"I battle pain every single day": Pain-related illness intrusiveness among persons with multiple sclerosis.

OBJECTIVES Pain has been identified as a highly prevalent and common correlate of physical and emotional dysfunction among persons with multiple sclerosis (PwMS). Yet, it remains unknown how PwMS experience the intrusiveness of pain relative to other challenges associated with living with MS. This study aimed to determine the extent to which PwMS experience pain as a particularly intrusive problem among the totality of their experience of MS-related challenges and to examine how cognitive and affective factors, including resiliency, are associated with PwMS's pain-related illness intrusiveness. METHOD Participants (N = 161) were PwMS with at least mild pain who were recruited through the North American Research Committee on Multiple Sclerosis Registry for this cross-sectional study. Participants completed the Illness Intrusiveness Ratings Scale twice regarding their (a) MS and (b) pain. Multiple regression analyses were run to evaluate the relationship between MS- and pain-related illness intrusiveness, as well as the cognitive and affective predictors of the latter. RESULTS Controlling for level of disease severity, pain-related illness intrusiveness was a significant predictor of MS-related illness intrusiveness (p < .001). Depressive symptom severity was the strongest predictor of pain-related illness intrusiveness (p < .001), followed by pain catastrophizing (p < .001). The relationship between pain-related illness intrusiveness and pain catastrophizing was mediated (med) by coping strategies (Rmed2 = .15) and support from family and friends (Rmed2 = .07), with the latter mediating pain-related illness intrusiveness's relationship with depressive symptom severity (Rmed2 = .10). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

[1]  A. Lo,et al.  Cognitive Behavioral Therapy for the Management of Multiple Sclerosis-Related Pain: A Randomized Clinical Trial. , 2020, International journal of MS care.

[2]  F. Foley,et al.  Development of the Multiple Sclerosis Resiliency Scale (MSRS) , 2018, Rehabilitation psychology.

[3]  D. Ehde,et al.  Cognitive and Affective Mechanisms of Pain and Fatigue in Multiple Sclerosis , 2018, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[4]  L. Lix,et al.  The validity and reliability of screening measures for depression and anxiety disorders in multiple sclerosis. , 2018, Multiple sclerosis and related disorders.

[5]  D. Ehde,et al.  Bouncing back again, and again: a qualitative study of resilience in people with multiple sclerosis , 2017, Disability and rehabilitation.

[6]  F. Foley,et al.  Assessment and Treatment of Psychiatric Distress, Sexual Dysfunction, Sleep Disturbances, and Pain in Multiple Sclerosis: A Survey of Members of the Consortium of Multiple Sclerosis Centers. , 2016, International journal of MS care.

[7]  G. Cutter,et al.  Prevalence of multiple sclerosis symptoms across lifespan: data from the NARCOMS Registry. , 2015, Neurodegenerative disease management.

[8]  D. Dorstyn,et al.  A biopsychosocial model of resilience for multiple sclerosis , 2015, Journal of health psychology.

[9]  D. Amtmann,et al.  Efficacy of a Telephone-Delivered Self-Management Intervention for Persons With Multiple Sclerosis: A Randomized Controlled Trial With a One-Year Follow-Up. , 2015, Archives of physical medicine and rehabilitation.

[10]  I. Molton,et al.  Resilience predicts functional outcomes in people aging with disability: a longitudinal investigation. , 2015, Archives of physical medicine and rehabilitation.

[11]  F. Foley,et al.  Psychological and physical predictors of illness intrusiveness in patients with multiple sclerosis , 2013, Journal of the Neurological Sciences.

[12]  A. Hayes Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach , 2013 .

[13]  M. Macleod,et al.  Prevalence and natural history of pain in adults with multiple sclerosis: Systematic review and meta-analysis , 2013, PAIN®.

[14]  Robert W Motl,et al.  Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis , 2013, BMC Neurology.

[15]  Kristopher J Preacher,et al.  Effect size measures for mediation models: quantitative strategies for communicating indirect effects. , 2011, Psychological methods.

[16]  Tracy Yuen,et al.  A systematic review of resilience in the physically ill. , 2011, Psychosomatics.

[17]  I. Molton,et al.  Effects of Self-Hypnosis Training and Cognitive Restructuring on Daily Pain Intensity and Catastrophizing in Individuals With Multiple Sclerosis and Chronic Pain , 2010, The International journal of clinical and experimental hypnosis.

[18]  D. Amtmann,et al.  Development of a PROMIS item bank to measure pain interference , 2010, PAIN.

[19]  G. Devins Using the illness intrusiveness ratings scale to understand health-related quality of life in chronic disease. , 2010, Journal of psychosomatic research.

