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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

Abstract
Objective

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.

Design
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.

Setting
Community-dwelling individuals with MS.

Participants
233 individuals (age range 22-83 years) were recruited from a larger longitudinal survey study of 562 individuals with MS.

Interventions.
Not applicable.

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.

Results
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.

Conclusions
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.

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About the Editors

  • Prof Timothy Vartanian

    Timothy Vartanian, Professor at the Brain and Mind Research Institute and the Department of Neurology, Weill Cornell Medical College, Cornell...
  • Dr Claire S. Riley

    Claire S. Riley, MD is an assistant attending neurologist and assistant professor of neurology in the Neurological Institute, Columbia University,...
  • Dr Rebecca Farber

    Rebecca Farber, MD is an attending neurologist and assistant professor of neurology at the Neurological Institute, Columbia University, in New...

This online Resource Centre has been made possible by a donation from EMD Serono, Inc., a business of Merck KGaA, Darmstadt, Germany.

Note that EMD Serono, Inc., has no editorial control or influence over the content of this Resource Centre. The Resource Centre and all content therein are subject to an independent editorial review.

The Grant for Multiple Sclerosis Innovation
supports promising translational research projects by academic researchers to improve understanding of multiple sclerosis (MS) for the ultimate benefit of patients.  For full information and application details, please click here

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Multiple Sclerosis and Related Disorders, September 2015, Vol 4 Issue 5