Resilience Matters in Multiple Sclerosis: The Independent Contribution of Psychological Resilience to Disability
ECTRIMS Online Library. Klineova S. 10/25/17; 199603; EP1583
Dr. Sylvia Klineova
Dr. Sylvia Klineova
Contributions
Abstract

Abstract: EP1583

Type: ePoster

Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology

Objective: To identify relationship between psychological resilience and measures of disability in patients with Multiple Sclerosis (MS).
Background: Resilience is a dynamic process encompassing positive adaptation within the context of significant adversity. Resilience facilitates healthy coping skills and thus improves quality of life. Despite the importance of this concept, resilience has been understudied in patients with MS. In this project we analyzed whether greater resilience is associated with lower MS disability, independently of demographics (age, sex, education), cerebral atrophy, anxiety and depression.
Methods: Patients with early MS (87 RRMS, 18 CIS; < 5 years diagnosed; median EDSS = 1.0) completed the Connor-Davidson Resilience Scale 10 item (CD-RISC-10): a well-established measure of psychological resilience. Disability was assessed with the MS Functional Composite (MSFC), which assesses upper extremity function (Nine Hole Peg Test, NHPT), gait (Timed 25 Foot Walk, T25FW), and cognition (Symbol Digit Modalities Test, SDMT). Cerebral atrophy was estimated with normalized brain volume and thalamic volume from 3D T1 3.0T MRIs. Mental Health Inventory assessed anxiety and depression. Any outliers were winsorized. We evaluated partial correlations between resilience and disability (MSFC, NHPT, T25FW, SDMT), controlling for demographics and cerebral atrophy. We then repeated analyses also controlling for anxiety and depression.
Results: Higher resilience was linked to lower disability on the MSFC (rp=.281, p=.005), and components SDMT (rp=.279, p=.005) and NHPT (rp=.252, p=.012), but not T25FW (rp=.037, p>.50). The independent contributions of resilience to lower disability on MSFC (rp=.222, p=.028), SDMT (rp=.224, p=.026), and NHPT (rp=.236, p=.019) remained when also controlling for anxiety and depression. In contrast, MSFC was unrelated to anxiety (rp=.071, p=.487) and depression (rp=.069, p=.500) when controlling for aforementioned covariates and CD-RISC-10. Resilience was unrelated to all demographics
(e.g., education) and cerebral atrophy (Ps>.10).
Discussion: We report a contribution of higher resilience (CD-RISC-10) to lower disability in MS, even independently of anxiety and depression. Lack of association between CD-RISC 10 and potentially confounding factors (cerebral atrophy, education as a proxy for socioeconomic status) strengthen our findings. Further studies are needed to examine whether higher resilience protects longitudinally.
Disclosure:
S. Klineova
has given non-promotional lectures with Biogen Idec.
M. Fabian, G. Pelle, C. Lewis
and J.F Sumowski have nothing to disclose.

Abstract: EP1583

Type: ePoster

Abstract Category: Pathology and pathogenesis of MS - 24 Neuropsychology

Objective: To identify relationship between psychological resilience and measures of disability in patients with Multiple Sclerosis (MS).
Background: Resilience is a dynamic process encompassing positive adaptation within the context of significant adversity. Resilience facilitates healthy coping skills and thus improves quality of life. Despite the importance of this concept, resilience has been understudied in patients with MS. In this project we analyzed whether greater resilience is associated with lower MS disability, independently of demographics (age, sex, education), cerebral atrophy, anxiety and depression.
Methods: Patients with early MS (87 RRMS, 18 CIS; < 5 years diagnosed; median EDSS = 1.0) completed the Connor-Davidson Resilience Scale 10 item (CD-RISC-10): a well-established measure of psychological resilience. Disability was assessed with the MS Functional Composite (MSFC), which assesses upper extremity function (Nine Hole Peg Test, NHPT), gait (Timed 25 Foot Walk, T25FW), and cognition (Symbol Digit Modalities Test, SDMT). Cerebral atrophy was estimated with normalized brain volume and thalamic volume from 3D T1 3.0T MRIs. Mental Health Inventory assessed anxiety and depression. Any outliers were winsorized. We evaluated partial correlations between resilience and disability (MSFC, NHPT, T25FW, SDMT), controlling for demographics and cerebral atrophy. We then repeated analyses also controlling for anxiety and depression.
Results: Higher resilience was linked to lower disability on the MSFC (rp=.281, p=.005), and components SDMT (rp=.279, p=.005) and NHPT (rp=.252, p=.012), but not T25FW (rp=.037, p>.50). The independent contributions of resilience to lower disability on MSFC (rp=.222, p=.028), SDMT (rp=.224, p=.026), and NHPT (rp=.236, p=.019) remained when also controlling for anxiety and depression. In contrast, MSFC was unrelated to anxiety (rp=.071, p=.487) and depression (rp=.069, p=.500) when controlling for aforementioned covariates and CD-RISC-10. Resilience was unrelated to all demographics
(e.g., education) and cerebral atrophy (Ps>.10).
Discussion: We report a contribution of higher resilience (CD-RISC-10) to lower disability in MS, even independently of anxiety and depression. Lack of association between CD-RISC 10 and potentially confounding factors (cerebral atrophy, education as a proxy for socioeconomic status) strengthen our findings. Further studies are needed to examine whether higher resilience protects longitudinally.
Disclosure:
S. Klineova
has given non-promotional lectures with Biogen Idec.
M. Fabian, G. Pelle, C. Lewis
and J.F Sumowski have nothing to disclose.

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