Coping in neurological disorders

Although there is an elevated occurrence of depression in neurological disorder patients relative to the general population, it is somewhat remarkable that over half of patients manage to maintain healthy mood states in the face of disease-related stress and in light of possible damage to mood-regulating neural systems. Coping is one of the best-studied positive health-promoting factors, and decades of research have demonstrated that coping style modulates the relationship between stress and negative emotional states. Research on coping in patients with multiple sclerosis (MS) has demonstrated that active and problem-focused coping strategies are associated with better adjustment and decreased likelihood of depression. Although cognitive deficits are often related to depression in MS patients, research suggests that the use of active coping strategies may mitigate the negative effects of this stressor. However, evidence also indicates that cognitive deficits may result in a diminished ability to use adaptive active coping strategies and a concomitant increased reliance on maladaptive coping. The clinical implications of these research findings are discussed.