How to cope with multiple sclerosis: goal adjustment or persistence?

Abstract

Background: According to the Dual Process Model of coping, flexible goal adjustment (FGA) may be a protective factor in chronic illness whereas tenacious goal pursuit (TGP) is considered maladaptive. The present study aimed to investigate the role of these factors in quality of life (QOL) in patients with Multiple Sclerosis (MS). We hypothesized that FGA and acceptance would be associated with better QOL, and that both constructs would significantly reduce the association between disease severity and QOL. Methods: A sample of 120 patients with MS was recruited. They completed validated questionnaires assessing QOL (physical functioning, psychological functioning, psychological distress), acceptance, FGA, and TGP. All hypotheses were tested by linear regression analyses. Findings: Acceptance significantly accounted for variance in all three indexes of quality of life (all β>0.20, p<.05), beyond the effects of demographic and illness characteristics. The role of goal regulation style was less clear. FGA significantly accounted for psychological wellbeing only (β=0.21, p<.05). Surprisingly, TGP predicted better psychological functioning (β=0.19, p<.05) and less psychological distress (β=-0.19, p<.05). No support was found for the hypothesis that acceptance and FGA would moderate the relation between illness severity and quality of life. Discussion: The findings suggest the potential importance of acceptance in understanding MS patients' quality of life, although its hypothesized protective function could not be confirmed. Further conceptual work on goal regulation style and acceptance is needed, as well as prospective work investigating their causal status.