Coping strategies and adjustment to multiple sclerosis among recently diagnosed patients: the mediating role of sense of coherence

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Objective:To examine the relationship between coping strategies (problem solving, emotional release, and avoidance) and adjustment (health-related quality of life, depression, and affective well-being) in a group of recently diagnosed multiple sclerosis patients (up to three years since diagnosis), and to explore the mediating role of sense of coherence between coping strategies and adjustment.Design:Cross-sectional.Setting:Multiple Sclerosis Clinic Centre.Subjects:A total of 102 patients (61.8% women; age (years): M = 35.8, SD = 11.9; 95% with a relapsing–remitting form of multiple sclerosis; Expanded Disability Status Scale score, between 1 and 4).Interventions:Not applicable.Main measures:Coping with multiple sclerosis (problem solving, emotional release, and avoidance), sense of coherence, health-related quality of life (SF-12), depression (CES-D), and affective well-being (PANAS).Results:Problem solving was linked to higher mental health (β = 0.28) and higher affective well-being (β = 0.36), emotional release was related to lower depression (β = −0.22); avoidance was associated to higher mental health (β = 0.25), higher affective well-being (β = 0.24), and lower depression (β = −0.29) (all betas were significant at p < 0.05). Sense of coherence mediated the relationship between emotional release and depression (Sobel z-value = −2.00; p < 0.05) and the relationship between avoidance and all the indicators of adjustment (mental health: Sobel z-value = 1.97; depression: Sobel z-value = −2.02; affective well-being: Sobel z-value= 2.05; p < 0.05).Conclusions:Emotional and avoidant coping strategies seem to be adaptive among recently diagnosed multiple sclerosis patients. A mediating role between coping strategies and adjustment is played by sense of coherence.

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