Psychological Resilience as a Protective Factor for the Motor System in Multiple Sclerosis

Multiple Sclerosis (MS) is a lifelong progressive neurologic disease of the central nervous system (CNS) that interrupts the flow of information within the brain and between the brain and the body, resulting in a variety of symptoms across the visual, sensory, motor, and autonomic functions. The concept of psychological resilience is emerging in clinical research, including research on MS, as a productive way to view the outcomes and experiences of living with a chronic disease and identify potential protective factors. The purpose of this dissertation was to examine the protective and predictive quality of psychological resilience in various domains of motor functioning. A sample of 130 patients underwent neuropsychological testing along with neurological examination at two distinct time points (baseline and 3-year follow-up). As part of each evaluation, patients were administered various tasks of motor functioning: the two-minute walk test (2MWT; a measure of gait endurance and stamina), timed 25-foot walk (T25FW; a measure of gait speed), nine-hole peg test (NHPT; a measure of upper extremity speed and coordination), grooved pegboard (G-Pegs; a measure of fine motor speed and dexterity), grip strength (Grip; a measure of upper body strength), and finger tapping test (FTT; a measure of simple motor speed), which served as this study’s outcomes. Psychological resilience, the primary predictor of interest, was operationalized as the self-reported ability of adapting well in the face of substantial adversity and significant sources of stress and was estimated using a validated self-report measure the Connor-Davidson Resilience Scale, 10 item version (CD-RISC-10). Additional predictors included mood, fatigue, demographic variables, disease variables, and magnetic resonance imaging (MRI) estimates. In contrast to our hypothesis, psychological resilience and functional outcomes were not correlated. Psychological resilience did not predict change in motor functioning over time and did not serve as a moderator between disease burden and motor functioning. As such, the present study does not provide support for psychological resilience as a protective factor for the motor system in MS or for resilience in predicting differential decline in motor functioning.