Coping Style Moderates the Effects of Pain on Depression in Multiple Sclerosis: A Possible Target for Intervention
Open Access
- Author:
- Bradson, Megan Lynn
- Graduate Program:
- Psychology
- Degree:
- Master of Science
- Document Type:
- Master Thesis
- Date of Defense:
- September 23, 2021
- Committee Members:
- Peter Andrew Arnett, Thesis Advisor/Co-Advisor
Frank Gerard Hillary, Committee Member
Kristin Buss (she/her), Program Head/Chair
Jennifer Elise Graham-Engeland, Committee Member - Keywords:
- multiple sclerosis
pain
depression
coping - Abstract:
- Objective. The present study examined coping style as a possible moderator in the relationship between pain and depression in persons with multiple sclerosis (PwMS). Methods. Fifty-four PwMS completed a comprehensive neuropsychological test battery and psychosocial questionnaires that assessed physical, cognitive, and emotional functioning. Using four pain indices (i.e., average pain, current pain, pain intensity composite, and pain interference composite) from the Brief Pain Inventory (BPI), an overall pain index was created to capture a more comprehensive index of individuals’ overall pain intensity and interference. The COPE questionnaire was used to derive three coping indices: active coping, avoidant coping, and a composite cope index that accounts for the relative contributions of both active and avoidant coping. The Beck Depression Inventory-Fast Screen (BDI-FS) was used to measure depression. A series of hierarchical linear regressions were conducted with depression as the outcome variable. Overall pain, each conceptualization of coping style, and their interactions were included as predictors. Disability status, measured with the Expanded Disability Status Scale (EDSS), and previous treatment for depression were included as covariates in the final analyses. Results. Regression analyses revealed that the interactions between overall pain and each conceptualization of coping were significant (p = .001-.003). Simple effects tests revealed that overall pain only predicted depression in PwMS with low active coping (p < .001), high avoidant coping (p < .001), and low composite coping index (i.e., less adaptive coping; p < .001). Overall pain did not predict depression in PwMS who utilized more active coping, less avoidant coping, or a combination of the two represented by the composite cope index. Conclusion. Coping style moderated the relationship between pain and depression in PwMS. More specifically, we found that pain predicted depression in PwMS who utilized more avoidant and less active coping strategies. Overall, these findings suggest that helping PwMS develop more active coping skills while relying less on avoidant coping may help limit the negative impact of pain on depression. Interventions aimed to improve coping style may be effective in enhancing the ability to manage pain and, subsequently, improve depression outcomes in MS.