Date of Award




Document Type


Degree Name

Doctor of Philosophy (PhD)


Department of Psychology


Clinical Psychology

Content Description

1 online resource (ix, 136 pages) : color illustrations.

Dissertation/Thesis Chair

Julia M Hormes

Committee Members

Mitchell Earleywine, Drew Anderson


adjustment to disease, anxiety, coping, depression, emotion regulation, multiple sclerosis, Multiple sclerosis, Depression, Mental, Adjustment (Psychology), Emotions, Self-control

Subject Categories



Multiple sclerosis (MS) is an immune-mediate disease affecting the central nervous system (CNS), producing a range of physical and emotional symptoms. Psychological disorders, particularly depression and anxiety, are common in MS, but only partially accounted for by MS symptoms. The associations between common MS sequelae (e.g., fatigue, pain, disability) and mental health indicators are weak and inconsistent, suggesting the presence of moderators. This research study examined two possible moderators of the association between MS sequelae and adjustment to disease: emotion regulation and coping. Emotion regulation refers to the processes used to modulate emotional experiences. It is closely related to coping, which refers to the strategies used to respond to stressful situations. Emotion dysregulation has been consistently linked to mood and anxiety disorders in the general population but has not been extensively studied in MS. One hundred and ninety-eight adults with MS (89.0% female, mean age = 43.42 years, SD = 12.05, 77.0% diagnosed with relapsing-remitting MS) completed an anonymous online survey that included the Performance Scales (PS), Difficulties in Emotion Regulation Scale (DERS), COPE Inventory, Center for Epidemiological Studies Depression Scale-Revised (CESD-R), and Penn State Worry Questionnaire (PSWQ). Emotion dysregulation was positively associated with transformed depression (β = 0.54, p < 0.001) and anxiety scores (β = 0.56, p < 0.001). Behavioral disengagement was positively associated with transformed depression score (β = 0.32, p < 0.001) whereas problem-focused coping was negatively associated with transformed depression score (β = -0.24, p < 0.001). Focusing on and venting of emotions (β = 0.32, p < 0.001) was positively associated with anxiety, whereas problem-focused coping was negatively associated with anxiety (β = -0.20, p = 0.010). Better emotion regulation and greater use of problem-focused coping mitigated the effect of functional disability on depression at lower levels of disability. Findings have implications for research and interventions focused on psychological adjustment to MS. In earlier stages of disease progression, bolstering ways of regulating emotions and managing stress may be especially beneficial. Additional forms of support may be needed at later stages of disease, although future research is needed to identify what would be the most helpful to people with MS.

Included in

Psychology Commons