The University of Southampton
University of Southampton Institutional Repository

Factors and processes involved in adjustment to multiple sclerosis

Factors and processes involved in adjustment to multiple sclerosis
Factors and processes involved in adjustment to multiple sclerosis
Multiple sclerosis (MS) creates numerous ongoing challenges which, for some, result in negative outcomes such as depression, poor quality of life, and impaired functioning. This thesis aimed to investigate the nature of psychological adjustment to MS and elucidate factors that interventions could address in order to promote successful adjustment. A review of the theoretical literature on chronic illness and a systematic review of the empirical MS literature suggested that various theoretical approaches are useful for explaining aspects of adjustment to MS but no single existing theory offered a comprehensive framework. An integrative cognitive behavioural model of adjustment to MS was proposed and elements of this were examined in the empirical chapters.
In an initial qualitative study, people with MS (n=30) were interviewed about their experiences of living with the disease. Inductively-derived themes characterised the context and process of adjustment and the resources, actions, thoughts and feelings that have a bearing on it. Findings supported and elaborated on the model, and new insights were used to revise it. The quantitative studies were nested within a trial of interventions for adjustment to MS (n=94). A cross-sectional study using pre-therapy data found that cognitive and behavioural variables explained substantial variance in distress and functional impairment. Unhelpful beliefs and behaviours relating to MS itself (illness perceptions and responses to symptoms) appeared most relevant for explaining functional impairment. Beliefs about the self and about experiencing and sharing emotions were important correlates of distress. In an analysis of change within the treatment trial, reductions in unhelpful cognitions and behaviours mediated the improvements observed within interventions. Cognitive and behavioural variables also moderated the effects of the interventions on outcomes. A final qualitative study (n=30) explored participants‘ experiences of the adjustment interventions. The set of interlinked themes provided insights into the broad range of positive outcomes of interventions, perceived therapeutic processes and factors that appear to promote engagement in interventions in this patient group.
Overall, the suggested cognitive behavioural model appears to be a useful means of understanding adjustment. This thesis pinpointed a number of potential cognitions and behaviours which may be important targets for adjustment interventions. Continued research efforts to understand factors that determine a range of adjustment outcomes and to determine what people with MS find helpful and appropriate is necessary for a more complete understanding of successful adjustment to MS and how it can be promoted
Dennison, Laura
15c399cb-9a81-4948-8906-21944c033c20
Dennison, Laura
15c399cb-9a81-4948-8906-21944c033c20
Moss-Morris, Rona
a502f58a-d319-49a6-8aea-9dde4efc871e

Dennison, Laura (2011) Factors and processes involved in adjustment to multiple sclerosis. University of Southampton, Social Sciences, Doctoral Thesis, 408pp.

Record type: Thesis (Doctoral)

Abstract

Multiple sclerosis (MS) creates numerous ongoing challenges which, for some, result in negative outcomes such as depression, poor quality of life, and impaired functioning. This thesis aimed to investigate the nature of psychological adjustment to MS and elucidate factors that interventions could address in order to promote successful adjustment. A review of the theoretical literature on chronic illness and a systematic review of the empirical MS literature suggested that various theoretical approaches are useful for explaining aspects of adjustment to MS but no single existing theory offered a comprehensive framework. An integrative cognitive behavioural model of adjustment to MS was proposed and elements of this were examined in the empirical chapters.
In an initial qualitative study, people with MS (n=30) were interviewed about their experiences of living with the disease. Inductively-derived themes characterised the context and process of adjustment and the resources, actions, thoughts and feelings that have a bearing on it. Findings supported and elaborated on the model, and new insights were used to revise it. The quantitative studies were nested within a trial of interventions for adjustment to MS (n=94). A cross-sectional study using pre-therapy data found that cognitive and behavioural variables explained substantial variance in distress and functional impairment. Unhelpful beliefs and behaviours relating to MS itself (illness perceptions and responses to symptoms) appeared most relevant for explaining functional impairment. Beliefs about the self and about experiencing and sharing emotions were important correlates of distress. In an analysis of change within the treatment trial, reductions in unhelpful cognitions and behaviours mediated the improvements observed within interventions. Cognitive and behavioural variables also moderated the effects of the interventions on outcomes. A final qualitative study (n=30) explored participants‘ experiences of the adjustment interventions. The set of interlinked themes provided insights into the broad range of positive outcomes of interventions, perceived therapeutic processes and factors that appear to promote engagement in interventions in this patient group.
Overall, the suggested cognitive behavioural model appears to be a useful means of understanding adjustment. This thesis pinpointed a number of potential cognitions and behaviours which may be important targets for adjustment interventions. Continued research efforts to understand factors that determine a range of adjustment outcomes and to determine what people with MS find helpful and appropriate is necessary for a more complete understanding of successful adjustment to MS and how it can be promoted

Text
DENNISON_LAURA_FINAL_THESIS.pdf - Other
Download (2MB)

More information

Published date: 23 November 2011
Organisations: University of Southampton, Social Sciences

Identifiers

Local EPrints ID: 208327
URI: http://eprints.soton.ac.uk/id/eprint/208327
PURE UUID: 0c2443c7-9bcc-4eac-bda1-3d24dc1b70ee
ORCID for Laura Dennison: ORCID iD orcid.org/0000-0003-0122-6610

Catalogue record

Date deposited: 20 Jan 2012 11:12
Last modified: 15 Mar 2024 03:26

Export record

Contributors

Author: Laura Dennison ORCID iD
Thesis advisor: Rona Moss-Morris

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×