title: Coping with Multiple Sclerosis Scale: Reconsideration of the Factorial Structure.
abstract: BACKGROUND
  The Coping with Multiple Sclerosis Scale (CMSS) was developed to assess coping strategies specific to multiple sclerosis (MS). Despite its wide application in MS research, psychometric support for the CMSS remains limited to the initial factor analytic investigation by Pakenham in 2001.
  
  
  METHODS
  The current investigation assessed the factor structure and construct validity of the CMSS. Participants with MS (N = 453) completed the CMSS, as well as measures of disability related to MS (Multiple Sclerosis Impact Scale), quality of life (World Health Organization Quality of Life Brief Scale), and anxiety and depression (Hospital Anxiety and Depression Scale).
  
  
  RESULTS
  The original factor structure reported by Pakenham was a poor fit to the data. An alternate seven-factor structure was identified using exploratory factor analysis. Although there were some similarities with the existing CMSS subscales, differences in factor content and item loadings were found. Relationships between the revised CMSS subscales and additional measures were assessed, and the findings were consistent with previous research.
  
  
  CONCLUSIONS
  Refinement of the CMSS is suggested, especially for subscales related to acceptance and avoidance strategies. Until further research is conducted on the revised CMSS, it is recommended that the original CMSS continue to be administered. Clinicians and researchers should be mindful of lack of support for the acceptance and avoidance subscales and should seek additional scales to assess these areas.
authors.forename: Holly A
authors.initials: HA
authors.lastname: Parkerson
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Kehler
authors.forename: Donald
authors.initials: D
authors.lastname: Sharpe
authors.forename: Heather D
authors.initials: HD
authors.lastname: Hadjistavropoulos