The relationship between cognitive fusion, stigma, and well-being in people with multiple sclerosis


Abbey Valvano, Rebecca M. Floyd, Lauren Penwell-Waines, Lara Stepleman, Kimberly Lewis, Amy House


The purpose of this study was to investigate whether cognitive fusion plays a mediating role in the effects of Multiple Sclerosis (MS)-related stigma on psychological distress and well-being. One hundred twenty-eight adults diagnosed with MS and receiving care at an outpatient MS Center in the Southeastern U.S. completed measures of stigma, cognitive fusion, depression, anxiety, and quality of life. Mediation analyses indicated that cognitive fusion can mediate the effects of stigma on depression, anxiety, and quality of life. These findings are unique in suggesting that cognitive fusion may be an important clinical consideration in treating the effects of MS-related stigma on psychological health and well-being. Reverse mediation also suggests that cognitive fusion is directly and indirectly affected by stigma, depression, anxiety, and quality of life. Appropriate next steps would include longitudinal research to better clarify the directional relationships between these variables and testing an Acceptance and Commitment Therapy (ACT) intervention for increasing psychological flexibility in people with MS in order to reduce the impact of experiences of stigma.

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