Coping Style Moderates the Effect of Pain on Depression Symptoms in Multiple Sclerosis

Objective: The present study examined coping style as a possible moderator in the relationship between pain and depression in persons with multiple sclerosis (PwMS). Methods: Fifty-four PwMS completed a comprehensive neuropsychological test battery and psychosocial questionnaires that assessed physical, cognitive, and emotional functioning. Using four pain indices (i.e., average pain, current pain, pain intensity, and pain interference) from the Brief Pain Inventory (BPI), an overall pain index was created to capture a more comprehensive index of individuals' overall pain intensity and interference. The COPE questionnaire was used to derive three coping indices: active coping, avoidant coping, and a composite cope index that accounts for the relative contributions of both active and avoidant coping. The Beck Depression Inventory-Fast Screen (BDI-FS) was used to measure depressive symptomatology. A series of hierarchical linear regressions were conducted with depressive symptoms as the outcome variable. Results: Regression analyses revealed that the interactions between overall pain and each conceptualization of coping were significant (p =. 001-.003). Simple effects tests revealed that overall pain only predicted depressive symptoms in PwMS with low active coping (p <. 001), high avoidant coping (p <. 001), and less adaptive coping via the composite coping index (p <. 001). Conclusion: We found that pain predicted depressive symptoms in PwMS who utilized more avoidant and less active coping strategies. Interventions aimed to improve coping style may be effective in enhancing the ability to manage pain and, subsequently, improve depression outcomes in MS.