In collaboration with Payame Noor University and Iranian Health Psychology Association

Document Type : Scientific Research

Authors

1 Assistant Professor of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran

2 PhD Candidate in Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran

Abstract

Objective: Multiple Sclerosis (MS) is a chronic and potentially debilitating disease that affects the central nervous system, which comprises the brain, spinal cord, and optic nerves. MS disrupts the flow of information within and between the brain and body, leading to a wide range of physical and cognitive symptoms. This condition is characterized by an abnormal immune response that targets myelin, the protective sheath surrounding nerve fibers, resulting in inflammation and damage. The present study aimed to investigate the relationship between emotional adaptation and mindfulness with the mediation of cognitive emotion regulation in patients with MS. Method: The method of this research was descriptive and the research design was a correlation design. The statistical population of the present study consisted of all people with MS in Tehran in 2022. For this purpose, the Iranian MS Association was referred and 300 patients were selected through voluntary and accessible sampling. To collect research data, questionnaires on emotional adaptation (Rubio et al, 2007), mindfulness (Cardaciotto et al, 2008), and, cognitive emotion regulation (Garnefski & Kraaij, 2006) were used. A unified questionnaire comprising all the scales was prepared to conduct this research. Subsequently, in coordination with the Iranian MS Society, individuals were contacted. If they volunteered and were willing to participate in the study, they were asked to visit the MS Society or MS treatment centers in Tehran to complete the questionnaire. The questionnaires were distributed individually, and during the research implementation, necessary explanations regarding how to respond and the purpose of the research were provided to the patients. The research was conducted from September to December 2022. Additionally, to adhere to ethical considerations, patients were assured that the research data would be analyzed collectively. Ethical principles in writing the article were followed according to the guidelines of the National Ethics Committee and the COPE (Committee on Publication Ethics) code of conduct. For data analysis in this research, descriptive statistical indices (mean, standard deviation, skewness, and kurtosis) and inferential statistical indices (Pearson correlation coefficient, path analysis) were used via SPSS and LISREL software version 24. Results: The results obtained from this research showed that the dimensions of mind-awareness (awareness focused on the present moment and acceptance) as exogenous variables of the research on the dimensions of emotional adaptation (lack of regulation of emotional and physiological arousals, hopelessness, and wishful thinking) have both direct and indirect effects (P<0.001). These effects underscore the complex interplay between present-moment awareness, acceptance, and the emotional processes in individuals with MS. The indirect effects were mediated through various pathways, indicating that mind awareness influences emotional adaptation directly and through its impact on other intermediate variables and coping mechanisms. Conclusion: What can be concluded from the present findings is the importance of training mindfulness skills in MS patients and improving cognitive skills in emotional regulation. According to the stress perceived by these people, the more a person focuses on desires and destructive thoughts loses focus on the present, and cannot accept his illness, the course and process of the disease will undoubtedly be faster. Future research should continue to explore the benefits of mindfulness and emotional regulation training in MS patients. Longitudinal studies could provide deeper insights into how these interventions impact disease progression and quality of life over time. Additionally, research could investigate the optimal methods for delivering mindfulness training to MS patients, considering factors such as disease severity, cognitive function, and individual preferences.

