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. 2016 Oct;39(5):855-65.
doi: 10.1007/s10865-016-9762-6. Epub 2016 Jul 2.

The role of appraisal and coping style in relation with societal participation in fatigued patients with multiple sclerosis: a cross-sectional multiple mediator analysis

Lizanne Eva van den Akker  1   2   3 , Heleen Beckerman  4   5   6 , Emma Hubertine Collette  7 , Gijs Bleijenberg  8 , Joost Dekker  4   5 , Hans Knoop  8 , Vincent de Groot  4   5   6 ; TREFAMS-ACE study group
Collaborators, Affiliations

The role of appraisal and coping style in relation with societal participation in fatigued patients with multiple sclerosis: a cross-sectional multiple mediator analysis

Lizanne Eva van den Akker et al. J Behav Med. 2016 Oct.

Abstract

To determine the relationship between appraisal and societal participation in fatigued patients with Multiple Sclerosis (MS), and whether this relation is mediated by coping styles. 265 severely-fatigued MS patients. Appraisal, a latent construct, was created from the General Self-Efficacy Scale and the helplessness and acceptance subscales of the Illness Cognition Questionnaire. Coping styles were assessed using the Coping Inventory Stressful Situations (CISS21) and societal participation was assessed using the Impact on Participation and Autonomy. A multiple mediator model was developed and tested by structural equation modeling on cross-sectional data. We corrected for confounding by disease-related factors. Mediation was determined using a product-of-coefficients approach. A significant relationship existed between appraisal and participation (β = 0.21, 95 % CI 0.04-0.39). The pathways via coping styles were not significant. In patients with severe MS-related fatigue, appraisal and societal participation show a positive relationship that is not mediated by coping styles.

Keywords: Appraisal; Coping; Multiple mediator model; Multiple sclerosis; Participation.

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Conflict of interest statement

Lizanne Eva van den Akker, Heleen Beckerman, Emma Hubertine Collette, Gijs Bleijenberg, Joost Dekker, Hans Knoop, Vincent de Groot, and TREFAMS-ACE study group declare that they have no conflict of interest. Human and animal rights and Informed consent All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Figures

Fig. 1
Fig. 1
Multiple mediation model of appraisal (independent variable), coping styles (mediating variables) and societal participation (dependent variable). For clarity, the MS-related confounding factors and observed variables used for the latent variables are not displayed
Fig. 2
Fig. 2
Final Multiple Mediator Model: relation of appraisal and societal participation, mediated with task-oriented, emotion-oriented and avoidance-oriented coping style. Adjustments for confounding by MS-related disability are not presented in the figure. *p ≤ 0.05; **p = 0.001
See this image and copyright information in PMC

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