What Biopsychosocial Factors Explain Self-management Behaviors in Multiple Sclerosis? The Role of Demographics, Cognition, Personality, and Psychosocial and Physical Functioning

Abstract

Objectives: To examine the biopsychosocial correlates of overall and individual self-management behaviors in persons with multiple sclerosis (MS), including demographics, co-occurring medical diagnoses, cognition, personality traits, and psychosocial and physical functioning as variables.

Design: Prospective cross-sectional cohort study.

Setting: Community-based comprehensive MS center.

Participants: Adults with MS (n=112) who completed a brief neuropsychological battery that included a self-report survey and performance-based measures of cognitive function.

Interventions: Not applicable.

Main outcome measures: The MS Self-management Scale-Revised total score was the primary outcome and its 5 subscales (Healthcare Provider Relationship/Communication, Treatment Adherence/Barriers, Social/Family Support, MS Knowledge and Information, Health Maintenance Behaviors) were secondary outcomes.

Results: Disease-modifying therapy usage (β=0.39), social support (β=0.31), subjective prospective memory (β=-0.25), emotional well-being (β=0.20), and histories of diabetes (β=-0.18) and high cholesterol (β=0.15) were significantly associated with overall self-management in a multivariate model. Correlates of individual self-management behaviors are also described.

Conclusions: The findings provide insights into the biopsychosocial characteristics contributing to the overall and individual self-management behaviors of persons with multiple sclerosis. The next steps will be to evaluate these factors in a clinical intervention.

Keywords: Diabetes mellitus; Multiple sclerosis; Personality; Prospective memory; Psychosocial functioning; Rehabilitation; Self-management.