Fuchs Tom A, Jaworski Michael G, Youngs Margaret, Abdel-Kerim Omar, Wojcik Curtis, Weinstock-Guttman Bianca, Benedict Ralph H B
Jacobs Multiple Sclerosis Center for Treatment and Research (TAF, MGJ, MY, OA-K, CW, BW-G, RHBB), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
The Buffalo Neuroimaging Analysis Center (TAF), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
Int J MS Care. 2022 Mar-Apr;24(2):45-53. doi: 10.7224/1537-2073.2021-005. Epub 2021 Jul 9.
Conscientiousness, or the proclivity for deliberation, achievement, and order, declines in many individuals with multiple sclerosis (MS). Decreased conscientiousness predicts future cognitive deterioration, brain atrophy, and employment loss in individuals with MS. As a psychological trait, it may be an actionable antecedent to these important outcomes. We pilot tested an application (app)-facilitated behavioral intervention to help adaptation to low conscientiousness and, in turn, improve employment.
Eleven individuals with MS (5 treatment, 6 control) with low conscientiousness were recruited for a 12-week randomized controlled trial. The treatment group received a newly developed behavioral treatment and smartphone app designed to help people behave more conscientiously, 2 teleconference booster sessions, and weekly telephone calls to monitor progress. Employment changes were recorded at baseline and follow-up. Patients provided detailed posttreatment interviews.
Participant groups were matched on baseline age, sex, education, disease duration, hours worked, and conscientiousness. All participants in the treatment arm reported benefits, found the app easy to use, and would recommend it to others. The treatment group reported significantly more positive work outcomes relative to controls at follow-up ( = .028). Other positive life changes were described by treatment participants during post-treatment interviews.
These results support the hypothesis that behaviors typically associated with low conscientiousness may be addressed by behavioral therapy in the MS population. In addition to the positive employment changes in the treatment group, several other quality of life changes were described by study participants. Additional research is needed.
尽责性，即深思熟虑、追求成就和井然有序的倾向，在许多多发性硬化症（MS）患者中会下降。尽责性降低预示着MS患者未来会出现认知衰退、脑萎缩和失业。作为一种心理特质，它可能是这些重要结果的一个可干预的先行因素。我们进行了一项初步测试，采用一款应用程序（app）辅助的行为干预措施，以帮助适应低尽责性，进而改善就业情况。
招募了11名尽责性较低的MS患者（5名治疗组，6名对照组），进行为期12周的随机对照试验。治疗组接受了一项新开发的行为治疗和一款旨在帮助人们更尽责行事的智能手机应用程序，2次电话会议强化课程，以及每周一次的电话随访以监测进展。在基线和随访时记录就业变化情况。患者提供了详细的治疗后访谈内容。
参与者组在基线年龄、性别、教育程度、病程、工作时长和尽责性方面相匹配。治疗组的所有参与者都报告了获益情况，认为该应用程序易于使用，并会向他人推荐。随访时，治疗组报告的积极工作成果相对于对照组显著更多（P = .028）。治疗参与者在治疗后访谈中描述了其他积极的生活变化。
这些结果支持了这样一种假设，即MS人群中通常与低尽责性相关的行为可能通过行为疗法得到改善。除了治疗组就业情况的积极变化外，研究参与者还描述了其他一些生活质量的变化。还需要进一步的研究。
