Relationships among depressive symptoms, benefit-finding, optimism, and positive affect in multiple sclerosis patients after psychotherapy for depression.
OBJECTIVE
While many patients with multiple sclerosis (MS) experience psychological problems, such as depression, benefit-finding is commonly reported. Using the Broaden-and-Build Model of positive emotions (Fredrickson, 2001) and the Expectancy-Value Model of optimism (Carver & Scheier, 1998) as two related, yet, distinct conceptual frameworks, this study examined positive affect and optimism as mediators of the relationship between improved depression and enhanced benefit-finding.


METHODS
MS patients (N=127), who participated in a larger, randomized clinical trial comparing two types of telephone psychotherapy for depression, were assessed at baseline, midtherapy (8 weeks), end of therapy (16 weeks), and 6- and 12-month posttherapy.


METHODS
Depression was measured with a telephone administered version of the Hamilton Rating Scale for Depression; Positive Affect was measured with the Positive Affect Subscale from the Positive and Negative Affect Scale; Optimism was measured with the Life Orientation Test-Revised; Benefit-Finding was measured with the revised version of the Stress-Related Growth Scale.


RESULTS
Data were analyzed with multilevel random-effects models, controlling for time since MS diagnosis and type of treatment. Improved depression was associated with increased benefit-finding over time. The relationship between improved depression and benefit-finding was significantly mediated by both increased optimism and increased positive affect.


CONCLUSIONS
Findings provide support to both theoretical models. Positivity appears to promote benefit-finding in MS.
Hart
Stacey L
SL
Department of Psychiatry, University of California, San Francisco, CA, USA. stacey.hart@psych.ryerson.ca
Vella
Lea
L
Mohr
David C
DC
D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D015928:Cognitive Behavioral Therapy; D003469:Culture; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009042:Motivation; D020528:Multiple Sclerosis, Chronic Progressive / Q000523:psychology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000523:psychology*; D010555:Personality Inventory; D011613:Psychotherapy; D012803:Sick Role; D013689:Telephone