psychosocial factors

Psychological stress is associated with multiple sclerosis (MS), but few studies have examined in detail the psychosocial factors that might mediate this relationship. A recent study found that, relative to healthy controls, individuals with MS scored higher in anxiety, were more likely to use avoidance stress coping strategies, less likely to use social support, and reported receiving lower levels of social support.


Multiple sclerosis (MS) is a common neurodegenerative autoimmune disease and a leading cause of disability. Stress can contribute to the development of autoimmune diseases like MS by dysregulating immune function. Studies on the links between stress and MS have found mixed results, which could be an indication that effects of stress on MS are moderated by how individuals deal with stress. Additional research on this topic has linked MS to early-life stress and lower social support.

A study in the Journal of Health Psychology examined psychosocial factors associated with MS by collecting data on 41 patients with MS and 41 healthy individuals, matched for age and sex. The participants were interviewed and filled out questionnaires on multiple psychosocial factors: anxiety levels, alexithymia (difficulty in identify and expressing emotions), perceived level of social support, early-life stress experiences, and strategies used to cope with stress (e.g., seeking social support, avoiding problems, acting spontaneously, or acting assertively). In addition, the degree of disease progression was scored using a neurologist’s rating of impairment and a self-assessment of functionality.

Compared to the healthy controls, individuals with MS showed a stronger reliance on avoidance and instinctive stress coping mechanisms. They reported less often seeking social support to deal with stress, and lower levels of social support. The MS group scored higher overall on measures of anxiety and alexithymia, and included a larger number of individuals that could be classified as having high anxiety(37% MS vs 7% non-MS) and having possible alexithymia (40% MS vs.20% in non-MS). In individuals with MS, the degree of MS-related impairment was positively associated with use of an avoidance coping style. Individuals with low self-assessed functionality scored high on anxiety and use of avoidance coping. The scores for early-life stress were similar between the MS and control group.

The results confirm past studies linking coping styles and social support to MS, but failed to find a link with early-life stress.The authors proposed that the poor social support associated with MS could be related to high anxiety and inability to express emotions (alexithymia), both of which could impair healthy social interactions. The teaching of new stress coping strategies in a psychotherapeutic environment could be an effective intervention to buffer effects of stress on MS in vulnerable individuals.


Written By: Jeffrey Zeyl

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