Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T10:07:36.500Z Has data issue: false hasContentIssue false
  • English
  • Français

Perceived Cognitive Difficulties and Cognitive Test Performance as Predictors of Employment Outcomes in People with Multiple Sclerosis

Published online by Cambridge University Press:  02 March 2015

Cynthia A. Honan ,
Rhonda F. Brown  and
Jennifer Batchelor
Cynthia A. Honan*
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia
Rhonda F. Brown
Affiliation:
College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
Jennifer Batchelor
Affiliation:
Department of Psychology, Macquarie University, Sydney, Australia
*
Correspondence and reprint requests to: Cynthia Honan, School of Psychology, University of New South Wales, NSW, 2052. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Perceived cognitive difficulties and cognitive impairment are important determinants of employment in people with multiple sclerosis (pwMS). However, it is not clear how they are related to adverse work outcomes and whether the relationship is influenced by depressive symptoms. Thus, this study examined perceived and actual general cognitive and prospective memory function, and cognitive appraisal accuracy, in relation to adverse work outcomes. The possible mediating and/or moderating role of depression was also examined. A cross-sectional community-based sample of 111 participants (33 males, 78 females) completed the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ), Beck Depression Inventory – Fast Screen (BDI-FS), and questions related to their current or past employment. They then underwent cognitive testing using the Screening Examination for Cognitive Impairment, Auditory Consonant Trigrams test, Zoo Map Test, and Cambridge Prospective Memory Test. Perceived general cognitive and prospective memory difficulties in the workplace and performance on the respective cognitive tests were found to predict unemployment and reduced work hours since MS diagnosis due to MS. Depression was also related to reduced work hours, but it did not explain the relationship between perceived cognitive difficulties and the work outcomes. Nor was it related to cognitive test performance. The results highlight a need to address the perceptions of cognitive difficulties together with cognitive impairment and levels of depression in vocational rehabilitation programs in pwMS. (JINS, 2015, 21, 156–168)

Keywords

Multiple sclerosisCognitionSubjective cognitionSelf-awarenessDepressionEmployment outcomes
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Issue 2 , February 2015 , pp. 156 - 168
Copyright
Copyright © The International Neuropsychological Society 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amato, M.P., Zipoli, V., & Portaccio, E. (2006). Multiple sclerosis-related cognitive changes: A review of cross-sectional and longitudinal studies. Journal of the Neurological Sciences, 245, 41–46. doi:10.1016/j.jns.2005.08.019 Google Scholar
Arnett, P.A., Barwick, F.H., & Beeney, J.E. (2008). Depression in multiple sclerosis: Review and theoretical proposal. Journal of the International Neuropsychological Society, 14, 691–724. doi:10.1017/S1355617708081174 Google Scholar
Arnett, P.A., Higginson, C.I., & Randolph, J.J. (2001). Depression in multiple sclerosis: Relationship to planning ability. Journal of the International Neuropsychological Society, 7, 665–674. Retrieved from http://journals.cambridge.org/action/displayJournal?jid=INS CrossRefGoogle ScholarPubMed
Arnett, P.A., Higginson, C.I., Voss, W.D., Bender, W.I., Wurst, J.M., & Tippin, J.M. (1999). Depression in multiple sclerosis: Relationship to working memory. Neuropsychology, 13, 546–556. doi:10.1037/0894-4105.13.4.546 CrossRefGoogle ScholarPubMed
Arnett, P.A., Higginson, C.I., Voss, W.D., Wright, B., Bender, W.I., Wurst, J.M., & Tippin, J.M. (1999). Depressed mood in multiple sclerosis: Relationship to capacity-demanding memory and attentional functioning. Neuropsychology, 13, 434–446. doi:10.1037/0894-4105.13.3.434 Google Scholar