[20]  Anthony Feinstein,et al.  Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients , 2009, Multiple sclerosis.

[21]  Chuong B Do,et al.  What is the expectation maximization algorithm? , 2008, Nature Biotechnology.

[22]  C. Douglas,et al.  Understanding chronic pain complicating disability: finding meaning through focus group methodology. , 2008, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[23]  R. Marrie,et al.  Validity of performance scales for disability assessment in multiple sclerosis , 2007, Multiple sclerosis.

[24]  R. Marrie,et al.  Validation of the NARCOMS registry: diagnosis , 2007, Multiple sclerosis.

[25]  G. Cutter,et al.  Persistent pain and uncomfortable sensations in persons with multiple sclerosis , 2007, Pain.

[26]  M. Hanley,et al.  Psychosocial factors associated with pain intensity, pain-related interference, and psychological functioning in persons with multiple sclerosis and pain , 2007, Pain.

[27]  M. Hanley,et al.  The scope and nature of pain in persons with multiple sclerosis , 2006, Multiple sclerosis.

[28]  J. Haselkorn,et al.  Correlates of pain interference in multiple sclerosis. , 2006 .

[29]  L. Kalia,et al.  Severity of chronic pain and its relationship to quality of life in multiple sclerosis , 2005, Multiple sclerosis.

[30]  R. Marrie,et al.  Validation of the NARCOMS Registry: fatigue assessment , 2005, Multiple sclerosis.

[31]  R. Bakshi,et al.  Predicting quality of life in multiple sclerosis: accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change , 2005, Journal of the Neurological Sciences.

[32]  W. Feneberg,et al.  [Therapy of pain syndromes in multiple sclerosis -- an overview with evidence-based recommendations]. , 2005, Fortschritte der Neurologie-Psychiatrie.

[33]  R. Califf,et al.  Health Insurance Portability and Accountability Act (HIPAA): must there be a trade-off between privacy and quality of health care, or can we advance both? , 2003, Circulation.

[34]  R. Kerns,et al.  Pain in multiple sclerosis: a biopsychosocial perspective. , 2002, Journal of rehabilitation research and development.

[35]  R. Paul,et al.  Illness intrusiveness, uncertainty, and distress in individuals with multiple sclerosis. , 2001 .

[36]  R. Kerns Psychosocial Aspects of Pain , 2000 .

[37]  E J Orav,et al.  Disease steps in multiple sclerosis: a longitudinal study comparing Disease Steps and EDSS to evaluate disease progression , 1999, Multiple sclerosis.

[38]  A. Osman,et al.  Factor Structure, Reliability, and Validity of the Pain Catastrophizing Scale , 1997, Journal of Behavioral Medicine.

[39]  E J Orav,et al.  Disease Steps in multiple sclerosis , 1995, Neurology.

[40]  Gary M. Klein,et al.  Differences in Illness Intrusiveness Across Rheumatoid Arthritis, End-Stage Renal Disease, and Multiple Sclerosis , 1993, The Journal of nervous and mental disease.

[41]  E. Stenager,et al.  Acute and chronic pain syndromes in multiple sclerosis , 1991, Acta neurologica Scandinavica.

[42]  A. Zigmond,et al.  The Hospital Anxiety and Depression Scale , 1983, Acta psychiatrica Scandinavica.

[43]  D. Ehde,et al.  Improving the quality of depression and pain care in multiple sclerosis using collaborative care: The MS-care trial protocol. , 2018, Contemporary clinical trials.

[44]  L. Magder,et al.  VHA Multiple Sclerosis Surveillance Registry and its similarities to other contemporary multiple sclerosis cohorts. , 2015, Journal of rehabilitation research and development.

[45]  C. Solaro,et al.  Pain and Multiple Sclerosis: Pathophysiology and Treatment , 2012, Current Neurology and Neuroscience Reports.

[46]  D. Ehde,et al.  Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: a systematic review. , 2011, Archives of physical medicine and rehabilitation.

[47]  W. Feneberg,et al.  Current Management of Pain Associated with Multiple Sclerosis , 2008, CNS drugs.

[48]  Yuan Bo Peng,et al.  The biopsychosocial approach to chronic pain: scientific advances and future directions. , 2007, Psychological bulletin.

[49]  Scott R. Bishop,et al.  The Pain Catastrophizing Scale: Development and validation. , 1995 .

[50]  Jacob Cohen QUANTITATIVE METHODS IN PSYCHOLOGY A Power Primer , 1992 .

[51]  Human Experimentation: Code of Ethics of the World Medical Association (Declaration of Helsinki). , 1964, Canadian Medical Association journal.