Social-psychological adjustment to multiple sclerosis. A longitudinal study.

This study employs a longitudinal design to analyze the adjustment process of 103 people diagnosed with multiple sclerosis and in the middle and later stages of their illness careers. The mean age of the sample at Time 2 is 52 years, and mean duration since diagnosis is 17 years. A highly reliable self concept measure is the indicator of adjustment and changes in adjustment from T1 (1974) to T2 (1981). Four sets of variables are analyzed in their relationship to adjustment: (1) socio-demographic; (2) disease-related; (3) medical; and (4) social-psychological. Females are more likely than males to show positive adjustment (improving self concepts). Hours of employment and living arrangement are also related to the adjustment process. The vast majority of respondents show only slight decline in mobility, but among the disease related variables, number of episodes (exacerbations) in past seven years is the strongest predictor of changes in adjustment. Nearly half the respondents seek medical attention for their M.S. once a year or less, and the choice of health care professional is related to changes in the course of the disease. Subjects with an internal locus of control have more positive adjustment scores. Those who say they cope through acceptance of the disease show improvements in self concept while those reporting religion or family as major coping strategies have decreasing self concepts. Results indicate that the majority make satisfactory adjustment as indicated by maintenance of positive self concepts over the 7 year period, although the disease is chronic and progressive. For patients in the middle and later stages of illness careers, the data suggest comprehensive rehabilitation efforts that enhance autonomy and develop the social-psychological resources of the lifestyle.