Aronson, K.J. (1997). Quality of life among persons with multiple sclerosis and their caregivers. Neurology, 48, 74–80. doi:10.1212/WNL.48.1.74 Google Scholar
Aupperle, R.L., Beatty, W.W., Shelton, F.N., & Gontkovsky, S.T. (2002). Three screening batteries to detect cognitive impairment in multiple sclerosis. Multiple Sclerosis, 8, 382–389. doi:10.1191/1352458502ms832oa Google Scholar
Beatty, W.W., Blanco, C.R., Wilbanks, S.L., Paul, R.H., & Hames, K.A. (1995). Demographic, clinical, and cognitive characteristics of multiple sclerosis patients who continue to work. Journal of Neurological Rehabilitation, 9, 167–173. doi:10.1177/154596839500900306 Google Scholar
Beatty, W.W., & Monson, N. (1991). Metamemory in multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 13, 309–327. doi:10.1080/01688639108401046 CrossRefGoogle ScholarPubMed
Beatty, W.W., Paul, R.H., Wilbanks, S.L., Hames, K.A., Blanco, C.R., & Goodkin, D.E. (1995). Quantifying multiple sclerosis patients with mild or global cognitive impairments using the Screening Examination for Cognitive Impairment (SEFCI). Neurology, 45, 718–723. doi:10.1212/WNL.45.4.718 Google Scholar
Beck, A.T., Steer, R.A., & Brown, G.K (1996). Beck depression inventory-II. San Antonio, TX: Psychological Corp.Google Scholar
Beck, A.T., Steer, R.A., & Brown, G.J. (2000). BDI-Fast Screen for medical patients manual. London: The Psychological Corporation.Google Scholar
Benedict, R.H.B., Cox, D., Thompson, L., Foley, F., Weinstock-Guttman, B., & Munschauer, F. (2004). Reliable screening for neuropsychological impairment in multiple sclerosis. Multiple Sclerosis, 10, 675–678. doi:10.1191/1352458504ms1098oa Google Scholar
Benedict, R.H.B., Fishman, I., McClellan, M.M., Bakshi, R., & Weinstock-Guttman, B. (2003). Validity of the Beck Depression Inventory-Fast Screen in multiple sclerosis. Multiple Sclerosis, 9, 393–396. doi:10.1191/1352458503ms902o CrossRefGoogle ScholarPubMed
Benedict, R.H.B., Munschauer, F., Linn, R., Miller, C., Murphy, E., Foley, F., & Jacobs, L. (2003). Screening for multiple sclerosis cognitive impairment using a self-administered 15-item questionnaire. Multiple Sclerosis, 9, 95–101. doi:10.1191/1352458503ms861oa Google Scholar
Benedict, R.H., Rodgers, J.D., Emmert, N., Kininger, R., & Weinstock-Guttman, B. (2014). Negative work events and accommodations in employed multiple sclerosis patients. Multiple Sclerosis Journal, 20, 116–119. doi:10.1177/1352458513494492 Google Scholar
Benedict, R.H.B., Wahlig, E., Bakshi, R., Fishman, I., Munschauer, F., Zivadinov, R., & Weinstock-Guttman, B. (2005). Predicting quality of life in multiple sclerosis: Accounting for physical disability, fatigue, cognition, mood disorder, personality, and behavior change. Journal of the Neurological Sciences, 231, 29–34. doi:10.1016/j.jns.2004.12.009 Google Scholar
Benedict, R.H., & Walton, M.K. (2012). Evaluating cognitive outcome measures for MS clinical trials: What is a clinically meaningful change? Multiple Sclerosis, 18, 1673–1679. doi:10.1177/1352458512454774 Google Scholar
Brooks, J.B.B., Giraud, V.O., Saleh, Y.J., Rodrigues, S.J., Daia, L.A., & Fragoso, Y.D. (2011). Paced auditory serial addition test (PASAT): A very difficult test even for individuals with high intellectual capability. Arquivos de Neuro-Psiquiatria, 69, 482–484. doi:10.1590/S0004-282X2011000400014 Google Scholar
Brown, R.F., Tennant, C.C., Sharrock, M., Hodgkinson, S., Dunn, S.M., & Pollard, J.D. (2006). Relationship between stress and relapse in multiple sclerosis: Part I. Important features. Multiple Sclerosis, 12, 453–464. doi:10.1191/1352458506ms1295oa Google Scholar
Bruce, J.M., & Arnett, P.A. (2004). Self-reported everyday memory and depression in patients with multiple sclerosis. Journal of Clinical and Experimental Neuropsychology, 26, 200–214. doi:10.1076/jcen.26.2.200.28081 Google Scholar
