Exploring the Impact of Lifetime Stressors on Multiple Sclerosis Symptoms

Multiple sclerosis (MS), a chronic autoimmune disorder affecting the central nervous system, is known for its wide range of symptoms that can significantly impact an individual’s quality of life. A recent study led by the Duke School of Nursing’s Carri Polick, Ph.D., R.N. delves into the relationship between lifetime stressors and the invisible symptoms of MS, such as fatigue, pain interference, and psychiatric morbidity.

The study, published in the journal Exploration of Neuroprotective Therapy, utilized a cross-sectional approach to examine how stressors experienced during childhood and adulthood contribute to these symptoms in people with MS. The research team distributed an online survey through the National MS Society to gather data from a large national sample of MS patients.

The findings revealed that both childhood and adult stressors significantly contribute to pain interference and psychiatric morbidity. Notably, childhood stressor severity independently correlated with both the likelihood and magnitude of fatigue. This suggests that adverse childhood experiences, such as abuse or neglect, may have a lasting impact on the well-being of individuals with MS.

“Since childhood stressors can impact the adult stress experience, and since interventions for patients with MS would largely be implemented for adults, we should be considering their current stressors, many of which are social drivers of health like financial stress, discrimination, unstable housing, and physical safety,” says Polick.

Adult stressor severity was found to independently correlate with psychiatric morbidity, highlighting the importance of considering stressors across the lifespan. The research conducted by Polick and her team underscores the potential role of stressor severity, which may not be captured in count-based trauma measurement tools. The study advocates for a more comprehensive approach to measuring stressors, considering both the count and severity, to better understand their impact on MS symptoms.

The implications of this study are significant for clinical practice. By recognizing the influence of lifetime stressors on MS symptoms, healthcare providers can tailor their therapeutic approaches to address these underlying factors. This could involve integrating stress management techniques and psychological support into the standard care for MS patients.

“Most people with MS experience mental health challenges such as depression and anxiety,” says Polick. “Better recognition of stressors could help support more/earlier referrals to resources like mental health care and MS support groups to help address the outcomes.”

The study provides valuable insights into the complex interplay between lifetime stressors and MS symptoms. It calls for a holistic approach to patient care that acknowledges the cumulative impact of stress throughout an individual’s life. As the field of neuroprotective therapy continues to evolve, this research paves the way for more personalized and effective strategies to improve the lives of those living with multiple sclerosis.

“Recent policy changes to screen for current SDOH needs are a great start but lack a lifetime approach,” Polick says. “Ideally, I envision a model where we can eventually incorporate lifetime stressor and resilience data to help assess individual health risks and coping behaviors.”