title: Social cognitive correlates of physical activity among persons with multiple sclerosis: Influence of depressive symptoms.
abstract: BACKGROUND
  Physical inactivity and elevated depressive symptoms are both highly prevalent and correlated among persons with multiple sclerosis (MS). Variables from Social Cognitive Theory (SCT) might be differentially correlated with physical activity in persons with MS who have elevated depressive symptoms.
  
  
  OBJECTIVE
  This study investigated the influence of elevated depressive symptoms on correlates of physical activity based on SCT in persons with MS.
  
  
  METHODS
  Participants (mean age = 50.3 years, 87% female, 69% Caucasian) completed questionnaires on physical activity, depressive symptoms, self-efficacy, social support, outcome expectations, functional limitations, and goal setting. The questionnaires were delivered and returned through the U.S. Postal Service. The sample (N = 551) was divided into 2 subgroups (i.e., elevated vs non-elevated levels of depressive symptoms) for statistical analyses. Bivariate correlations and stepwise multiple regressions were conducted using SPSS.
  
  
  RESULTS
  Self-efficacy (r = 0.16), functional limitations (r = 0.22) and goal-setting (r = 0.42) were significantly (p < 0.05) associated with physical activity among the elevated depressive sample. The regression analysis indicated that self-efficacy predicted physical activity in Step 1 (β = 0.16, p < 0.05), but was no longer significant when goal-setting (β = 0.06, p > 0.05) entered the model. All social cognitive variables were significantly associated with physical activity levels (r = 0.16-0.40, p < 0.001) among the non-elevated depressive sample. Self-efficacy predicted physical activity in Step 1 (β = 0.24, p < 0.001), but it was no longer significant once goal-setting, functional limitations, and self-evaluative outcome expectations entered the model.
  
  
  CONCLUSIONS
  Based on SCT, self-efficacy and goal-setting represent possible targets of behavior interventions for increasing physical activity among persons with MS who have elevated depressive symptoms. There is a larger set of targets among those with MS who do not have elevated symptoms.
authors.affiliation: Center for Behavioral Cardiovascular Health, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA. Electronic address: ie2145@cumc.columbia.edu.
authors.forename: Ipek
authors.initials: I
authors.lastname: Ensari
authors.affiliation: University of Illinois at Urbana-Champaign, Department of Kinesiology and Community Health, 906S Goodwin Ave, 233 Freer Hall, Urbana, IL 61801, USA. Electronic address: kinnett2@illinois.edu.
authors.forename: Dominique
authors.initials: D
authors.lastname: Kinnett-Hopkins
authors.affiliation: University of Alabama at Birmingham, Department of Physical Therapy, 1705 University Blvd SHPB 336, Birmingham, AL 35233-1212, USA. Electronic address: robmotl@uab.edu.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Motl
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003071:Cognition; D003863:Depression / Q000150:complications*; D006233:Persons with Disabilities; D015444:Exercise; D005260:Female; D006040:Goals; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States
keywords: Depression; HADS; Multiple sclerosis; Physical activity; Social cognitive theory