title: Predictors of anxiety in multiple sclerosis.
abstract: OBJECTIVE
  The aims of this study were to (1) identify the predictors of symptoms of anxiety, and (2) evaluate the differential association of somatic and nonsomatic symptoms of depression on anxiety over time in persons with multiple sclerosis (MS).
  
  
  METHODS
  Participants were 513 persons with MS who previously enrolled in a study exploring the experience of living with MS and completed a 4-month follow-up survey. The main outcome measure used was the Hospital Anxiety and Depression Scale-Anxiety. Demographic, disease-associated variables (time since onset of MS, Expanded Disability Status Scale Mobility, pain, and fatigue), and Time 1 psychological variables were entered into a hierarchical regression model to examine predictors at baseline for anxiety symptoms at Time 2.
  
  
  RESULTS
  A large portion of the sample was White (92%), female (82%), and had relapsing-remitting MS (57%). After adjusting for demographic and disease related variables, anxiety (β <.001), employment (β = .07), and nonsomatic depressive symptoms (β = .10) at baseline significantly predicted anxiety at Time 2, ps < .05. Interactions revealed significant effects for time since onset of MS and somatic symptoms as well as time since onset and nonsomatic symptoms, ps < .05. Nonsomatic symptoms were more linked to anxiety early in the disease and somatic symptoms were more prominently linked to anxiety later in the disease.
  
  
  CONCLUSIONS
  Findings suggest that nonsomatic symptoms of depression and employment predict anxiety in MS. The relationship between different aspects of depression and anxiety may change over the course of the disease.
authors.affiliation: Veterans Affairs Puget Sound Health Care System.
authors.forename: Narineh
authors.initials: N
authors.lastname: Hartoonian
authors.affiliation: Department of Rehabilitation Medicine.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Terrill
authors.affiliation: Department of Rehabilitation Medicine.
authors.forename: Meghan L
authors.initials: ML
authors.lastname: Beier
authors.affiliation: Veterans Affairs Puget Sound Health Care System.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.affiliation: School of Psychology, Australian Catholic University.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Day
authors.affiliation: Department of Rehabilitation Medicine, University of Washington School of Medicine.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Alschuler
mesh_terms: D000223:Adaptation, Psychological; D001008:Anxiety Disorders / Q000150:complications* / Q000523:psychology*; D059350:Chronic Pain / Q000150:complications / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D004185:Disability Evaluation; D004651:Employment; D005221:Fatigue / Q000150:complications / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology*; D011795:Surveys and Questionnaires