title: The interrelations between spiritual well-being, pain interference and depressive symptoms in patients with multiple sclerosis.
abstract: Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain interference. In mediation models, depression was not related to pain interference via spiritual well-being, or to spiritual well-being via pain interference. Pain interference was related to depression via spiritual well-being and meaning/peace, and to spiritual well-being and meaning/peace via depressive symptoms. Finally, spiritual well-being and meaning/peace were related to depression via pain interference, and to pain interference via depressive symptoms. For patients with MS, a multi-faceted approach to treatment that includes pain reduction and promotion of spiritual well-being may be beneficial, although amelioration of depression remains a critical task.
authors.affiliation: McMaster Childrens Hospital, Hamilton Health Sciences, Hamilton, Canada.
authors.forename: Sheri A
authors.initials: SA
authors.lastname: Nsamenang
authors.affiliation: Department of Psychology, East Tennessee State University, 420 Rogers Stout Hall, Johnson City, TN, 37614, USA. hirsch@etsu.edu.
authors.forename: Jameson K
authors.identifier: http://orcid.org/0000-0003-3901-0452
authors.initials: JK
authors.lastname: Hirsch
authors.affiliation: Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, London, UK.
authors.forename: Raluca
authors.initials: R
authors.lastname: Topciu
authors.affiliation: Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Goodman
authors.affiliation: Departments of Psychiatry and Family Medicine, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009103:Multiple Sclerosis / Q000150:complications; D015999:Multivariate Analysis; D011788:Quality of Life / Q000523:psychology*; D029181:Spirituality
keywords: Depressive symptoms; Multiple sclerosis; Pain interference; Spiritual well-being