title: Self-efficacy as a longitudinal predictor of perceived cognitive impairment in individuals with multiple sclerosis.
abstract: OBJECTIVE
  To determine whether self-efficacy longitudinally predicts 2 types of perceived cognitive impairment (PCI) in multiple sclerosis (MS): general cognitive functioning and executive functioning; and secondarily to assess whether self-efficacy mediates the relationships between depression, fatigue, and PCI.
  
  
  METHODS
  Longitudinal analysis of self-report survey data collected over 3 years. Hierarchical regression analyses examined the relationship between self-efficacy and PCI, adjusting for depression and fatigue. Additional analyses tested self-efficacy as a mediator between depression, fatigue, and PCI.
  
  
  METHODS
  Community.
  
  
  METHODS
  Community-dwelling individuals with MS (N=233; age range, 22-83y) were recruited from a larger longitudinal survey study of individuals with MS (N=562).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Primary outcome measures were the Applied Cognition-General Concerns and the Applied Cognition-Executive Function domains of the Quality of Life in Neurological Disorders (NeuroQoL) measures.
  
  
  RESULTS
  Self-efficacy was significantly correlated with PCI at baseline (r=.40-.53) and 3 years later (r=.36-.44). In multivariate regression analyses, self-efficacy was a significant longitudinal predictor of PCI, both for general cognitive functioning (β=.20, P<.01) and executive functioning (β=.16, P<.05). Self-efficacy partially mediated the relationships between depression, fatigue, and PCI.
  
  
  CONCLUSIONS
  Self-efficacy may influence how individuals with MS perceive their cognitive functioning over time. Interventions that target self-efficacy, particularly early in the disease course, may lead to improvements in PCI, as well as improvements in fatigue and depression.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA. Electronic address: ajhughes@uw.edu.
authors.forename: Abbey J
authors.initials: AJ
authors.lastname: Hughes
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Meghan
authors.initials: M
authors.lastname: Beier
authors.affiliation: Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA.
authors.forename: Narineh
authors.initials: N
authors.lastname: Hartoonian
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Multiple Sclerosis Center of Excellence West, Veterans Affairs Puget Sound Health Care System, Seattle, WA.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Amtmann
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D004522:Educational Status; D005221:Fatigue / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D009483:Neuropsychological Tests; D011788:Quality of Life; D020377:Self Efficacy; D012720:Severity of Illness Index
keywords: Cognition; Executive function; Longitudinal studies; Multiple sclerosis; Rehabilitation; Self efficacy; Self report