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Self-Efficacy as a Longitudinal Predictor of Perceived Cognitive Impairment in Individuals with Multiple Sclerosis
Abbey J. Hughes, Meghan Beier, PhD, Narineh Hartoonian, PhD, Aaron P. Turner, PhD, Dagmar Amtmann, PhD, Dawn M. Ehde, PhD
Archives of Physical Medicine and Rehabilitation, In Press, Accepted Manuscript, Available online 15 January 2015
Self-efficacy plays an important role in symptom management and may be predictive of perceived cognitive impairment (PCI) for individuals with multiple sclerosis (MS). The primary aim of this study was to determine if self-efficacy longitudinally predicts two types of PCI in MS: general cognitive functioning and executive functioning. The secondary aim was to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI.
Longitudinal analysis of self-report survey data collected over three 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.
Community-dwelling individuals with MS.
233 individuals (age range 22-83 years) were recruited from a larger longitudinal survey study of 562 individuals with MS.
Main Outcome Measures.
Primary outcome measures were the Applied Cognition General Concerns (ACGC) and Executive Function (ACEF) domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures.
Self-efficacy was significantly correlated with PCI at baseline (r = .40 to .53) and three years later (r = .36 to .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.
Self-efficacy may influence how individuals with MS will 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.