The Intermediary Role of Optimism and Mental Health in the Relationship Between Disability-Related Stress and Life Satisfaction: A Serial Mediation Model

Abstract

Although research has examined the relationship between stress and life satisfaction for individuals with multiple sclerosis (MS), less is known about the mechanism through which disability-related stress affects life satisfaction. The purpose of the study was to examine the intermediary role of optimism and mental health in the relationship between disability-related stress and life satisfaction in people with MS. In this cross-sectional study, the sample consisted of U.S. 373 adults with MS (mean age = 47.77 years; SD = 11.70). Descriptive statistics, correlation analyses, and a serial mediation analysis were conducted in this study. Our findings suggested that disability-related stress was inversely associated with optimism, mental health, and life satisfaction. Optimism was positively associated with mental health and life satisfaction. Mental health was positively associated with life satisfaction. The serial mediation analysis results suggested that disability-related stress was negatively associated with life satisfaction through optimism and mental health. Our findings provided implications for clinicians to facilitate optimism and mental health promotion for people with MS.

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References

Anderssen

Sivertsen

Lonning

K. J.

(2020). Life satisfaction and mental health among transgender students in Norway. BMC Public Health, 20, Article 138. https://doi.org/10.1186/s12889-020-8228-5

Artemiadis

A. K.

Vervainioti

A. A.

Alexopoulos

E. C.

Rombos

Anagnostouli

M. C.

Darviri

(2012). Stress management and multiple sclerosis: A randomized controlled trial. Archives of Clinical Neuropsychology, 27(4), 406–416. https://doi.org/10.1093/arclin/acs039

Bishop

Frain

Tschopp

M. K.

(2008). Self-management, perceived control, and subjective quality of life in multiple sclerosis: An exploratory study. Rehabilitation Counseling Bulletin, 51(1), 45–56.

Bishop

Shepard

Stenhoff

D. M.

(2007). Psychosocial adaptation and quality of life in multiple sclerosis: Assessment of the Disability Centrality Model. Journal of Rehabilitation, 73(1), 3–12.

Blackwell

S. E.

Rius-Ottenheim

Schulte-van Mareen

Y. W. M.

Carlier

I. V. E.

Middelkoop

V. D.

Zitman

F. G.

Spinhoven

Holmes

E. A.

Giltay

E. J.

(2013). Optimism and mental imagery: A possible cognitive marker to promote well-being? Psychiatry Research, 206(1), 56–61. https://doi.org/10.1016/j.psychres.2012.09.047

Briones-Buixassa

Mila

Aragones

J. M.

Bufill

Olaya

Arrufat

F. X.

(2015). Stress and multiple sclerosis: A systematic review considering potential moderating and mediating factors and methods of assessing stress. Health Psychology Open, 2(2), 1–16. https://doi.org/10.1177/2055102915612271

Bryan

C. J.

Ray-Sannerud

B. N.

Morrow

C. E.

Etienne

(2013). Optimism reduces suicidal ideation and weakens the effect of hopelessness among military personnel. Cognitive Therapy and Research, 37(5), 996–1003. https://doi.org/10.1007/s10608-013-9536-1

Carillo

Martinez-Sanchis

Etchemendy

(2019). Qualitative analysis of the best possible self intervention: Underlying mechanisms that influence its efficacy. PLOS ONE, 14(4), Article e0216896. https://doi.org/10.137/journal.pone.0216896

Cella

Riley

Stone

Rothrock

Reeve

Yount

Amtmann

Bode

Buysse

Choi

Cook

Devellis

DeWalt

Fries

J. F.

Gershon

Hahn

E. A.

Lai

J. S.

Pilkonis

Revicki

, . . . PROMIS Cooperative Group. (2010). The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. Journal of Clinical Epidemiology, 63(11), 1179–1194. https://doi.org/10.1016/j.jclinepi.2010.04.011

10.