Keywords

Main Subjects

Aloni, R., Shahar, G., Ben-Ari, A., Margalit, D., & Achiron, A. (2023). Negative and positive personification of multiple sclerosis: Role in psychological adaptation. Journal of Psychosomatic Research164, 111078.
Boyko, A., & Melnikov, M. (2020). Prevalence and incidence of multiple sclerosis in Russian federation: 30 years of studies. Brain Sciences10(5), 305.
Briggs, F. B., & Hill, E. (2020). Estimating the prevalence of multiple sclerosis using 56.6 million electronic health records from the United States. Multiple Sclerosis Journal26(14), 1948-1952.
Bagheri-Sheykhangafshe, F., Tajbakhsh, K., Savabi Niri, V., Bourbour, Z., & Otadi, S. (2023). The Effectiveness of Compassion-Focused Therapy on Pain Catastrophizing, Sexual Function, and Resilience in Women with Multiple Sclerosis (MS). International Journal of Behavioral Sciences, 17(3), 133-140.
Cardaciotto, L., Herbert, J. D., Forman, E. M., Moitra, E., & Farrow, V. (2008). The assessment of present-moment awareness and acceptance: The Philadelphia Mindfulness Scale. Assessment, 15, 204-223.
Carvalho, T., Sousa-Mendes, A., Gomes, C., & Guedes, C. (2021). Understanding stress in patients with multiple sclerosis: The joint predictive role of disease characteristics and emotion regulation processes. European Psychiatry64(S1), S464-S465.
Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural equation modeling9(2), 233-255.
Desrosiers, A., Vine, V., Curtiss, J., & Klemanski, D. J. (2014). Observing nonreactively: A conditional process model linking mindfulness facets, cognitive emotion regulation strategies, and depression and anxiety symptoms. Journal of Affective Disorders, 165, 31-37.
Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis–a review. European journal of neurology26(1), 27-40.  
Dunbar, A. S., Perry, N. B., Cavanaugh, A. M., & Leerkes, E. M. (2015). African American parents’ racial and emotion socialization profiles and young adults’ emotional adaptation. Cultural Diversity and Ethnic Minority Psychology21(3), 409.  
Duraney, E. J., Fisher, M. E., Manglani, H. R., Andridge, R. R., Nicholas, J. A., & Prakash, R. S. (2022). Impact of mindfulness training on emotion regulation in multiple sclerosis: Secondary analysis of a pilot randomized controlled trial. Rehabilitation Psychology67(4), 449.
Etemadifar, M., Sajjadi, S., Nasr, Z., Firoozeei, T. S., Abtahi, S. H., Akbari, M., & Fereidan-Esfahani, M. (2013). Epidemiology of multiple sclerosis in Iran: a systematic review. European neurology70(5-6), 356-363.
Farzin Rad, B., Rashidian, M., Shakeri Juybari, Z., & Dehghani Ashkezari, E. (2022). Investigating the Validity and Reliability of the Persian Version of the Philadelphia Mindfulness Scale (PHLMS) among Clients of Counseling and Psychotherapy Centers. Journal of Applied Psychological Research, 13(1), 345-362. (in Persian)
Garnefski, N., & Kraaij, V. (2006). Cogntive Emotion Regulation Questionnaire: development of a short 18 item version (CERQ short). Personality and Individual Differences, 41, 1045–1053.
Gay, M. C., Bungener, C., Thomas, S., Vrignaud, P., Thomas, P. W., Baker, R., ... & Montreuil, M. (2017). Anxiety, emotional processing and depression in people with multiple sclerosis. BMC neurology17(1), 1-10.
Gilbertson, R. M., & Klatt, M. D. (2017). Mindfulness in motion for people with multiple sclerosis: a feasibility study. International journal of MS care19(5), 225-231.
Hancock, G. R., & Freeman, M. J. (2001). Power and sample size for the root mean square error of approximation test of not close fit in structural equation modeling. Educational and Psychological Measurement61(5), 741-758.
Harn, P. L., & Bo, S. H. (2019). The effectiveness of playful positive psychology interventions with Six Bricks and DUPLO® Play Box for Taiwan children on emotional adaptation. Journal of Research and Review9(5), 5-8.
Hauser, S. L., & Cree, B. A. (2020). Treatment of multiple sclerosis: a review. The American journal of medicine133(12), 1380-1390.
Huang, Q., Zhang, Q., An, Y., & Xu, W. (2019). The relationship between dispositional mindfulness and PTSD/PTG among firefighters: The mediating role of emotion regulation. Personality and Individual Differences151, 109492.
Iacobucci, D. (2010). Structural equations modeling: Fit indices, sample size, and advanced topics. Journal of consumer psychology20(1), 90-98.
Kline, R. B. (2015). Principles and practice of structural equation modeling. Guilford publications.
Kober, S. E., Pinter, D., Enzinger, C., Damulina, A., Duckstein, H., Fuchs, S., ... & Wood, G. (2019). Self-regulation of brain activity and its effect on cognitive function in patients with multiple sclerosis–First insights from an interventional study using neurofeedback. Clinical Neurophysiology130(11), 2124-2131.
Lancaster, K., Thomson, S. J., Chiaravalloti, N. D., & Genova, H. M. (2022). Improving mental health in Multiple Sclerosis with an interpersonal emotion regulation intervention: A prospective, randomized controlled trial. Multiple Sclerosis and Related Disorders60, 103643.
