Akboğa Yeşim Eylev, Türkel Nur Nihal, Demirci Adem, Ertek İrem Ekmekçi
Department of Neurology, Sincan Training and Research Hospital, Ankara, Turkey.
Department of Psychiatry, Ankara Penitentiary Campus State Hospital, Avenue of Mevlana No:29, Yenimahalle, Ankara, 06590, Turkey.
Neurol Sci. 2025 Sep 17. doi: 10.1007/s10072-025-08507-x.
Relapsing-remitting MS (RRMS) is characterized by considerable uncertainty due to the unpredictable nature of attacks and their variable impact on functionality. This uncertainty contributes to patients' fear of attacks, which in turn adversely affects their well-being and quality of life. However, the underlying mechanisms driving this fear remain insufficiently understood. The present study aimed to investigate the relationships among fear of relapse, perfectionism, and intolerance of uncertainty in individuals with RRMS.
This descriptive, cross-sectional study included 222 patients with RRMS. Participants completed the Frost Perfectionism Scale to assess maladaptive perfectionism, the Fear of Relapse Scale to measure fear of relapse, and the Intolerance of Uncertainty Scale.
According to the study's findings, perfectionism was significantly associated with increased intolerance of uncertainty (β = 0.51, p < 0.001) and heightened fear of relapse (total effect β = 0.39, p < 0.001). Intolerance of uncertainty was also positively related to fear of relapse (β = 0.37, p < 0.001). Mediation analysis further revealed that intolerance of uncertainty significantly mediated the relationship between perfectionism and fear of relapse, accounting for approximately 48% of the total effect (indirect effect β = 0.19, 95% CI [0.11, 0.26]).
The findings indicated that both perfectionism and intolerance of uncertainty significantly influence the fear of relapse in RRMS patients. Therefore, intervention strategies designed to address maladaptive perfectionistic tendencies and high intolerance of uncertainty may help reduce fear of relapses and ultimately enhance the quality of life for individuals with MS.
复发缓解型多发性硬化症（RRMS）的特点是存在相当大的不确定性，因为发作具有不可预测性，且对功能的影响各不相同。这种不确定性导致患者对发作产生恐惧，进而对他们的幸福感和生活质量产生不利影响。然而，导致这种恐惧的潜在机制仍未得到充分理解。本研究旨在调查RRMS患者中对复发的恐惧、完美主义和对不确定性的不耐受之间的关系。
这项描述性横断面研究纳入了222例RRMS患者。参与者完成了Frost完美主义量表以评估适应不良的完美主义，完成了复发恐惧量表以测量对复发的恐惧，以及不确定性不耐受量表。
根据研究结果，完美主义与对不确定性的不耐受增加（β = 0.51，p < 0.001）和对复发的恐惧加剧（总效应β = 0.39，p < 0.001）显著相关。对不确定性的不耐受也与对复发的恐惧呈正相关（β = 0.37，p < 0.001）。中介分析进一步表明，对不确定性的不耐受显著介导了完美主义与对复发的恐惧之间的关系，约占总效应的48%（间接效应β = 0.19，95% CI [0.11, 0.26]）。
研究结果表明，完美主义和对不确定性的不耐受均显著影响RRMS患者对复发的恐惧。因此，旨在解决适应不良的完美主义倾向和对不确定性的高度不耐受的干预策略可能有助于减少对复发的恐惧，并最终提高MS患者的生活质量。
