Mood disorders are highly prevalent in people with multiple sclerosis MS. MS causes changes to a person's sense of self. The Social Identity Model of Identity Change posits that group membership can have a positive effect on The Social Identity Model of Identity Change posits that group membership can have a positive effect on mood during identity change.
The family is a social group implicated in adjustment to MS. The objectives of this study were to investigate whether family identity can predict mood in people with MS and to test whether this prediction was mediated by social support and connectedness to others. This cross-sectional survey of participants comprised measures of family identity, family social support, connectedness to others, and mood.
Family identity predicted mood both directly and indirectly through parallel mediators of family social support and connectedness to others. Involving the family in adjustment to MS could reduce low mood.
Social identity change in people with multiple sclerosis: People with multiple sclerosis MS undergo changes to their identity and this might have an effect on mood. The subjective experience of this identity change is currently not well understood.
Past research highlights that social groups, Past research highlights that social groups, established prior to diagnosis, might protect against the harmful effects of identity change. No studies have specifically investigated this and the implications this may have for psychological interventions for mood in people with MS.
This thesis first presents a systematic review of the efficacy of group based psychological interventions for low mood in people with MS compared to individual based interventions.
Group based interventions were found to be more effective as treatments for depression in people with MS and this may be due to the peer support available.
Previous research has highlighted that people may be more willing to accept peer support from people with whom they share a social identity. People undergo changes to identity due to MS, this thesis focuses on identity change following diagnosis.
The family is seen as an important source of social support. A meta-synthesis of the role of the family in acting as a secure base for identity reconstruction was undertaken. The family may provide a secure base for identity reconstruction, as long as the coping strategies used by the person with MS and the family are aligned.
Sixteen interviews were conducted with people with MS to examine changes to identity over time and what factors might have influenced this. Social support was important for incorporating the MS identity into overall sense of self. Family identity was directly negatively correlated to mood; however, it had an increased effect on mood through the mediators of social support and connectedness to others. This research in this thesis found that, if coping strategies are aligned, the family provides a secure base for identity reconstruction through social support, which can lead to self reflected appraisals in the person with MS.
Identifying with the family group can have a positive effect on mood and can lead to increased interaction with other people with MS following adjustment.
The implications of this research are that people do experience changes to their identity following a diagnosis of MS and that social support can help a person to incorporate this into their sense of self. The family can provide a secure base for identity reconstruction. Group psychological interventions have a greater effect on depression and anxiety in people with MS compared to individual interventions. People may be more willing to engage in group interventions after an initial period of adjustment.
The increased inclusion of the family in support for the person with MS could facilitate the adjustment process. Comparing individual and group intervention for psychological adjustment in people with multiple sclerosis: A feasibility randomised controlled trial. To modify a published group intervention for adjustment to multiple sclerosis MS to suit an individual format, and to assess the feasibility of a randomised controlled trial RCT to compare individual and group intervention To modify a published group intervention for adjustment to multiple sclerosis MS to suit an individual format, and to assess the feasibility of a randomised controlled trial RCT to compare individual and group intervention for people with multiple sclerosis and low mood.
Feasibility randomised controlled trial. Participants were recruited through healthcare professionals at a hospital-based multiple sclerosis service and the MS Society. People with multiple sclerosis. Adjustment to multiple sclerosis in individual or group delivery format. Participants completed mood and quality of life assessments at baseline and at four-month follow-up. Measures of feasibility included: Participants were screened for inclusion using the General Health Questionnaire and Hospital Anxiety and Depression Scale, and were randomly allocated to receive either individual or group intervention, with the same content.
Twenty-one participants were recruited mean age There were no statistically significant differences between the groups on the outcome measures of mood and quality of life.
The intervention could be provided on an individual basis and the trial design was feasible. There were lower attendance rates at group sessions compared to individual sessions. Social identity in people with multiple sclerosis: A meta-synthesis of qualitative research. Purpose-Many aspects of the self are lost as a consequence of having multiple sclerosis MS.
The Social Identity Model of Identity Change argues that previously established identities form a basis of continued social support, by providing grounding and connectedness to others to facilitate the establishment of new identities.
Family support is a salient factor in adjustment to MS and may enable the establishment of new identities. The purpose of this paper is to investigate identity reconstruction following a diagnosis of MS.