Lee, E. J., DeDios, S., Simonette, C., & Lee, G. K. (2013). Family adaptation model for spousal caregivers of people with multiple sclerosis: Testing the stress-processing theory. Journal of Vocational Rehabilitation39(2), 91-100.
Mami, S., & Heidary, M. (2019). Effectiveness of Intensive Short-Term Dynamic Psychotherapy on Sexual Function and Emotional Expression in Women with Multiple Sclerosis. Health Psychology, 7(28), 131-150. (in Persian)
McNulty, K., Livneh, H., & Wilson, L. M. (2004). Perceived uncertainty, spiritual well-being, and psychosocial adaptation in individuals with multiple sclerosis. Rehabilitation Psychology49(2), 91.
Meyer-Arndt, L., Kuchling, J., Brasanac, J., Hermann, A., Asseyer, S., Bellmann-Strobl, J., ... & Weygandt, M. (2022). Prefrontal-amygdala emotion regulation and depression in multiple sclerosis. Brain Communications4(3), 152.
Miller, J. R., Altaras, C., Vissicchio, N. A., Zemon, V., Portnoy, J. G., Gromisch, E. S., ... & Foley, F. W. (2020). The influence of trait mindfulness on depression in multiple sclerosis: potential implications for treatment. Quality of Life Research29(12), 3243-3250.
Mirmosayyeb, O., Shaygannejad, V., Bagherieh, S., Hosseinabadi, A. M., & Ghajarzadeh, M. (2021). Prevalence of multiple sclerosis (MS) in Iran: a systematic review and meta-analysis. Neurological Sciences, 1-9.
Pagnini, F., Cavalera, C., Rovaris, M., Mendozzi, L., Molinari, E., Phillips, D., & Langer, E. (2019). Longitudinal associations between mindfulness and well-being in people with multiple sclerosis. International Journal of Clinical and Health Psychology19(1), 22-30
Poerio, G. L., Totterdell, P., Emerson, L. M., & Miles, E. (2016). Social daydreaming and adjustment: An experience-sampling study of socio-emotional adaptation during a life transition. Frontiers in Psychology7, 13.
Polat Dunya, C., Tulek, Z., Uchiyama, T., Haslam, C., & Panicker, J. N. (2020). Systematic review of the prevalence, symptomatology and management options of sexual dysfunction in women with multiple sclerosis. Neurourology and urodynamics39(1), 83-95.
Prakash, R. S., Schirda, B., Valentine, T. R., Crotty, M., & Nicholas, J. A. (2019). Emotion dysregulation in multiple sclerosis: Impact on symptoms of depression and anxiety. Multiple sclerosis and related disorders36, 101399.
Rubio, V. J., Aguado, D., Hontangas, P. M., & Hernández, J. M. (2007). Psychometric properties of an emotional adjustment measure: An application of the graded response model. European Journal of Psychological Assessment23(1), 39.
Samin, T., & Akhlaghi Kohpaei, H. (2019). Prediction of Life Expectancy based on Quality of Life, Perceived Stress and Fatigue in Patients with Multiple Sclerosis (MS). Health Psychology, 8(29), 101-118. (in Persian)
San Jose, A. M., Oreja-Guevara, C., Lorenzo, S. C., Notario, L. C., Vega, B. R., & Pérez, C. B. (2016). Psychotherapeutic and psychosocial interventions for managing stress in multiple sclerosis: the contribution of mindfulness-based interventions. Neurología (English Edition)31(2), 113-120.
Schirda, B., Nicholas, J. A., & Prakash, R. S. (2015). Examining trait mindfulness, emotion dysregulation, and quality of life in multiple sclerosis. Health Psychology34(11), 1107.  
Senders, A., Hanes, D., Bourdette, D., Carson, K., Marshall, L. M., & Shinto, L. (2019). Impact of mindfulness-based stress reduction for people with multiple sclerosis at 8 weeks and 12 months: A randomized clinical trial. Multiple sclerosis journal25(8), 1178-1188.
Simpson, R., Posa, S., Langer, L., Bruno, T., Simpson, S., Lawrence, M., ... & Bayley, M. (2023). A systematic review and meta-analysis exploring the efficacy of mindfulness-based interventions on quality of life in people with multiple sclerosis. Journal of Neurology270(2), 726-745.
Soundy, A., Roskell, C., Elder, T., Collett, J., & Dawes, H. (2016). The psychological processes of adaptation and hope in patients with multiple sclerosis: a thematic synthesis. Open Journal of Therapy and Rehabilitation4(1), 22-47.
Spencer, L. A., Silverman, A. M., & Cook, J. E. (2019). Adapting to multiple sclerosis stigma across the life span. International Journal of MS Care21(5), 227-234.
Sünbül, Z. A., & Güneri, O. Y. (2019). The relationship between mindfulness and resilience: The mediating role of self-compassion and emotion regulation in a sample of underprivileged Turkish adolescents. Personality and Individual Differences139, 337-342.
Yosefi, K., Zargham Hajebi, M., & saravani, S. (2021). Predicting Attitude to Suicidal Thoughts Based on Psychological Hardiness and Perceived Physical Image in MS Patients. Health Psychology, 10(39), 157-170. (in Persian)
Ziccardi, S., Pizzini, F. B., Guandalini, M., Tamanti, A., Cristofori, C., & Calabrese, M. (2023). Making Visible the Invisible: Automatically Measured Global and Regional Brain Volume Is Associated with Cognitive Impairment and Fatigue in Multiple Sclerosis. Bioengineering10(1), 41