Perceived Uncertainty, Spiritual Well-Being, and Psychosocial Adaptation in Individuals With Multiple Sclerosis.

Abstract

Objective: To examine the role of spiritual well-being as a mediator and moderator between perceived uncertainty and psychosocial adaptation to multiple sclerosis (MS). Participants and Design: Fifty individuals (40 women, 10 men) diagnosed with multiple sclerosis. Main Outcome Measures: Selfreport measures on illness uncertainty, spiritual (religious and existential) well-being, and psychosocial adjustment to illness were analyzed by a series of hierarchical multiple regression analyses. Results: Both uncertainty and spiritual well-being independently predicted psychosocial adjustment to MS after the influence of demographic and disability-related variables were considered. Spiritual well-being demonstrated a mediator effect but, mostly, failed to show a moderator effect. Conclusion: Spiritual well-being exerts an appreciable influence on adaptation to MS and also acts to mitigate the impact of uncertainty on adaptation. Rehabilitation psychologists may wish to consider its beneficial role as part of their clinical work. Multiple sclerosis (MS), one of the most common disabling diseases of young adults, is an inflammatory demyelinating disorder of the central nervous system with an estimated prevalence of about 250,000‐350,000 individuals in the United States (Devins & Shnek, 2000; Kalb, 1996; Schapiro, 1998). First symptoms usually appear at the young adult age, but the disease may also become evident later in life. The course of MS is highly variable and makes studies of etiology and possible mechanisms of treatment challenging. Because of MS’s highly variable clinical course, individual outcomes cannot be reliably predicted. For many individuals, MS starts with a relapsing‐remitting pattern with episodic exacerbations of neurological dysfunction, which remit completely or partially. Over the years, for most individuals, the disease develops into the secondary progressive form with accumulated disability (Lublin & Reingold, 1996).