title: Coping mediates and moderates the relationship between executive functions and psychological adjustment in multiple sclerosis.
abstract: OBJECTIVE
  To identify the moderating and mediating relationship of different coping strategies between executive function and stress, depression and anxiety in people with multiple sclerosis (PwMS).
  
  
  METHODS
  Participants were 107 people with relapsing remitting or secondary progressive multiple sclerosis who were administered tasks of executive function and completed self-report measures of stress, depression, anxiety, and coping.
  
  
  RESULTS
  An indirect relationship was found between executive function and psychosocial adjustment through maladaptive coping strategies: behavioral and mental disengagement, and substance abuse; adaptive coping strategies: acceptance, active, positive reinterpretation, and growth, as well as for an index of adaptive coping. In general, a relationship was found between better performance on tasks of executive function and psychosocial adjustment when adaptive coping strategies were low, as opposed to high, or maladaptive coping strategies were high, as opposed to low. Some unexpected findings are also discussed.
  
  
  CONCLUSIONS
  Executive function and psychosocial adjustment is mediated and moderated by coping strategies used by PwMS. Well-preserved executive function provides relative protection from poorer adjustment in the presence of high maladaptive or low adaptive coping. PwMS who perform poorly on tasks of executive function benefit from using less cognitively demanding adaptive coping strategies to enhance adjustment outcomes and further research in this area would be advantageous to underpin effective intervention strategies.
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Grech
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne.
authors.forename: Litza A
authors.initials: LA
authors.lastname: Kiropoulos
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Kirby
authors.affiliation: Department of Neurology, Monash Medical Centre.
authors.forename: Ernest
authors.initials: E
authors.lastname: Butler
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne.
authors.forename: Mark
authors.initials: M
authors.lastname: Paine
authors.affiliation: Melbourne School of Psychological Sciences, University of Melbourne.
authors.forename: Robert
authors.initials: R
authors.lastname: Hester
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001288:Attention; D003657:Decision Making; D003863:Depression / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008606:Mental Processes; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000523:psychology*; D011340:Problem Solving; D011597:Psychomotor Performance; D013315:Stress, Psychological / Q000523:psychology; D019966:Substance-Related Disorders / Q000523:psychology; D014705:Verbal Behavior