Abbey J Hughes1, Meghan Beier2, Narineh Hartoonian3, Aaron P Turner4, Dagmar Amtmann2, Dawn M Ehde2. 1. Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA. Electronic address: ajhughes@uw.edu. 2. Department of Rehabilitation Medicine, University of Washington, Seattle, WA. 3. Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA. 4. Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA.
Abstract
OBJECTIVES: To determine whether self-efficacy longitudinally predicts 2 types of perceived cognitive impairment (PCI) in multiple sclerosis (MS): general cognitive functioning and executive functioning; and secondarily to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI. DESIGN: Longitudinal analysis of self-report survey data collected over 3 years. Hierarchical regression analyses examined the relationship between self-efficacy and PCI, adjusting for depression and fatigue. Additional analyses tested self-efficacy as a mediator between depression, fatigue, and PCI. SETTING: Community. PARTICIPANTS: Community-dwelling individuals with MS (N=233; age range, 22-83y) were recruited from a larger longitudinal survey study of individuals with MS (N=562). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Primary outcome measures were the Applied Cognition-General Concerns and the Applied Cognition-Executive Function domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures. RESULTS: Self-efficacy was significantly correlated with PCI at baseline (r=.40-.53) and 3 years later (r=.36-.44). In multivariate regression analyses, self-efficacy was a significant longitudinal predictor of PCI, both for general cognitive functioning (β=.20, P<.01) and executive functioning (β=.16, P<.05). Self-efficacy partially mediated the relationships between depression, fatigue, and PCI. CONCLUSIONS: Self-efficacy may influence how individuals with MS perceive their cognitive functioning over time. Interventions that target self-efficacy, particularly early in the disease course, may lead to improvements in PCI, as well as improvements in fatigue and depression.
OBJECTIVES: To determine whether self-efficacy longitudinally predicts 2 types of perceived cognitive impairment (PCI) in multiple sclerosis (MS): general cognitive functioning and executive functioning; and secondarily to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI. DESIGN: Longitudinal analysis of self-report survey data collected over 3 years. Hierarchical regression analyses examined the relationship between self-efficacy and PCI, adjusting for depression and fatigue. Additional analyses tested self-efficacy as a mediator between depression, fatigue, and PCI. SETTING: Community. PARTICIPANTS: Community-dwelling individuals with MS (N=233; age range, 22-83y) were recruited from a larger longitudinal survey study of individuals with MS (N=562). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Primary outcome measures were the Applied Cognition-General Concerns and the Applied Cognition-Executive Function domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures. RESULTS: Self-efficacy was significantly correlated with PCI at baseline (r=.40-.53) and 3 years later (r=.36-.44). In multivariate regression analyses, self-efficacy was a significant longitudinal predictor of PCI, both for general cognitive functioning (β=.20, P<.01) and executive functioning (β=.16, P<.05). Self-efficacy partially mediated the relationships between depression, fatigue, and PCI. CONCLUSIONS: Self-efficacy may influence how individuals with MS perceive their cognitive functioning over time. Interventions that target self-efficacy, particularly early in the disease course, may lead to improvements in PCI, as well as improvements in fatigue and depression.
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