1. Investigation of social identity and mood in people with MS: Can family identity predict mood? Alex Barker, Nadina Lincoln, Roshan das Nair, Nigel Hunt Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham Contact: Alex Barker,
Introduction
Results - Mediation Analysis
Changes to identity following a diagnosis of multiple sclerosis (MS) can have a negative psychological effect on the individual [1]. Mood disorders are common in people with MS [3, 6].
The Social Identity Model of Identity Change (SIMIC) [4], states that belonging to a large number of groups before a life changing transition can protect from the effects of this transition by providing groups to fall back on [1]. The SIMIC proposes that social groups can provide a basis for social support, grounding and connectedness to others, allowing people to build new identities.
The family is a social group that has been found to be a salient factor in adjustment to MS [5] and a source of support for people with MS [2]. This group may enable the establishment of new identities as proposed by the SIMIC.
Figure 1: The Social Identity Model of Identity Change
Family identity influenced mood indirectly through its effect on social support and willingness to join new groups. Family identity positively predicted levels of social support (p = <0.01).
Social support levels were also found to predict mood levels (p <0.01).
Family identity was found to predict willingness to join new groups (, p = <0.05).
Willingness to join new groups was found to predict mood levels (p = <0.05).
A bias-corrected confidence interval for the indirect effect (β = -0.16) of family identity of mood through social support (based on 5,000 bootstrap samples) was below zero (95% CI’s = to -0.08).
A bias corrected confidence interval for the indirect effect (β = -0.03) of family identity on mood through willingness to join new groups was entirely below zero (95% CI’s = to ).
There was also evidence that family identity influenced mood independent of the mediating effect of social support and willingness to join new groups (p < .05).
belonging to multiple groups
Life-changing transition
well being
maintaining group membership
Time -
taking on new identities
compatibility of pre- and post change identity +
Method
Conclusion
Figure 2: Model with regression coefficients (β)
Method – Sampling
Questionnaire pack sent to 400 people with MS from a patient database at University Hospitals of Leicester NHS Trust
Link to online version of the questionnaire pack was also available
Method - Questionnaire Pack
Participants were asked to complete the Social Identification Scale, the Hospital Anxiety and Depression Scale, the Multi-dimensional Scale of Perceived Social Support and the New Groups subscale of the Exeter Identity Transition Scale.
Method – Analysis
Correlations between variables were examined before undertaking a mediation analysis.
A mediation analysis was conducted to examine whether family identity predicted mood through the mediators of social support and willingness to take part in new groups
Family identity can protect against low mood in line with the SIMIC
Family identity had a negative effect on mood scores via its effect on family social support and willingness to engage in social groups
0.22
0.73
0.18
0.14
Implications
Involving the family in the early stages of diagnosis and treatment of MS could increase support for the individual and reduce the high prevalence of mood disorders.
Teaching family members on how to successfully provide social support, could lead to greater identification with the family group and a reduction in low mood
Families could be taught how to encourage participation in other social groups.
0.19
All p values were significant at <0.05
Methodological Considerations
Sample
A large and diverse sample was used in this study
Whilst this study suggested family identity predicted mood scores, a longitudinal study could test this over a period of time.
Of 400 invited , 203 participants returned completed questionnaires. (123 postal, 80 online).
Table 1: Model coefficients
Consequent
Antedecent
M1 Family Social Support
M2 Willingness to join new groups
Y Mood
Path
CoEff. SE p
CoEff
X Family Identity A1
0.73
0.11
<0.01 B1
0.18
0.08
<0.05 C
-0.19
0.09 - A2
0.06 B2
-0.14
CONSTANT I1
26.53
2.62 I2
9.51
5.03 I3
33.43
2.43
R2 =0.24
R2 = 0.02
R2 = 0.20
F (1, 191) = 46.47, p = <0.01
F (1, 191) = 4.56, p = <0.01
F (3, 189) = 16.56, p = <0.05
References
1. Haslam et al. (2008). Maintaining group memberships: Social identity continuity predicts well-being after stroke. Neuropsychological Rehabilitation, 18,
2. Irvine et al. (2009). Psychosocial adjustment to multiple sclerosis: exploration of identity redefinition. Disability and Rehabilitation, 31(8),
3. Janssens et al. (2003). Impact of recently diagnosed multiple sclerosis on quality of life, anxiety, depression and distress of patients and partners. Acta Neurol Scand. 108(6),
4. Jetten, J. & Panchana, N. (2012). Not wanting to grow old; a social identity model of identity change (SIMIC) analysis of driving cessation among older adults. In: Jetten J, Haslam AS & Haslam C (eds.) The Social Cure: Identity, Health and Well-Being. Hove & New York.: Psychology Press.
5. Wineman, N. M. (1990). Adaptation to multiple sclerosis – The role of social support, functional disability and perceived uncertainty. Nursing Research, 39,
6. Zorzon et al. (2001). Depression and anxiety in multiple sclerosis. A clinical and MRI study in 95 subjects. J Neurol, 248, 416–421.