title: Unemployment in multiple sclerosis: the contribution of personality and disease.
abstract: BACKGROUND
  Multiple sclerosis (MS) is the leading cause of neurological disability among young and middle-aged adults. One of the most devastating consequences of MS in this relatively young population group is unemployment. Although certain demographic and disease factors have been associated with employment, few studies have examined the contribution of person-specific factors, such as personality.
  
  
  OBJECTIVE
  The goal of this study was to determine the extent to which personality, demographics, and clinical measures contribute to unemployment in MS.
  
  
  METHODS
  A total of 101 individuals with MS who were enrolled in a clinical trial on cognition underwent a brief neuropsychological battery and completed questionnaires related to vocation, mood, fatigue, and personality. Neurological impairment was measured with the Expanded Disability Status Scale (EDSS).
  
  
  RESULTS
  Employment status was related with disease duration, MS subtype, level of neurological impairment, fatigue, performance on measures assessing information processing speed (Symbol Digit Modalities Test (SDMT)), learning and memory (Selective Reminding Test), and the personality characteristic of persistence. Based on a forward logistic regression analysis, EDSS, SDMT, and persistence were the strongest predictors of employment status.
  
  
  CONCLUSIONS
  These findings underscore the importance of personality on outcomes in MS and point to the need for more clinical attention and research in this area.
authors.affiliation: Kessler Foundation Research Center, West Orange, NJ, USA. lstrober@kesslerfoundation.org
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Strober
authors.forename: Christopher
authors.initials: C
authors.lastname: Christodoulou
authors.forename: Ralph H B
authors.initials: RH
authors.lastname: Benedict
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Westervelt
authors.forename: Patricia
authors.initials: P
authors.lastname: Melville
authors.forename: William F
authors.initials: WF
authors.lastname: Scherl
authors.forename: Bianca
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.forename: Syed
authors.initials: S
authors.lastname: Rizvi
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Goodman
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Krupp
mesh_terms: D000328:Adult; D000339:Affect; D016009:Chi-Square Distribution; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D000077265:Donepezil; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D007858:Learning; D016015:Logistic Models; D008297:Male; D008568:Memory; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D009483:Neuropsychological Tests; D009518:New York; D018697:Nootropic Agents / Q000627:therapeutic use; D010551:Personality; D010880:Piperidines / Q000627:therapeutic use; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014478:Unemployment / Q000523:psychology*
chemical_list: D007189:Indans; D018697:Nootropic Agents; D010880:Piperidines; D000077265:Donepezil