Chen

R. K.

Crewe

N. M.

(2009). Life satisfaction among people with progressive disabilities. Journal of Rehabilitation, 75(2), 50–58.

11.

Chwastiak

Ehde

D. M.

Gibbons

L. E.

Sullivan

Bowen

J. D.

Kraft

G. H.

(2002). Depressive symptoms and severity of illness in multiple sclerosis: Epidemiologic study of a large community sample. American Journal of Psychiatry, 159(11), 1862–1868.

12.

Clench-Aas

Bang Nes

Dalgard

O. S.

Aaro

L. E.

(2011). Dimensionality and measurement invariance in the Satisfaction with Life Scale in Norway. Quality of Life Research, 20, 1307–1317. https://doi.org/10.1007/s11136-011-9859-x

13.

Conversano

Rotondo

Lensi

Della Vista

Arpone

Reda

M. A.

(2010). Optimism and its impact on mental and physical well-being. Clinical Practice and Epidemiology in Mental Health, 6, 25–29. https://doi.org/10.2174/1745017901006010025

14.

Daukantaitė

Zukauskiene

(2012). Optimism and subjective well-being: Affectivity plays a secondary role in the relationship between optimism and global life satisfaction in the middle-aged women. Longitudinal and cross-cultural findings. Journal of Happiness Studies, 13(1), 1–16. https://doi.org/10.1007/s10902-010-9246-2

15.

Dennison

Moss-Morris

Chalder

(2009). A review of psychological correlates of adjustment in patients with multiple sclerosis. Clinical Psychology Review, 29(2), 141–153. https://doi.org/10.1016/j.cpr.2008.12.001

16.

Diener

Emmons

R. A.

Larsen

R. J.

Griffin

(1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71–75.

17.

Dumitrache

C. G.

Windle

Herrera

R. R.

(2015). Do social resources explain the relationship between optimism and life satisfaction in community-dwelling older people? Testing a multiple mediation model. Journal of Happiness Studies, 16(3), 633–654. https://doi.org/10.1007/s10902-014-9526-3

18.

Esnaola

Benito

Agirre

I. A.

Freeman

Sarsa

(2017). Measurement invariance of the Satisfaction with Life Scale (SWLS) by country, gender and age. Psicothema, 29(4), 596–601. https://doi.org/10.7334/psicothema2016.394

19.

Fergusson

D. M.

McLeod

G. F. H.

Horwood

L. J.

Swain

N. R.

Chapple

Poulton

(2015). Life satisfaction and mental health problems (18 to 35 years). Psychological Medicine, 45(11), 2427–2436. https://doi.org/10.1017/S0033291715000422

20.

Hart

S. L.

Vella

Mohr

D. C.

(2008). Relationships among depressive symptoms, benefit-finding, optimism, and positive affect in multiple sclerosis patients after psychotherapy for depression. Health Psychology, 27(2), 230–238. https://doi.org/10.1037/0278-6133.27.2.230

21.

Hayes

A. F.

(2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guildford Press.

22.

Hays

R. D.

Schalet

B. D.

Spritzer

K. L.

Cella

(2017). Two-item PROMIS® global physical and mental health scales. Journal of Patient-Reported Outcomes, 1(1), 2. https://doi.org/10.1186/s41687-017-0003-8

23.

Hirsch

J. K.

Conner

K. R.

(2006). Dispositional and explanatory style optimism as potential moderators of the relationship between hopelessness and suicidal ideation. Suicide and Life-Threatening Behavior, 36(6), 661–669.

24.

Jiang

Moreno

(2022). Examining the interplay of emotion regulation strategies, social stress, and gender in predicting life satisfaction of emerging adults. Personality and Individual Differences, 185, Article 111255. https://doi.org/10.1016/j.paid.2021.111255

25.

Kern

Schrempf

Schneider

Schultheiss

Reichmann

Ziemssen

(2009). Neurological disability, psychological distress, and health-related quality of life in MS patients within the first three years after diagnosis. Multiple Sclerosis Journal, 15(6), 752–758.