Chiaravalloti, N.D., & De Luca, J. (2003). Assessing the behavioral consequences of multiple sclerosis: An application of the Fronal Systems Behavior Scale (FrSBe). Cognitive and Behavioral Neurology, 16, 54–67. Retrieved from http://journals.lww.com/cogbehavneurol/pages/default.aspx Google Scholar
Christodoulou, C., Melville, P., Scherl, W.F., Morgan, T., Macallister, W.S., Canfora, D.M., & Krupp, L.B. (2005). Perceived cognitive dysfunction and observed neuropsychology performance: Longitudinal relation in persons with multiple sclerosis. Journal of the International Neuropsychological Society, 11, 614–619. doi:10.1017/S1355617705050733 Google Scholar
Chwastiak, L., Ehde, D.M., Gibbons, L.E., Sullivan, M., Bowen, J.D., & Kraft, G.H. (2002). Depressive symptoms and severity of illness in multiple sclerosis: Epidemiologic study of a large community sample. American Journal of Psychiatry, 159, 1862–1868. doi:10.1176/appi.ajp.159.11.1862 CrossRefGoogle ScholarPubMed
Cohen, J, Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis in the behavioral sciences (3rd ed.). Mahwah, NJ: Erlbaum.Google Scholar
Demaree, H.A., Gaudino, E., & De Luca, J. (2003). The relationship between depressive symptoms and cognitive dysfunction in multiple sclerosis. Cognitive Neuropsychiatry, 8, 161–171. doi:10.1080/13546800244000265 Google Scholar
Edgley, K., Sullivan, M., & Dehoux, E. (1991). A survey of multiple sclerosis. Part 2. Determinants of employment status. Canadian Journal of Rehabilitation, 4, 127–132.Google Scholar
Fleming, K., Goldberg, T.E., Gold, J.M., & Weinberger, D.R. (1995). Verbal working memory dysfunction in schizophrenia: Use of a Brown-Peterson paradigm. Psychiatry Research, 56, 155–161. doi:10.1016/0165-1781(95)02589-3 Google Scholar
Foley, J., Wilson, B., & Shiel, A. (2004). Prospective memory in multiple sclerosis [Abstract]. Brain Impairment, 5, 99. doi:10.1375/brim.5.1.96.35400 Google Scholar
Gold, S.M., Schulz, H., Monch, A., Schulz, K., & Heesen, C. (2003). Cognitive impairment in multiple sclerosis does not affect reliability and validity of self-report health measures. Multiple Sclerosis, 9, 404–410. doi:10.1191/1352458503ms927oa CrossRefGoogle Scholar
Goverover, Y., Genova, H., Hali, G., Chiaravalloti, N., & DeLuca, J. (2014). Metacognitive knowledge and online awarenes in persons with multiple sclerosis. NeuroRehabilitation, 35, 315–323. doi:10.3233/NRE-141113 Google Scholar
Harnish, M.J., Beatty, W.W., Nixon, S.J., & Parsons, O.A. (1994). Performance by normal subjects on the Shipley Institute of Living Scale. Journal of Clinical Psychology, 50, 881–882. doi:10.1002/1097-4679(199411)50:6<881::AID-JCLP2270500611>3.0.CO; 2-4.Google Scholar
Honan, C.A., Brown, R.F., & Hine, D.W. (2014). The Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ): Development of a shortened scale. Disability and Rehabilitation, 36, 635–641. doi:10.3109/09638288.2013.805258 Google Scholar
Honan, C.A., Brown, R.F., Hine, D.W., Vowels, L., Wollin, J.A., Simmons, R.D., & Pollard, J.D. (2012). The Multiple Sclerosis Work Difficulties Questionnaire. Multiple Sclerosis, 18, 871–880. doi:10.1177/1352458511431724 Google Scholar
Janardhan, V., & Bakshi, R. (2002). Quality of life in patients with multiple sclerosis: The impact of fatigue and depression. Journal of Neurological Sciences, 205, 51–58. PII:S0022-510X(02)00312-XGoogle Scholar
Janssens, A.C., van Doorn, P.A., de Boer, J. B., van der Meché, F.G., Passchier, J., & Hintzen, R.Q. (2003). Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurologica Scandinavica, 108, 389–395. doi:10.1034/j.1600-0404.2003.00166.x Google Scholar
Jønsson, A., Andresen, J., Storr, L., Tscherning, T., Soelberg Sørensen, P., & Ravnborg, M. (2006). Cognitive impairment in newly diagnosed multiple sclerosis patients: A 4-year follow-up study. Journal of the Neurological Sciences, 245, 77–85. doi:10.1016/j.jns.2005.09.016 Google Scholar
Karadayi, H., Arisoy, O., Altunrende, B., Boztas, M.H., & Sercan, M. (2014). The relationship of cognitive impairment with neurological and psychiatric variables in multiple sclerosis patients. International Journal of Psychiatry in Clinical Practice, 18, 45–51. doi:10.3109/13651501.2013.845221 Google Scholar
