The four self-efficacy trajectories among people with multiple sclerosis : Clinical associations and implications. / Young, Carolyn A; Mills, Roger; Langdon, Dawn; Sharrack, Basil; Majeed, Tahir; Kalra, Seema; Footitt, David; Rog, David; Harrower, Tim; Nicholas, Richard; Woolmore, John; Thorpe, John; Hanemann, C Oliver; Ford, Helen; Paling, David; Ellis, Cathy; Palace, Jackie; Constantinescu, Cris; Tennant, Alan.

In: Journal of the Neurological Sciences, Vol. 436, 120188, 15.05.2022.

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  • Carolyn A Young
  • Roger Mills
  • Dawn Langdon
  • Basil Sharrack
  • Tahir Majeed
  • Seema Kalra
  • David Footitt
  • David Rog
  • Tim Harrower
  • Richard Nicholas
  • John Woolmore
  • John Thorpe
  • C Oliver Hanemann
  • Helen Ford
  • David Paling
  • Cathy Ellis
  • Jackie Palace
  • Cris Constantinescu
  • Alan Tennant


BACKGROUND: Longitudinal studies among people with Multiple Sclerosis (pwMS) have shown that self-efficacy is linked to physical, cognitive and psychological functioning.

OBJECTIVES: To determine the distribution of self-efficacy in a large sample of pwMS, examining whether there are distinct groups which show different self-efficacy trajectories over time, and the health status characteristics of any groups identified.

METHODS: Participants completed serial questionnaire packs, including Unidimensional Self-efficacy-MS (USE-MS) scale, for the Trajectories of Outcome in Neurological Conditions-MS (TONiC-MS) study over an average 46-month period. The resulting longitudinal data were analysed by a group-based trajectory model.

RESULTS: 5887 pwMS were studied: mean age 50.2 years (SD 12.0); 73.6% female; Relapsing Remitting MS (61.8%), Secondary Progressive (22.9%), Primary Progressive (11.1%), Rapidly Evolving Relapsing Remitting MS (4.2%). Four distinct self-efficacy trajectories emerged, with declining, slightly declining, stable or improving self-efficacy, each showing different patterns of health status indicators such as EQ-5D-5L, disability and depression. USE-MS ≤ 18 at baseline detected all participants in the two declining groups.

CONCLUSION: Future trials on interventions for self-efficacy should assume a priori that those with low levels of self-efficacy (USE-MS ≤ 18 at baseline) are likely to be on a declining trajectory and may need different interventions from those with stable self-efficacy.

Original languageEnglish
Article number120188
JournalJournal of the Neurological Sciences
Publication statusPublished - 15 May 2022
This open access research output is licenced under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

ID: 45616846