Characteristics influencing therapy switch behavior after suboptimal response to first-line treatment in patients with multiple sclerosis. Factors driving disease-modifying therapy DMT switch behavior are not well understood. The objective of this paper is to identify patient characteristics and clinical events predictive of therapy switching in patients with suboptimal The objective of this paper is to identify patient characteristics and clinical events predictive of therapy switching in patients with suboptimal response to DMT.
Of suboptimal responders, Compared with one relapse alone, MRI worsening alone most strongly predicted switch behavior odds ratio 6. Younger patients with disease activity, especially MRI changes, are more likely to have their therapy switched sooner than patients who are older at the time of MS diagnosis and DMT initiation. Fingolimod Therapy in Early Multiple Sclerosis: No further ethical approval is required for studies using GPRD that do not involve patient contact.
This was a descriptive study. Its aim was to estimate the incidence and prevalence of MS by age in men and women and to describe secular trends and geographic variations within the UK between and The study population included all patients with acceptable data who contributed follow-up time to the database after GPRD defines a patient's data as unacceptable if there is evidence of poor data recording, non-contiguous follow-up or if their registration with the practice is temporary.
This is probably due to inclusion of patients with prevalent disease whose initial diagnosis pre-dated the computerisation of their practice's records. The follow-up period ended with the earlier of either their transfer-out date or their practice's last data collection date. Incident cases were defined as the first occurrence of a code for MS if it occurred after the 2-year screening period.
The analysis plan is shown in figure 1. For every patient, the number of days of follow-up available on the GPRD was calculated for each year from to We determined whether patients had any prior diagnosis of MS in the GPRD on the 1st January each year and, if not, whether any incident diagnosis occurred during the year. Incidence rates were estimated from Poisson regression models with log time at risk as an offset variable. Prevalence rates were estimated from logistic regression models.
The explanatory variables in the models were age, year and region. Data for men and women were analysed separately. We estimated the prevalence and incidence of MS in these patients over this period of time using GPRD data only, as described above.
We compared these rates with those calculated for the same patients using the additional diagnoses obtained from HES. These rates were used to adjust estimates of incidence and prevalence rates for the whole GPRD population. We applied these adjusted age-specific and gender-specific incidence and prevalence rates to population statistics obtained from the Office for National Statistics ONS for the UK population to estimate the absolute numbers of new and prevalent cases of MS in the UK population in To estimate the numbers of incident and prevalent cases of MS in the UK population in for men and women in each decade of life, we calculated incidence and prevalence rates in the entire GPRD population and applied age-specific correction factors to account for under-reporting in GP records alone.
The prevalence of MS increased by about 2. The prevalence rates that are below the trend line in the early s may be an artefact due to patients being first diagnosed before their entry to the database, despite the 2-year screening period. Secular trends in the prevalence of multiple sclerosis General Practice Research Database — There was a consistent downward trend in the incidence of MS in the whole study population over the year study period figure 3 A.
In , MS incidence in women fell to The rate of decline between and was 1. This implies that the female-to-male ratio among incident cases, approximately 2. Secular trends in the incidence of multiple sclerosis General Practice Research Database — A Incidence per 10 5 patient years in women and men all age groups.
Mortality rates fell in the GPRD population over the study period. In the 70—year age group, for example, they fell from 5. Among other age groups, the proportional decline was similar. The mortality rate among patients with MS was more than twice that of other patients in all age groups and in both sexes, but also declined at a similar proportional rate.
Life expectancy rose from We applied the age-specific mortality ratios for people with and without MS observed in the present study to estimate changes in life expectancies in people with MS over the same decade.
They increased from Incidence and prevalence of multiple sclerosis in women and men by age General Practice Research Database — A Incidence per 10 5 patient years. B Prevalence per 10 5 patients. The highest prevalence and incidence rates were observed in Scotland.
Among the other 12 regions of the UK, latitude accounted for HES identified an additional prevalent cases and incident cases in men and prevalent cases and incident cases in women. Age-specific correction factors were estimated. We also estimated the numbers of incident and prevalent cases of MS in the four countries which comprise the UK table 5. The overall prevalence of MS increased by approximately 2. We observed a decline in the rate at which new cases of MS were diagnosed, and the rising prevalence rate can likely be accounted for by trends in mortality rates.