Khan, F., McPhail, T., Brand, C., Turner-Stokes, L., & Kilpatrick, T. (2006). Multiple sclerosis: Disability profile and quality of life in an Australian community cohort. International Journal of Rehabilitation Research, 29, 87–96. doi:10.1097/01.mrr.0000194393.56772.62 Google Scholar
Lezak, M.D., Howieson, D.B., & Loring, D.W. (2004). Neuropsychological assessment (4th ed.). New York: Oxford University Press.Google Scholar
Lobentanz, I.S., Asenbaum, S., Vass, K., Sauter, C., Klösch, G., Kollegger, H., & Zeitlhofer, J. (2004). Factors influencing quality of life in multiple sclerosis patients: Disability, depressive mood, fatigue and sleep quality. Acta Neurologica Scandinavica, 110, 6–13. doi:10.1111/j.1600-0404.2004.00257.x Google Scholar
Lovera, J., Bagert, B., Smoot, K.H., Wild, K., Frank, R., Bogardus, K., & Bourdette, D.N. (2006). Correlations of perceived deficits questionnaire of Multiple Sclerosis Quality of Life Inventory with Beck Depression Inventory and neuropsychological tests. Journal of Rehabilitation Research & Development, 43, 73–82. doi:10.1682/JRRD.2004.09.0118 Google Scholar
Maor, Y., Olmer, L., & Mozes, B. (2001). The relation between objective and subjective impairments in cognitive function among multiple sclerosis patients - the role of depression. Multiple Sclerosis, 7, 131–135. doi:10.1177/13524585010070020 Google Scholar
Matotek, K., Saling, M.M., Gates, P., & Sedal, L. (2001). Subjective complaints, verbal fluency, and working memory in mild multiple sclerosis. Applied Neuropsychology, 8, 204–210. doi:10.1207/S15324826AN0804_2 Google Scholar
Macallister, W.S., & Krupp, L.B. (2005). Multiple sclerosis-related fatigue. Physical Medicine and Rehabilitation Clinics of North America, 16, 483–502.Google Scholar
Middleton, L.S., Denney, D.R., Lynch, S.G., & Parmenter, B. (2006). The relationship between perceived and objective cognitive functioning in multiple sclerosis. Archives of Clinical Neuropsychology, 21, 487–494. doi:10.1016/j.acn.2006.06.008 Google Scholar
Miller, A., & Dishon, S. (2006). Health-related quality of life in multiple sclerosis: The impact of disability, gender and employment status. Quality of Life Research, 15, 259–271. doi:10.1007/s11136-005-0891-6 Google Scholar
Niino, M., Mifune, N., Kohriyama, T., Mori, M., Ohashi, T., Kawachi, I., & Kikuchi, S. (2014). Apathy/depression, but not subjective fatigue, is related with cognitive dysfunction in patients with multiple sclerosis. BMC Neurology, 14, 3. doi:10.1186/1471-2377-14-3 CrossRefGoogle Scholar
Norris, G., & Tate, R.L. (2000). The Behavioral Assessment of the Dysexecutive Syndrome (BADS): Ecological, concurrent and construct validity. Neuropsychological Rehabilitation, 10, 33–45. doi:10.1080/096020100389282 CrossRefGoogle Scholar
O’Connor, B.P. (1998). SIMPLE: All-in-one programs for exploring interactions in moderated multiple regression. Educational and Psychological Measurement, 58, 836–840. doi:10.1177/0013164498058005009 Google Scholar
Ownsworth, T., Stewart, E., Fleming, J., Griffin, J., Collier, A.M., & Schmidt, J. (2013). Development and preliminary psychometric evaluation of the Self-Perceptions in Rehabilitation Questionnaire (SPIRQ) for brain injury rehabilitation. American Journal of Occupational Therapy, 67, 336–344.Google Scholar
Ozakbas, S., Ormeci, B., Akdede, B.B.K., Alptekin, K., & Idiman, E. (2004). Utilization of the auditory consonant trigram test to screen for cognitive impairment in patients with multiple sclerosis: Comparison with the paced auditory serial addition test. Multiple Sclerosis, 10, 686–689. doi:10.1191/1352458504ms1111oa Google Scholar
Polman, C.H., Reingold, S.C., Banwell, B., Clanet, M., Cohen, J.A., Filippi, M., & Wolinsky, J.S. (2011). Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria. Annals of Neurology, 69, 292–302. doi:10.1002/ana.22366 Google Scholar
Polman, C.H., Reingold, S.C., Edan, G., Filippi, M., Hartung, H., Kappos, L., & Wolinsky, J.S. (2005). Diagnostic criteria for multiple sclerosis: 2005 revisions to the McDonald Criteria. Annals of Neurology, 58, 840–846. doi:10.1002/ana.20703 CrossRefGoogle Scholar
