title: Emotional distress and activities of daily living functioning in persons with multiple sclerosis.
abstract: BACKGROUND
  Emotional distress is higher in persons with multiple sclerosis (MS) than in other chronic illnesses. Not known is whether personal attributes of the person with MS and/or the presence of social support will function as mediating and/or moderating variables between emotional distress and adaptation to the illness.
  
  
  OBJECTIVE
  Determine if personal attributes and social support function as mediating and/or moderating variables between emotional distress and ADL functioning in persons with MS.
  
  
  METHODS
  Secondary analyses of data obtained from 686 persons with MS through self-report measures of emotional distress, personal attributes, social support, and ADL functioning was conducted. Separate mediation and moderation models were tested using stepwise and hierarchical multiple regression. Demographic variables of education, age, and length of MS illness, were controlled in all analyses.
  
  
  RESULTS
  Personal attributes and social support functioned as mediator variables between emotional distress and ADL functioning. Additionally, personal attributes and not social support functioned as a moderator. Significant main effects were shown for social support and emotional distress in the moderator model.
  
  
  CONCLUSIONS
  Personal attributes and social support mediated the effects of emotional distress by decreasing its impact on ADL functioning. Personal attributes, as a moderator variable, demonstrated that higher levels were associated with low levels of emotional stress and moderate or lower levels of personal attributes were associated with increased emotional distress suggesting that personal attributes may intervene between emotional distress and ADL functioning by attenuating or preventing a stress appraisal response.
authors.affiliation: College of Nursing, Rutgers, The State University of New Jersey, Newark 07102, USA.
authors.forename: E E
authors.initials: EE
authors.lastname: Gulick
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004522:Educational Status; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D012944:Social Support