26.

Kessler

R. C.

(1997). The effects of stressful life events on depression. Annual Review of Psychology, 48(1), 191–214.

27.

Koltuniuk

Pytel

Kulik

Rosinczuk

(2021). The role of disease acceptance, life satisfaction, and stress perception on the quality of life among patients with multiple sclerosis: A descriptive and correlational study. Rehabilitation Nursing Journal, 46(4), 205–213. https://doi.org/10.1097/RNJ.0000000000000288

28.

Lee

(2022). A serial mediation model of gratitude on life satisfaction in people with multiple sclerosis: The intermediary role of perceived stress and mental health symptoms. Multiple Sclerosis and Related Disorders, 58(3), 103421.

29.

Lee

Chan

(in press). The Development and psychometric validation of the Brief Disability Related Stress Scale in individuals with multiple sclerosis. Rehabilitation Counseling Bulletin.

30.

Lee

Rumrill

Reyes

McDaniels

(in press). The association between hope and employment among individuals with multiple sclerosis: A hierarchical logistic regression model. Work: A Journal of Prevention, Assessment & Rehabilitation.

31.

Lee

Tansey

T. N.

Chan

Bishop

Hoyt

W. T.

Hancock

L. M.

(2022). Exploration of the effects of protective person–environment factors between functional impairments and stress in individuals with multiple sclerosis: Mediation and moderation analyses. Rehabilitation Counseling Bulletin, 65(2), 95–107.

32.

Lee

Kim

Wachholtz

(2016). The effect of perceived stress on life satisfaction: The mediating effect on self-efficacy. Chongsonyonhak Yongu, 23(10), 29–47. https://doi.org/10.21509/KJYS.2016.10.23.10.29

33.

Lee

Y. P. B.

(2020). Protective person-environment factors as mediators between functional disability and stress in individuals with multiple sclerosis: A parallel mediation model. The University of Wisconsin-Madison.

34.

Holmes

E. A.

Blackwell

S. E.

(2017). Seeing light at the end of the tunnel: Positive prospective mental imagery and optimism in depression. Psychiatry Research, 247, 155–162. https://doi.org/10.1016/j.psychres.2016.11.025

35.

MacDonald

B. K.

Cockerill

J. W. A.

Sarder

W. A. S.

Shorvon

S. D.

(2000). The incidence and prevalence of neurological disorders in a prospective community based study in the UK. Brain, 123(4), 665–676. https://doi.org/10.1093/brain/123.4.665

36.

Maier

S. F.

Seligman

M. E. P.

(1976). Learned helplessness: Theory and evidence. Journal of Experimental Psychology: General, 105(1), 3–46. https://doi.org/10.1037/0096-3445.105.1.3

37.

Marrie

R. A.

Reingold

Cohen

Stuve

Trojano

Sorensen

P. S.

Cutter

Reider

(2015). The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic review. Multiple Sclerosis Journal, 21(3), 305–317. https://doi.org/10.1177/1352458514564487

38.

Meevissen

Y. M.

Peters

M. L.

Alberts

H. J.

(2011). Become more optimistic by imagining a best possible self: Effects of a two week intervention. Journal of Behavior Therapy and Experimental Psychiatry, 42(3), 371–378. https://doi.org/10.1016/j.jbtep.2011.02.012

39.

Minden

S. L.

Feinstein

Kalb

R. C.

Miller

Mohr

D. C.

Patten

S. B.

Bever

Schiffer

R. B.

Gronseth

G. S.

Narayanaswami

(2013). Evidence based guidelines: Assessment and management of psychiatric disorders in individuals with MS. Neurology, 82(2), 174–181. https://doi.org/10.1212/WNL.0000000000000013

40.

