title: Longitudinal predictors of psychological distress and self-esteem in people with ALS.
abstract: OBJECTIVE
  To identify predictors of psychological distress (measured by anxiety and depression) and low self-esteem and to determine whether these change over time in people with ALS.
  
  
  METHODS
  We interviewed 50 patients with ALS living with a spouse/partner; further interviews were held at median intervals of 6 and then 5 months. Although carers were interviewed, we report the patients' data. Patients completed measures about their social support and marital relationship; the functional impact of ALS; everyday cognitive, emotional, and behavioral changes; symptoms of anxiety and depression; and self-esteem. The ALS Severity Scale was also completed.
  
  
  RESULTS
  From the initial sample of 50, 26 patients were interviewed on all three occasions. At the first interview, negative social support and bulbar impairment were most predictive of psychological distress; pre-illness marital intimacy was the best predictor of patients' self-esteem. Over time, negative social support and pre-illness marital intimacy retained an ability to predict patients' affective state and self-esteem.
  
  
  CONCLUSIONS
  Social factors are important in determining longer-term psychological well-being in people with ALS who are in the relatively early stages of the disease.
authors.affiliation: MRC Center for Neurodegeneration Research, King's College London, Department of Psychology, Institute of Psychiatry, UK. l.goldstein@iop.kcl.ac.uk
authors.forename: L H
authors.initials: LH
authors.lastname: Goldstein
authors.forename: L
authors.initials: L
authors.lastname: Atkins
authors.forename: S
authors.initials: S
authors.lastname: Landau
authors.forename: R G
authors.initials: RG
authors.lastname: Brown
authors.forename: P N
authors.initials: PN
authors.lastname: Leigh
mesh_terms: D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000209:etiology; D010244:Bulbar Palsy, Progressive / Q000150:complications / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000209:etiology; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008393:Marriage / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D011237:Predictive Value of Tests; D011584:Psychology / Q000706:statistics & numerical data / Q000639:trends; D012649:Self Concept; D012944:Social Support; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors