Relationship of perceived stress and employment status in individuals with multiple sclerosis

Article type: Research Article

Authors: Beier, Meghan^{a; *} | Hartoonian, Narineh^b | D’Orio, Vanessa L.^c | Terrill, Alexandra L.^d | Bhattarai, Jagriti ‘Jackie’^a | Paisner, Noah D.^e | Alschuler, Kevin N.^e

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Division of Rehabilitation Psychology and Neuropsychology, Baltimore, MD, USA | [b] Multiple Sclerosis Center of Excellence, VA Puget Sound Health Care System, Seattle Division, Seattle, WA, USA | [c] Yeshiva University, Ferkauf Graduate School of Psychology, Bronx, NY, USA | [d] University of Utah, Division of Occupational Therapy, Salt Lake City, UT, USA | [e] Department of Rehabilitation Medicine, University of Washington (UW), UW Medicine Multiple Sclerosis Center, Seattle, WA, USA

Correspondence: [*] Address for correspondence: Meghan Beier, Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Division of Rehabilitation Psychology and Neuropsychology, Church Home Professional Building, Suite 413, 98 North Broadway, Baltimore, MD 21231, USA. Tel.: +1 410 502 9227; Fax: +1 410 502 2419;E-mail: mbeier1@jhu.edu.

Abstract: BACKGROUND:Many individuals with multiple sclerosis (MS) are unemployed relatively soon after diagnosis. There is a paucity of research on the relationship between psychological distress and employment status in persons with MS. OBJECTIVE:To explore the relative distress of employed versus unemployed individuals with MS. METHODS:Secondary cross-sectional analysis of a mailed survey. Variables were categorized by demographics (age, gender, education, marital status), disease (EDSS, MS symptom duration, fatigue, MS-type), and psychosocial factors (depression, anxiety, perceived stress, self-reported general cognitive concerns, self-reported executive dysfunction). Univariate logistic regression analysis was used to identify variables significantly associated with employment status. All significant variables were then included in a multivariate model to identify the most salient correlates. RESULTS:Univariate analyses identified 10 variables that were significantly associated with employment status: age, education, EDSS, MS symptom duration, MS-type, depression symptoms, perceived stress, fatigue, and self-reported cognitive symptoms. The multivariate model yielded four demographic and disease-related variables and one emotional distress variable (older age, moderate disability [EDSS], longer symptom duration, MS-type, higher perceived stress) as significant. CONCLUSIONS:After adjusting for disease variables, demographics, and significant psychosocial factors, perceived stress remained associated with employment status, such that greater perceived stress was associated with being unemployed.

Keywords: Occupational status, productivity, emotional distress, MS symptoms

DOI: 10.3233/WOR-192859

Journal: Work, vol. 62, no. 2, pp. 243-249, 2019