The illness representations of multiple sclerosis and their relations to outcome

Illness representations were assessed in 103 adults with multiple sclerosis (MS) using a widely accepted generic five-component structure of identity, time-line, consequences, cause and cure/controllability. A cross-sectional, correlational design was employed to examine the relationships between the different components of illness representations and the length of time that people had been diagnosed with MS, which demonstrated that no significant associations existed. The inter-relationships among the five components, as well as, the associations between he different components of illness representations and outcome (i.e. illness intrusiveness, physical functioning, depression, anxiety and self-esteem) were also explored. The consequences component showed the most inter-relationships, being positively related to the identity and time-line components and negatively related with the cure/controllability dimension. The identity and consequences were significantly related with each of the areas of outcome, indicating that a strong illness identity and a belief in more serious consequences were associated with greater impairment in each outcome area. A series of stepwise multiple regression analyses were used to determine whether the illness representation components predicted outcome. Overall, illness representations, were important predictors of outcome, where the consequences component was the most important predictor of each outcome area. The perception that MS had serious consequences for the lives of individuals with MS therefore associated with higher levels of illness intrusiveness, greater impairment of physical functioning, higher levels of depression and anxiety, and lower self-esteem. These findings provide evidence to suggest that healthcare professionals who have contact with people with MS should have an awareness of the importance of illness representations and their relations to outcome for this illness population. This would therefore allow individuals with beliefs that may result in psychological, social and physical difficulties to be identified.