Adjustment to multiple sclerosis and identity satisfaction among newly diagnosed women: what role does motherhood play?

ABSTRACT

The present study aimed to describe the levels of depressive symptoms, affective well-being and identity satisfaction in a group of women recently diagnosed with multiple sclerosis (MS), accounting for differences in age, motherhood, and disease duration. Moreover, the role of identity satisfaction in depressive symptoms and affective well-being was evaluated, examining the moderating effect of motherhood. The study involved 74 women, aged between 19 and 57 years (Mean = 37.7 years, SD = 10.7 years). Thirty-two women (43.2%) had children, aged between 2 and 29 years. All women had relapsing-remitting multiple sclerosis (RRMS) and mild to moderate disability. Mothers experienced greater depressive symptoms than childless women. Moreover, motherhood moderated the effect of disease duration on adjustment, with mothers reporting greater depressive symptoms, less affective well-being and less identity satisfaction than childless women as time passed since the diagnosis. Finally, greater identity satisfaction was related to less depressive symptoms and greater affective well-being, with a moderating effect of motherhood. The results outline the relevance of the process of identity redefinition for women’s adjustment to MS early in the illness. Moreover, the results underscore the need to take into account the additional burden of motherhood when promoting women’s adjustment to MS.

KEYWORDS:

• Affective well-being
• depressive symptoms
• identity
• motherhood
• multiple sclerosis

Notes

1. Cognitive impairment was evaluated through the Brief Repeatable Battery of Neuropsychological Tests (BRB-N), a sensitive measure of cognitive deficits in multiple sclerosis patients. Patients reporting two or more BRB-N test scores under cut-off threshold were considered to have clinical significant cognitive impairment and thus were excluded from the study.

2. The cut-off age of 40 was chosen because MS is usually diagnosed before this age and because most births in Italy are from mothers under the age of 40 (ISTAT 2016).

3. The Expanded Disability Status Scale (EDSS) score (Kurtzke 1983), the most widely used measure of disability in MS, is evaluated by a neurologist. The EDSS score varies between 0 and 10. In our study, the participants’ EDSS scores ranged between 0 (no disability) and 4 (autonomous, able to walk without aid or rest some 500 meters, moderate neurological deficits in diverse functional systems), therefore representing patients with mild to moderate levels of disability (Table 1).

4. All the analyses were also performed adjusting the p value for multiple comparisons (Bonferroni correction). With the more conservative p value of 0.0125, the interaction effect of motherhood X disease duration remained statistically significant for depressive symptoms, was at the limit of significance for affective well-being and did not reach significance for identity satisfaction. Considering that the study was explorative and no previous research investigated this topic, we retained and commented results statistically significant at p < .05.

Additional information

Funding

This work was supported by the Cosso Foundation - Pinerolo (TO) Italy.