Relationships among depressive symptoms, benefit-finding, optimism, and positive affect in multiple sclerosis patients after psychotherapy for depression

Health Psychol. 2008 Mar;27(2):230-8. doi: 10.1037/0278-6133.27.2.230.

Abstract

Objective: While many patients with multiple sclerosis (MS) experience psychological problems, such as depression, benefit-finding is commonly reported. Using the Broaden-and-Build Model of positive emotions (Fredrickson, 2001) and the Expectancy-Value Model of optimism (Carver & Scheier, 1998) as two related, yet, distinct conceptual frameworks, this study examined positive affect and optimism as mediators of the relationship between improved depression and enhanced benefit-finding.

Design: MS patients (N=127), who participated in a larger, randomized clinical trial comparing two types of telephone psychotherapy for depression, were assessed at baseline, midtherapy (8 weeks), end of therapy (16 weeks), and 6- and 12-month posttherapy.

Main outcome measures: Depression was measured with a telephone administered version of the Hamilton Rating Scale for Depression; Positive Affect was measured with the Positive Affect Subscale from the Positive and Negative Affect Scale; Optimism was measured with the Life Orientation Test-Revised; Benefit-Finding was measured with the revised version of the Stress-Related Growth Scale.

Results: Data were analyzed with multilevel random-effects models, controlling for time since MS diagnosis and type of treatment. Improved depression was associated with increased benefit-finding over time. The relationship between improved depression and benefit-finding was significantly mediated by both increased optimism and increased positive affect.

Conclusion: Findings provide support to both theoretical models. Positivity appears to promote benefit-finding in MS.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Affect*
  • Cognitive Behavioral Therapy*
  • Culture*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • Disability Evaluation
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Motivation*
  • Multiple Sclerosis, Chronic Progressive / psychology*
  • Multiple Sclerosis, Relapsing-Remitting / psychology*
  • Personality Inventory
  • Psychotherapy*
  • Sick Role
  • Telephone*