modifying treatment on the peripheral IL-1ß concentration.

Changes to the septo-fornical area might play a role in the pathogenesis of anxiety in multiple sclerosis

BACKGROUND

Reports on the relationships between white matter lesion load (WMLL) and fatigue and anxiety in multiple sclerosis (MS) are inconsistent.

OBJECTIVE

To investigate the association of total and tract-specific WMLL with fatigue and anxiety.

METHODS

Total and regional T2 WMLL was assessed for 19 tracts in 48 MS patients (30 females). ICBM-DTI-81 Atlas-based parcellation was combined with WMLL segmentation of T2-weighted magnetic resonance imaging (MRI). Fatigue, anxiety, and depression were assessed using Fatigue Impact Scale, State Trait Anxiety Inventory, and Beck Depression Inventory, respectively.

RESULTS

Fatigue, anxiety, and depression showed significant inter-correlation. We found no association between fatigue and total or regional WMLLs, whereas anxiety was associated with total and regional WMLLs in nine tracts. After adjusting for total WMLL, age, and depression, only the column and body of the fornix (CBF) remained significantly associated with anxiety. Post hoc analyses showed no CBF lesions on T1-weighted MRI and suggested, but could not confirm, that the septum pellucidum might play a role in the pathogenesis of anxiety.

CONCLUSION

Our results suggest that anxiety in MS patients may have a neuropathological substrate in the septo-fornical area, which requires further validation using larger sample size and ultra-high-field MRI in targeted prospective studies.

Cognitive-constructivist Approach in Medical Settings: The Use of Personal Meaning Questionnaire for Neurological Patients' Personality Investigation

Objective: The cognitive-constructivist psychotherapy approach considers the self as a continuous regulation process between present and past experience, in which attributions of meaning is characterized by the use of internal rules. In this conception, everyone would be driven by a specific inner coherence called Personal Meaning Organization (PMO). Such approach has never been applied to neurological patients by means of ad hoc developed tools. We performed an explorative study aimed to characterize personality styles in different neurological conditions within the theoretical framework of cognitive-constructivist model.

Materials and Methods: Three groups of neurological patients (Amyotrophic Lateral Sclerosis, Multiple Sclerosis, Primary Headache) and a sample of healthy participants, each composed by 15 participants, for a total of 60 participants, were recruited. The Personal Meaning Questionnaire (PMQ), an Italian questionnaire assessing PMOs construct, and other clinical tools for psychological and quality of life assessment were administered to all subjects.

Results: The main finding concerned the detection, across all clinical conditions, of a higher prevalence of phobic personality style, with Amyotrophic Lateral Sclerosis showing a relevant prevalence of such PMO with respect to all other neurological conditions and controls. However, with respect to controls, in all clinical conditions, PMQ highlighted a tendency, even if not statistically significant, to codify experience by means of specific cognitive and emotional patterns.

Conclusion: Our findings represent the first contribution towards understanding the personality profiles of patients affected by neurological conditions according to cognitive-constructivist theory.

Psychological profiles of patients with multiple sclerosis based on Hobfoll’s conservation of resources theory

<b>Background</b><br /> The psychological perspective plays a crucial role in designing therapy for people suffering from multiple sclerosis. The aim of the article is to distinguish different psychological profiles of patients.<br /> <br /> <b>Participants and procedure</b><br /> The study was conducted using the paper-and-pencil method on 77 patients suffering from multiple sclerosis. The theory we applied was Hobfoll’s conservation of resources theory. We also analyzed the impact of personal and situational variables on the functioning of patients with different kinds of resources.<br /> <br /> <br /> <b>Results</b><br /> Cluster analysis was used to construct the profiles of patients. Based on statistical analyses using the k-means method, we distinguished: Profile 1, with a prevalence of resource losses (n = 30), Profile 2, covering people who value their resources the most (n = 25), and Profile 3, with a prevalence of resource gains (n = 18).<br /> <br /> <b>Conclusions</b><br /> The obtained psychological profiles reflect the varied dynamics of the patients’ functioning and should inspire an improvement of multidisciplinary rehabilitation.

Factors contributing to the development of perceived stigma in people with newly diagnosed epilepsy: A one-year longitudinal study

PURPOSE

We evaluated the course of perceived stigma and the factors associated with perceived stigma over the first year in newly diagnosed people with epilepsy (PWE).

METHODS

We recruited newly diagnosed PWE from 12 tertiary hospitals in Korea. The perceived stigma of epilepsy was assessed using the Stigma Scale at baseline and one year later. At the time of diagnosis, demographic, clinical seizure-related, and psychological data were collected. The predictive factors for perceived stigma over one year were analyzed using logistic regression analyses.

RESULTS

Two hundred eighteen newly diagnosed PWE were included at baseline, and 153 completed the study. The percentage of participants who felt stigmatized decreased from 30.7% at the time of diagnosis to 17.6% at the end of follow-up. Introverted personality and a high level of anxiety were independent factors contributing to stigma at the time of epilepsy diagnosis. At the one-year follow-up, introverted personality and lower economic status were predictive of the development of perceived stigma.

CONCLUSION

Introverted personality was an important factor contributing to the development of perceived stigma at the time of diagnosis and at one year after diagnosis. In addition, a high level of anxiety and a low economic status were independently related to feelings of stigma at baseline and at one year after diagnosis, respectively. There may be a decrease in the perception of stigma over one year in newly diagnosed PWE.