Research Article| Volume 73, 104608, May 2023

Healthier living with MS: The key role of self-efficacy and emotion regulation


      • In people with MS, MS Self-efficacy has a negative effect on distress but a positive effect on the QOL.
      • Difficulties in emotion regulation mediate the relationship between MS self-efficacy and distress in people with MS.
      • Difficulties in emotion regulation mediate the relationship between MS self-efficacy and QOL in people with MS.
      • In the relapsing-remitting MS, the means of MS self-efficacy was higher and the mean distress was lower than in the secondary progressive MS.
      • There was no significant difference between types of MS in terms of the difficulties in emotion regulation and QOL.



      Understanding distress and quality of life (QOL) is important in improving the lives of people with multiple sclerosis (MS), and investigating their antecedents is very important. The present study aimed to examine the role of multiple sclerosis self-efficacy and difficulties in emotion regulation in predicting distress and QOL in people with MS. Also, this study compared types of MS (RRMS, PPMS, and SPMS) in terms of MS self-efficacy, difficulties in emotion regulation, distress, and QOL.


      This study included 122 people with three types of MS (RRMS=33, PPMS=62, and SPMS=25). Data were collected by the use of four scales: Quality of Life (QOL), Psychological Distress (DASS), Difficulties in Emotion Regulation (DERS), and Multiple Sclerosis Self-Efficacy (MSSE). Pearson's correlation, path analysis, MANOVA, and Tukey's post hoc test were used for data analysis.


      Findings indicated MS self-efficacy had negative and significant effects on difficulties in emotion regulation and distress and had a positive and significant effect on QOL. Difficulties in emotion regulation had a negative and significant effect on QOL and a positive and significant effect on distress. Also, the indirect effect (through difficulties in emotion regulation) of MS self-efficacy on distress and QOL was significant. In addition, the comparisons showed that differences between RRMS and SPMS in terms of MS self-efficacy and distress were significant.


      Self-efficacy and emotion regulation are key components in improving the life (reducing distress and increasing QOL) of people with MS, although it depends to some extent on the type of MS disease.


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