Coping strategies and adjustment to multiple sclerosis among recently diagnosed patients: the mediating role of sense of coherence

OBJECTIVE: To examine the relationship between coping strategies (problem solving, emotional release, and avoidance) and adjustment (health-related quality of life, depression, and affective well-being) in a group of recently diagnosed multiple sclerosis patients (up to three years since diagnosis), and to explore the mediating role of sense of coherence between coping strategies and adjustment. DESIGN: Cross-sectional. SETTING: Multiple Sclerosis Clinic Centre. SUBJECTS: A total of 102 patients (61.8% women; age (years): M = 35.8, SD = 11.9; 95% with a relapsing-remitting form of multiple sclerosis; Expanded Disability Status Scale score, between 1 and 4). INTERVENTIONS: Not applicable. MAIN MEASURES: Coping with multiple sclerosis (problem solving, emotional release, and avoidance), sense of coherence, health-related quality of life (SF-12), depression (CES-D), and affective well-being (PANAS). RESULTS: Problem solving was linked to higher mental health ( β = 0.28) and higher affective well-being ( β = 0.36), emotional release was related to lower depression ( β = -0.22); avoidance was associated to higher mental health ( β = 0.25), higher affective well-being ( β = 0.24), and lower depression ( β = -0.29 ) (all betas were significant at p < 0.05). Sense of coherence mediated the relationship between emotional release and depression (Sobel z-value = -2.00; p < 0.05) and the relationship between avoidance and all the indicators of adjustment (mental health: Sobel z-value = 1.97; depression: Sobel z-value = -2.02; affective well-being: Sobel z-value= 2.05; p < 0.05). CONCLUSIONS: Emotional and avoidant coping strategies seem to be adaptive among recently diagnosed multiple sclerosis patients. A mediating role between coping strategies and adjustment is played by sense of coherence.