Self-Efficacy as a longitudinal predictor of perceived cognitive impairment in individuals with multiple sclerosis

Abbey J. Hughes, Meghan Beier, Narineh Hartoonian, Aaron P. Turner, Dagmar Amtmann, Dawn M. Ehde

Research output: Contribution to journalArticlepeer-review

Abstract

Abstract Objectives To determine whether self-efficacy longitudinally predicts 2 types of perceived cognitive impairment (PCI) in multiple sclerosis (MS): general cognitive functioning and executive functioning; and secondarily to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI. Design Longitudinal analysis of self-report survey data collected over 3 years. Hierarchical regression analyses examined the relationship between self-efficacy and PCI, adjusting for depression and fatigue. Additional analyses tested self-efficacy as a mediator between depression, fatigue, and PCI. Setting Community. Participants Community-dwelling individuals with MS (N=233; age range, 22-83y) were recruited from a larger longitudinal survey study of individuals with MS (N=562). Interventions Not applicable. Main Outcome Measures Primary outcome measures were the Applied Cognition-General Concerns and the Applied Cognition-Executive Function domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures. Results Self-efficacy was significantly correlated with PCI at baseline (r=.40-.53) and 3 years later (r=.36-.44). In multivariate regression analyses, self-efficacy was a significant longitudinal predictor of PCI, both for general cognitive functioning (β=.20, P<.01) and executive functioning (β=.16, P<.05). Self-efficacy partially mediated the relationships between depression, fatigue, and PCI. Conclusions Self-efficacy may influence how individuals with MS perceive their cognitive functioning over time. Interventions that target self-efficacy, particularly early in the disease course, may lead to improvements in PCI, as well as improvements in fatigue and depression. NMSS Postdoctoral Research Fellow, Department of Rehabilitation Medicine, University of Washington, 325 Ninth Ave, Box 359612, Seattle, WA 98104.

Original languageEnglish (US)
Article number56084
Pages (from-to)913-919
Number of pages7
JournalArchives of physical medicine and rehabilitation
Volume96
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

Keywords

  • Cognition
  • Executive function
  • Longitudinal studies
  • Multiple sclerosis
  • Rehabilitation
  • Self efficacy
  • Self report

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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