title: Factors associated with emotional and behavioral outcomes in adolescents with multiple sclerosis.
abstract: BACKGROUND
  Multiple sclerosis (MS) onset during adolescence has the potential to disrupt a key period of psychosocial maturation.
  
  
  OBJECTIVE
  We aimed to examine the prevalence and risk factors associated with emotional and behavioral outcomes in adolescents with MS.
  
  
  METHODS
  The Behavioral Assessment System for Children-2nd Edition (BASC-2) was completed by 31 adolescents with MS (mean age = 16.1 years), 31 age-matched controls, and parents of all participants. BASC-2 outcomes were compared between groups. Base rates were examined for scores falling at least one or two standard deviations below norm. Associations between BASC-2 outcomes and features of disease severity and IQ were examined.
  
  
  RESULTS
  Youth with MS were reported by their parents to have more symptoms of depression and somatization and lower adaptive skills compared with reports by parents of controls. On the self-report, patients endorsed more problems of inattention/hyperactivity and lower self-reliance relative to controls. Behavioral concerns and reduced adaptive functioning in the MS group were associated with fatigue, poor relations with parents, and perceived social stress. Psychosocial outcomes did not associate with number of relapses, Expanded Disability Status Scale score, disease duration, brain lesion volume or IQ.
  
  
  CONCLUSIONS
  Youth with MS are at risk of difficulties in behavioral and emotional health. Relations with parents emerged as a key factor influencing the emotional well-being of youth with MS, suggesting an important role for family-centered care in this population.
authors.affiliation: Department of Psychology, York University, Toronto, Canada. ctill@yorku.ca
authors.forename: C
authors.initials: C
authors.lastname: Till
authors.forename: E
authors.initials: E
authors.lastname: Udler
authors.forename: R
authors.initials: R
authors.lastname: Ghassemi
authors.forename: S
authors.initials: S
authors.lastname: Narayanan
authors.forename: D L
authors.initials: DL
authors.lastname: Arnold
authors.forename: B L
authors.initials: BL
authors.lastname: Banwell
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D004644:Emotions; D005260:Female; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D008603:Mental Health; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D009864:Ontario / Q000453:epidemiology; D010287:Parent-Child Relations; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012919:Social Behavior; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult