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Updated: May 28, 2026

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
The relationship between self-reported executive performance and psychological characteristics in multiple sclerosis
K van der Hiele1, N G A Spliethoff-Kamminga, R P Ruimschotel
1National Multiple Sclerosis Foundation, Maassluis, The Netherlands.
Self-reports of executive function in multiple sclerosis (MS) are generally reliable. However, 29% of MS patients misjudged their abilities, with underestimators showing significant psychological distress and coping issues.
Area of Science:
- Neuroscience
- Psychology
- Clinical Medicine
Background:
- Cognitive functioning self-reports in multiple sclerosis (MS) may not align with objective measures.
- Understanding discrepancies between perceived and actual executive performance is crucial for patient care.
Purpose of the Study:
- To investigate the psychological characteristics of patients with multiple sclerosis (MS) who underestimate, overestimate, or accurately estimate their executive functioning.
- To identify factors associated with self-report accuracy in executive performance among MS patients.
Main Methods:
- A two-phase study involving cognitive complaints questionnaires (self- and partner-reported) and subsequent cognitive, neurological, and psychological assessments.
- 114 patients with MS were assessed for executive performance estimation accuracy using the Behavioural Assessment of the Dysexecutive Syndrome-Dysexecutive Questionnaire.
Main Results:
- 29% of MS patients inaccurately estimated their executive performance (15% underestimated, 14% overestimated).
- Underestimators exhibited higher levels of depression, anxiety, psychosocial stress, used 'disclosure of emotions' coping, and showed more passive reactions.
- Partner-reported estimations also showed discrepancies, with 19% overestimating and 4% underestimating patient performance.
Conclusions:
- Self-reported executive functioning in MS is generally reliable, but a significant minority misjudges their abilities.
- Identifying underestimators is critical due to associated psychological distress and maladaptive coping mechanisms requiring intervention.
- While informants offer valuable insights, they are not a definitive measure for cognitive impairment in MS.
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