An examination of emotion regulation and health-related quality of life in patients with Multiple Sclerosis

Tarrant, Rachel (2023) An examination of emotion regulation and health-related quality of life in patients with Multiple Sclerosis. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Background: Multiple Sclerosis (MS) is a chronic, and unpredictable, neurodegenerative disease of the central nervous system (CNS). Due to the unpredictability of the disease, and diversity of symptoms, an individual’s perspective of their overall health and well-being may change with an MS diagnosis, labelled health-related quality of life (HRQOL). A reported symptom of MS is emotion dysregulation. Emotion regulation refers to the ability to initiate, inhibit or modulate the occurrence, intensity or duration of feelings. There is limited research to allow clinicians and patients to fully understand the relationship between emotion regulation and HRQOL among patients with MS. Objective: The goal of the present study is to gain a better understanding of the role of emotion regulation in HRQOL among Canadian patients with MS. Specifically, this study aimed to determine if emotion regulation, and its associated constructs, could predict mental and physical HRQOL after controlling for age, gender, and social support. Method: Adults diagnosed with MS participated in this cross-sectional study. Self-report data was collected from June 2015 - April 2018 through online and mail-out survey methods following recruitment using social media and neurology clinic referrals. The Difficulties in Emotion Regulation Scale (DERS), Short Form-12 Health Survey (SF-12 HS), and a sociodemographic questionnaire were used to collect information on variables of interest. Missing data was handled using multiple imputation. Correlations and hierarchical regressions were performed to determine the predictive value of emotion regulation and its multifaceted constructs (i.e., goals, impulsivity, strategies, clarity, awareness, and non-acceptance) on HRQOL among those with MS. Results: The final sample consisted of 54 participants with MS. Pearson correlation revealed that mental health related quality of life (MHRQOL), but not physical health related quality of life (PHRQOL), significantly decreased as emotion dysregulation increased. Hierarchical multiple regression revealed that emotion regulation predicated MHRQOL over and above age, gender, and social support, with the construct of goaldirected behaviour driving this association. Discussion: The current study provides support that emotion regulation, with a particular focus on goal-directed behaviour, is related to MHRQOL, over and above age, gender and social support. This study did not find the same association between emotion regulation and PHRQOL. The results of the current study highlight the importance of psycho-social intervention that targets emotion regulation in those with MS. Future directions for research might include complementary qualitative analysis of experiences of emotion dysregulation in patients with MS.

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