Meeting an Unmet Need in Multiple Sclerosis

Meeting an Unmet Need in Multiple Sclerosis (MS): An Evaluation of the Effectiveness of a Transdiagnostic Psychological Treatment and Its Outcomes

The primary objectives of this study is to examine the efficacy of the Unified Protocol in decreasing depression and anxiety among individuals with MS and the secondary outcomes (e.g., improved well-being, QOL, coping, etc.) that may occur in tandem.

The primary objectives of this study is to examine the efficacy of the Unified Protocol in decreasing depression and anxiety among individuals with MS and the secondary outcomes (e.g., improved well-being, QOL, coping, etc.) that may occur in tandem. To achieve this, the investigation has the following specific aims: Specific Aim 1: Conduct a pilot Randomized Controlled Trial (RCT) of the Unified Protocol among individuals with MS to determine the effectiveness of the intervention in reducing depression and anxiety. Hypothesis 1: Individuals who participate in the Unified Protocol intervention will report a decrease in their depression and anxiety compared to individuals in the control group. Specific Aim 2: Conduct a pilot RCT of the Unified Protocol among individuals with MS to determine the effectiveness of the intervention in improving secondary outcomes of psychological well-being, QOL, coping, and MS symptomatology over time. Hypothesis 2: Individuals who participate in the Unified Protocol intervention will report an increase in psychological well-being, QOL, coping, and MS symptomatology over time compared to participants in the control group.

The Unified Protocol consists of 12-weeks, virtual, group sessions focused on reducing depression and anxiety through: (1) Increasing emotional awareness; (2) Cognitive restructuring against dysfunctional beliefs; (3) Changing action tendencies associated with disordered emotions; (4) Preventing emotional avoidance and utilizing emotion exposure techniques; (5) Providing mutual help among group members; and (6) Providing opportunities for corrective experiences.

The control group will not receive any intervention and will complete the same baseline and follow-up assessments.

Self-report measure of depression. Scores range from 0-21 with higher scores indicating greater depression.

Self-report measure of anxiety. Scores range from 0-21 with higher scores indicating greater anxiety.

Self-report measure of fatigue. Scores range from 0-84 with higher scores indicating greater fatigue.

Self-report measure of sleep. Scores range from 0-21 with higher scores indicating greater sleep problems.

Self-report measure of self-efficacy. Scores range from 10-40 with higher scores indicating greater self-efficacy.

Self-report measure of disease self-efficacy. Scores range from 0-100 (T-scores) with higher scores indicating greater self-efficacy.

Self-report measure of resilience. Scores range from 8-40 with higher scores indicating greater resilience.

Self-report measure of coping. Scores range from 4-16 for each coping scale with higher scores indicating greater coping.

Self-report measure of positive coping. Scores range from 43-129 for the total scale with higher scores indicating greater benefit-finding.

Self-report measure of quality of life and satisfaction. Scores range from 5-35 with higher scores indicating greater life satisfaction.

Self-report measure of quality of life. Scores range from 8-56 with higher scores indicating greater quality of life.

Self-report measure of psychological well-being. Scores range from 14-84 for each subscale with higher scores indicating greater psychological well-being.

Inclusion Criteria: Diagnosis of multiple sclerosis 18 years of age or older Experiencing significant depression and/or anxiety English-speaking Able to provide informed consent Access to the internet Exclusion Criteria: History of any other neurological illness (e.g. traumatic brain injury, epilepsy, dementia) Current participation in another randomized controlled trial Cognitive impairment that would affect my ability to fully participate in the group Unable to attend group sessions Active participation in another formal clinical group or psychological therapy Any other medical or psychological condition that, in the judgement of the investigators, prevents successful participation in the study