Psychological symptoms and perceived cognitive impairment in multiple sclerosis: The role of rumination

Abstract

Purpose/objective: Perceived cognitive impairment is a common concern among individuals with multiple sclerosis (MS) and is associated with prevalent psychological symptoms, namely depression and anxiety. The mechanisms by which these psychological symptoms are associated with perceived cognitive impairment among people diagnosed with MS have been unexplored. A possible mechanism is rumination, a maladaptive form of self-reflection that is commonly associated with anxiety and depression. The purpose of this study was to examine the associations of symptoms of anxiety and depression with perceived cognitive impairment, and to examine whether anxiety and depression indirectly affect cognitive impairment through rumination. Research Method/Design: The study utilized a cross-sectional observational design. People diagnosed with MS (N = 111) were recruited from an MS clinic in Toronto, and through the community. Participants completed self-report questionnaires that included the Multiple Sclerosis Neuropsychological Screening Questionnaire (MSNQ), the Hospital Anxiety and Depression Scale (HADS), and the Rumination-Reflection Questionnaire (RRQ). Two indirect effect statistical analyses were conducted using bootstrapping techniques.

Results: We found a positive association between both symptoms of depression and anxiety and perceived cognitive impairment. Moreover, psychological symptoms were related to perceived cognitive impairment indirectly through rumination, indicating ruminative thinking style may be implicated in the relationship between anxiety, depression, and perceived cognitive impairment.

Conclusions/implications: These findings provide additional support for previous research examining the relationship between psychological symptoms (e.g., anxiety and depression) and perceived cognitive impairment, and enrich our understanding of a potential mechanism driving these relationships. (PsycINFO Database Record