Evidence map›Paper›PMID 39619286›Full record

ArticleSclerosis2024

Resilience, Mental Health, Sleep, and Smoking Mediate Pathways Between Lifetime Stressors and Multiple Sclerosis Severity.

Carri S Polick, Hala Darwish, Leonardo Pestillo de Oliveira, Ali Watson, Joao Ricardo Nickenig Vissoci, Patrick S Calhoun, Robert J Ploutz-Snyder, Cathleen M Connell, Tiffany J Braley, Sarah A Stoddard

Abstract read
In one paragraph

Article in Sclerosis, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The impact of early life stress on patient-reported outcomes in multiple sclerosis.Multiple sclerosis journal - experimental, translational and clinical
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Carri S PolickSchool of Nursing, Duke University, Durham, NC 27710, USA.ORCID 0000-0002-0555-5190
Hala DarwishDivision of Multiple Sclerosis & Neuroimmunology, Department of Neurology, Michigan Medicine, Ann Arbor, MI 48109, USA.ORCID 0000-0001-5744-6466
Leonardo Pestillo de OliveiraHealth Promotion Department, Cesumar University, Maringa 87050-900, Parana, Brazil.ORCID 0000-0001-5278-0676
Ali WatsonSchool of Medicine, Duke University, Durham, NC 27710, USA.
Joao Ricardo Nickenig VissociDepartment of Neurosurgery, Duke University, Durham, NC 27710, USA.
Patrick S CalhounVA Healthcare System, Durham, NC 27705, USA.
Robert J Ploutz-SnyderSchool of Nursing, University of Michigan, Ann Arbor, MI 48109, USA.ORCID 0000-0002-8503-2073
Cathleen M ConnellSchool of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
Tiffany J BraleyDivision of Multiple Sclerosis & Neuroimmunology, Department of Neurology, Michigan Medicine, Ann Arbor, MI 48109, USA.ORCID 0000-0003-0680-7828
Sarah A StoddardSchool of Nursing, University of Michigan, Ann Arbor, MI 48109, USA.ORCID 0000-0001-5825-4159

Funding

Complexity: Innovations in Promoting Health through Team ScienceT32NR016914 · NINR · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARJORIE E MCCULLAGH · 2017 to 2026
$3.5M
NINR NIH HHS T32 NR016914
6 · The paper itself

Abstract

Introduction: Lifetime stressors (e.g., poverty, violence, discrimination) have been linked to features of multiple sclerosis (MS); yet mechanistic pathways and relationships with cumulative disease severity remain nebulous. Further, protective factors like resilience, that may attenuate the effects of stressors on outcomes, are seldom evaluated. Aim: To deconstruct pathways between lifetime stressors and cumulative severity on MS outcomes, accounting for resilience. Methods: Adults with MS (N = 924) participated in an online survey through the National MS Society listserv. Structural equation modeling was used to examine the direct and indirect effects of lifetime stressors (count/severity) on MS severity (self-reported disability, relapse burden, fatigue, pain intensity, and interference) via resilience, mental health (anxiety and depression), sleep disturbance, and smoking. Results: The final analytic model had an excellent fit (GFI = 0.998). Lifetime stressors had a direct relationship with MS severity (β = 0.27, Conclusions: This work provides foundational evidence to inform the conceptualization of pathways by which stress could influence MS disease burden. Resilience may attenuate the effects of stressors, while poor mental health, smoking, and sleep disturbances may exacerbate their impact. Parallel with usual care, these mediators could be targets for early multimodal therapies to improve the disease course.

Indexed as

mental healthmultiple sclerosisresiliencesleepsmokingstress

Identifiers

PMID39619286
PMCPMC11606570

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.