Randolph, J.J., Arnett, P.A., & Freske, P. (2004). Metamemory in multiple sclerosis: Exploring affective and executive contributors. Archives of Clinical Neuropsychology, 19, 259–279. doi:10.1016/S0887-6177(03)00026-X Google Scholar
Randolph, J.J., Arnett, P.A., & Higginson, C.I. (2001). Metamemory and tested cognitive functioning in multiple sclerosis. The Clinical Neuropsychologist, 15, 357–368. doi:10.1076/clin.15.3.357.10278 Google Scholar
Rao, S.M., Leo, G.J., Bernardin, L., & Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis. I: Frequency, patterns, and predictions. Neurology, 41, 685–691. doi:10.1212/WNL.41.5.685 Google Scholar
Rao, S.M., Leo, G.J., Ellington, L., Nauertz, T., Bernardin, L., & Unverzagt, F. (1991). Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning. Neurology, 41, 692–696. doi:10.1212/WNL.41.5.692 CrossRefGoogle ScholarPubMed
Sadovnik, A.D. (1996). Depression and multiple sclerosis. Neurology, 46, 628–632. doi:10.1212/WNL.46.3.628 Google Scholar
Schubert, D.S.P., & Foliart, R.H. (1993). Increased depression in multiple sclerosis. A meta-analysis. Psychosomatics, 34, 124–130. doi:10.1016/S0033-3182(93)71902-7 Google Scholar
Schulz, D., Kopp, B., Kunkel, A., & Faiss, J.H. (2006). Cognition in the early stage of multiple sclerosis. Journal of Neurology, 253, 1002–1010. doi:10.1007/s00415-006-0145-8 Google Scholar
Sherer, M., Bergloff, P., Levin, E., Walter, M., Oden, K.E., & Nick, T. (1998). Impaired awareness and employment outcome after traumatic brain injury. Journal of Head Trauma Rehabilitation, 13, 52–61. Retrieved from http://journals.lww.com/headtraumarehab/pages/default.aspx Google Scholar
Shrout, P.E., & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445. doi:10.1037/1082-989X.7.4.422 Google Scholar
Smith, A. (1982). Symbol Digit Modalities Test. Manual. Los Angeles, CA: Western Psychological Services.Google Scholar
Solari, A., Mancuso, L., Motta, A., Mendozzi, L., & Serrati, C. (2002). Comparison of two brief neuropsychological batteries in people with multiple sclerosis. Multiple Sclerosis, 8, 169–176. doi:10.1191/1352458502ms780oa Google Scholar
Sobel, M.E. (1982). Asymptotic intervals for indirect effects in structural equations models. In S. Leinhart (Ed.), Sociological methodology. San Francisco: Jossey-Bass.Google Scholar
Stuss, D.T., Stethem, L.L., & Pelchat, G. (1988). Three tests of attention and rapid information processing: An extension. The Clinical Neuropsychologist, 2, 246–250. doi:10.1080/13854048808520107 Google Scholar
Stuss, D.T., Stethem, L.L., & Poirier, C.A. (1987). Comparison of three tests of attention and rapid information processing across six age groups. The Clinical Neuropsychologist, 1, 139–152. doi:10.1080/13854048708520046 CrossRefGoogle Scholar
Sundgren, M., Maurex, L., Wahlin, Å., Piehl, F., & Brismar, T. (2013). Cognitive impairment has a strong relation to nonsomatic symptoms of depression in relapsing–remitting multiple sclerosis. Archives of Clinical Neuropsychology, 28, 144–155. doi:10.1093/arclin/acs113 Google Scholar
Tabacknick, B.G., & Fidell, L.S. (2013). Using multivariate statistics (6th ed.). New York: Pearson.Google Scholar
Taylor, R. (1990). Relationships between cognitive test performance and everyday cognitive difficulties in multiple sclerosis. British Journal of Clinical Psychology, 29, 251–253. doi:10.1111/j.2044-8260.1990.tb00882.x Google Scholar
Wilson, B.A., Alderman, N., Burgess, P., Emslie, H., & Evans, J. (1996). Behavioural assessment of the dysexecutive syndrome. Bury St Edmunds: Thames Valley Test Company.Google Scholar
Wilson, B.A., Emslie, H., Foley, J., Shiel, A., Watson, P., Hawkins, K., & Evans, J.J. (2005). The Cambridge Prospective Memory Test: CAMPROMPT. London: Harcourt Assessment.Google Scholar
Zachary, R.A. (1994). Shipley Institute of Living Scale. Revised Manual. Los Angeles, CA: Western Psychological Services.Google Scholar