Coping among individuals with multiple sclerosis: Evaluating a goodness-of-fit model

Multiple sclerosis (MS) is a chronic illness involving both controllable and uncontrollable stressors. The goodness-of-fit hypothesis posits that managing stressors effectively requires the use of different coping approaches in the face of controllable and uncontrollable stressors. To test the applicability of the goodness-of-fit model in a sample of adults with MS, we evaluated the ratio of 2 types of coping (an active problem-solving approach and an emotion-based meaning-focused approach) as a moderator of the relations between stress uncontrollability and mental health outcomes.

Participants were veterans with MS (N = 90) receiving medical services through the Veterans Health Administration who completed telephone-based interviews. Regression analyses tested the interaction of stress uncontrollability and the problem- and meaning-focused coping ratio on anxious and depressive symptoms. Significant interactions were probed at 1 SD above the mean of coping (use of predominantly problem-focused coping) and 1 SD below the mean of coping (use of predominantly meaning-focused coping).

Findings largely supported the goodness-of-fit hypothesis. Anxiety and depressive symptoms were elevated when participants used more problem-focused strategies relative to meaning-focused strategies in the face of perceived uncontrollable stress. Conversely, symptoms of anxiety and depression were lower when uncontrollable stress was met with predominantly meaning-focused coping; however, the relations did not reach statistical significance.

The impact of uncontrollable stressors on mental health outcomes for individuals with MS may vary depending on the degree to which problem-focused versus meaning-focused coping strategies are employed, lending support to the goodness-of-fit model.