Monroe

S. M.

Slavich

G. M.

Torres

L. D.

Gotlib

I. H.

(2007). Major life events and major chronic difficulties are differentially associated with history of major depressive episodes. Journal of Abnormal Psychology, 116(1), 116–124. https://doi.org/10.1037/0021-843X.116.1.116

41.

National Multiple Sclerosis Society. (2020). MS prevalence. https://www.nationalmssociety.org/About-the-Society/MS-Prevalence

42.

Nicholl

C. R.

Lincoln

N. B.

Francis

V. M.

Stephan

T. F.

(2001). Assessment of emotional problems in people with multiple sclerosis. Clinical Rehabilitation, 15(6), 657–668. https://doi.org/10.1191/0269215501cr427oa

43.

Patten

S. B.

Williams

J. V.

Lavorato

D. H.

Berzins

Metz

L. M.

Bulloch

A. G.

(2012). Health status, stress and life satisfaction in a community population with MS. Canadian Journal of Neurological Sciences, 39(2), 206–212. https://doi.org/10.1017/S031716710001324X

44.

Peters

L. M.

Flink

I. K.

Boersma

Linton

S. J.

(2010). Manipulating optimism: Can imagining a best possible self be used to increase positive future expectancies? The Journal of Positive Psychology, 5(3), 204–211.

45.

Rao

S. M.

Huber

S. J.

Bornstein

R. A.

(1992). Emotional changes with multiple sclerosis and Parkinson’s disease. Journal of Consulting and Clinical Psychology, 60(3), 369–378. https://doi.org/10.1037/0022-006X.60.3.369

46.

Salehpoor

Rezaei

Hosseininezhad

(2014). Quality of life in multiple sclerosis (MS) and role of fatigue, depression, anxiety, and stress: A bicenter study from north of Iran. Iranian Journal of Nursing and Midwifery Research, 19(6), 593–599.

47.

Sanaeinasab

Saffari

Hashempour

Karimi Zarchi

A. A.

Alghamdi

W. A.

Koenig

H. G.

(2017). Effect of a transactional model education program on coping effectiveness in women with multiple sclerosis. Brain and Behavior, 7, Article e00810.

48.

Scheier

M. F.

Carver

C. S.

Bridges

M. W.

(1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A re-evaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67, 1063–1078.

49.

Seligman

M. E. P.

(2006). Learned optimism: How to change your mind and your life. Vintage Books.

50.

Sheldon

K. M.

Lyubomirsky

(2006). How to increase and sustain positive emotion: The effects of expressing gratitude and visualizing best possible selves. Journal of Positive Psychology, 1, 73–82.

51.

Shnek

Z. M.

Foley

F. W.

LaRocca

N. G.

Smith

C. R.

Halper

(1995). Psychological predictors of depression in multiple sclerosis. Journal of Neurologic Rehabilitation, 9(1), 15–23. https://doi.org/10.1177/154596839500900103

52.

Simpson

Booth

Lawrence

Byrne

Mair

Mercer

(2014). Mindfulness based interventions in multiple sclerosis: A systematic review. BMC Neurology, 14, Article 15. https://doi.org/10.1186/1471-2377-14-15

53.

Taylor

Dorstyn

D. S.

Prior

(2020). Stress management interventions for multiple sclerosis: A meta-analysis of randomized controlled trials. Journal of Health Psychology, 24(2), 266–279. https://doi.org/10.1177/1359105319860185

54.

Umucu

C. L.

Lee

Vargas-Medrano

Diaz-Pacheco

Misra

Martin

S. L.

Thompson

P. M.

Gadad

B. S.

(2022). Is gratitude associated with suicidal ideation in veterans with mental illness and student veterans with PTSD symptoms? The Journal of Nervous and Mental Disease, 210(1), 26–31.

55.

Watterson

R. A.

Williams

J. V.

Lavorato

D. H.

Patten

S. B.

(2017). Descriptive epidemiology of generalized anxiety disorder in Canada. The Canadian Journal of Psychiatry, 62(1), 24–29.