There was a consistent downward trend in overall incidence of MS in the whole study population over the year study period, and the rate of decline did not differ between men and women or with age.
It is possible that this is due to new diagnostic techniques which reduced the risk of false positive diagnoses over the study period. We were not able to analyse the effects of prior pregnancy on the age of onset of MS in women in this study, although it has previously been reported that pregnancy reduces the risk of onset of MS.
We found the highest incidence and prevalence rates among the 13 regions of the UK in Scotland, but no trend with latitude among the other 12 regions. This suggests that the difference between Scotland and other regions of the UK is probably not the result of a consistent trend with latitude, but may involve factors not associated with latitude. A major strength of this study is that it covers a representative sample of GPs spread geographically throughout the UK, and a patient population with age and sex distributions similar to those of the general UK population.
The study population of some 4 million patients provides greater statistical precision than earlier regional surveys. Our analyses depend upon the accuracy of diagnosis and recording of MS by GPs: The prevalence rates we found are slightly higher than the rates reported by Thomas et al in , also using the GPRD: Alonso and colleagues reported incidence rates of 7.
An overall incidence rate of MS of 3. The downward trend in incidence that we found is in contrast to studies in Denmark, where the female incidence of MS has almost doubled since the s while male incidence has remained constant. Moreover, separate surveys carried out and analysed at different times may be subject to methodological differences. It is not clear why our study has detected a decreasing incidence while others have suggested increasing incidence.
Changes in awareness of MS and the challenges of diagnosing MS may account for changes incidence over time. However, we could identify no specific reason why the methodology or data source we used should have had an impact on our finding of decreasing incidence of MS over the period of the study. In the current study, the mean female-to-male ratio for MS was 2. For example, a recent analysis of trends in the sex ratio in MS for individuals born between and found a marked increase in Northern Europe not including the UK from 2.
This may be partly accounted for by changing health-related behaviours of men in recent years, perhaps having more contact with medical services than was the case historically. We are not able to identify any particular reason why the study methodology or data source could have confounded our findings regarding sex-ratio.
A recent study using HES data for the period — showed regional variations in hospital admission rates for MS in England. Early studies on MS suggested a trend with latitude with increasing prevalence in more temperate climates in Northern and Southern hemispheres. Regional variation in MS epidemiology may be due to genetic or environmental factors and interactions between them. This is supported by studies on the effect of month of birth on subsequent risk of MS in Northern and Southern hemispheres.
Further studies are needed to investigate the causative factors of MS, particularly the role of Vitamin D, genetic susceptibility factors and infective agents. This study provides a comprehensive picture of the prevalence and incidence of MS throughout the UK over two decades. It shows that more than people in the UK were newly diagnosed with MS in and that patients with MS are living longer, leading to a rising population living with the disease.
This has important implications for resource provision in the UK. All authors were involved in drafting and reviewing the manuscript. Statistical analysis was carried out by SVM. The guarantor for the study is ISM.
Paper Masters Custom Research Papers on Multiple Sclerosis Paper Masters writes custom research papers on Multiple Sclerosis and delve into a sample of a paper ordered for an analysis of the degenerative disorder.
Introduction Multiple Sclerosis is a demyelization disorder of the central nervous system and the spinal cord; which leads to patches of plaques in the regions of the brain and spinal cord.
Incidence and prevalence of multiple sclerosis in women and men by age (General Practice Research Database –). (A) Incidence (per 10 5 patient years). (B) Prevalence (per 10 5 patients). People with multiple sclerosis (MS) undergo changes to their identity and this might have an effect on mood. The subjective experience of this identity change is currently not well understood. Past research highlights that social groups, established prior to diagnosis, might protect against the .
The free Health research paper (Multiple Sclerosis A+ Research Paper essay) presented on this page should not be viewed as a sample of our on-line writing service. If you need fresh and competent research / writing on Health, use the professional writing service offered by our company. Multiple Sclerosis. It is the least severe, has little progression, and takes up twenty percent of all cases. The second type is Benign Relapsing-Remitting Multiple Sclerosis. It carries symptoms that fluctuate in severity, mild disability, and it makes up thirty percent of the total. The third type is Chronic Relapsing Multiple Sclerosis.