Engels Daniel, Flierl-Hecht Andrea, Shalaginova Gabriela, Rek Stephanie, Keeser Daniel, Reinhard Matthias A, Padberg Frank, Kümpfel Tania, Gerdes Lisa Ann
Institute of Clinical Neuroimmunology and Biomedical Center (BMC), LMU University Hospital, Faculty of Medicine, LMU Munich, Munich, Germany.
Institute of Clinical Neuroimmunology and Biomedical Center (BMC), LMU University Hospital, Faculty of Medicine, LMU Munich, Munich, Germany.
J Neurol Sci. 2025 Feb 15;469:123381. doi: 10.1016/j.jns.2024.123381. Epub 2025 Jan 2.
Critical life events challenge our competence to develop coping strategies. In people with multiple sclerosis (MS), the impact of genetics, disease-specific, and psychometric factors on coping strategies have not been explored to date.
In a unique cohort of 56 monozygotic twins discordant for MS, we applied comprehensive psychometric and clinical testing to measure factors influencing the psychosocial impact (including stressors and coping strategies) of a critical life event, exemplified by the COVID-19 pandemic (measured by the COVID-19 Pandemic Mental Health Questionnaire, CoPaQ). CoPaQ results were compared to an independent age- and sex-matched control cohort. We applied factor analysis, structural equation modeling, hypothesis testing, and regression models.
We detected no differences in the perception of 14 CoPaQ subscales between MS and non-MS co-twins. However, compared to the independent control group, MS co-twins valued 5/14 CoPaQ subscales differently. Strong perception of pandemic-related stressors in MS co-twins was accompanied by higher HADS-Anxiety (ρ = 0.69, Hospital Anxiety and Depression Scale), HADS-Depression (ρ = 0.57), BDI-II (ρ = 0.74, Beck Depression Inventory), and MSIS-29-psychological scores (ρ = 0.58, Multiple Sclerosis Impact Scale 29). In a generalized linear mixed model, individuals who perceived pandemic-related stressors as more burdensome relied on inner resources, with a notable dependency on twinship.
Using a unique twin approach, our study suggests that coping with critical life events is mainly driven by the genetic background. However, in people with MS, coping and the perception of stressors is further confounded by psychometric and disease-related factors.
重大生活事件挑战我们制定应对策略的能力。迄今为止，尚未探讨遗传因素、疾病特异性因素和心理测量因素对多发性硬化症（MS）患者应对策略的影响。
在一个由56对患MS的单卵双胞胎组成的独特队列中，我们应用了全面的心理测量和临床测试，以测量影响重大生活事件（以COVID-19大流行为例，通过COVID-19大流行心理健康问卷（CoPaQ）进行测量）的心理社会影响（包括压力源和应对策略）的因素。将CoPaQ结果与一个独立的年龄和性别匹配的对照组进行比较。我们应用了因子分析、结构方程建模、假设检验和回归模型。
我们未发现MS双胞胎和非MS双胞胎在14个CoPaQ分量表的认知上存在差异。然而，与独立对照组相比，MS双胞胎对14个CoPaQ分量表中的5个的重视程度不同。MS双胞胎对大流行相关压力源的强烈认知伴随着更高的医院焦虑抑郁量表（HADS）焦虑得分（ρ = 0.69）、HADS抑郁得分（ρ = 0.57）、贝克抑郁量表（BDI-II）得分（ρ = 0.74）和多发性硬化症影响量表29（MSIS-29）心理得分（ρ = 0.58）。在广义线性混合模型中，那些认为大流行相关压力源更繁重的个体依赖内部资源，且对双胞胎关系有显著依赖性。
通过独特的双胞胎研究方法，我们的研究表明，应对重大生活事件主要由遗传背景驱动。然而，在MS患者中，应对方式和对压力源的认知会进一步受到心理测量因素和疾病相关因素的干扰。
