title: Stress-stimulated volitional coping competencies and depression in multiple sclerosis.
abstract: OBJECTIVE
  The present study examined the relationship between volitional modes of coping (self-regulation, volitional inhibition, and self-control) and depression in individuals with multiple sclerosis.
  
  
  METHODS
  A cross-sectional study of 121 participants aged 22-60 years with clinically defined MS who were consecutively admitted to a neurological rehabilitation center during a 23-month period. Correlation analyses and hierarchical regressions were conducted to evaluate the predictive value of volitional competencies (Volitional Components Questionnaire, short form, VCQ-S) on depression (Centre for Epidemiologic Studies Depression Scale, CES-D), while controlling for demographic (age, gender, and education) and certain clinical variables (Expanded Disability Status Scale, EDSS; disease duration; and Modified Fatigue Impact Scale, MFIS).
  
  
  RESULTS
  Hierarchical regression analyses of depression revealed a model in which 68% of the variance in the CES-D was explained by daily stress situations (VCQ-S), self-regulation (VCQ-S), fatigue (MFIS), and education. However, when the analysis included only participants who had scored above the cut-off of the CES-D (n=42), the VCQ-S factor volitional inhibition seemed to play a more relevant part in depression. In particular, the VCQ-S scales stimulation of self-access, stimulation of volitional inhibition, self-motivation, and emotional perseverance/state orientation after failure appear to be valuable predictors on CES-D.
  
  
  CONCLUSIONS
  The results suggest that personality-accentuated volitional coping competencies elicited by daily stressful situations could be a relevant factor for depressive mood states in individuals with MS. However, to clarify the exact relationships of this rather circular framework, longitudinal study designs with objective measurements and a stronger focus on MS-specific stressors are needed.
authors: Department of Cognitive Rehabilitation, Neurological Rehabilitation Center Godeshöhe, University Hospital, Bonn, Waldstrasse 2-10, D-53117 Bonn, Germany. nielsen-prohl@godeshoehe.de
authors: J
authors: J
authors: Nielsen-Prohl
authors: J
authors: J
authors: Saliger
authors: V
authors: V
authors: Güldenberg
authors: G
authors: G
authors: Breier
authors: H
authors: H
authors: Karbe
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology*; D014836:Volition / Q000502:physiology*; D055815:Young Adult