The interrelations between spiritual well-being, pain interference and depressive symptoms in patients with multiple sclerosis

Sheri A. Nsamenang, Jameson K. Hirsch, Raluca Topciu, Andrew D. Goodman, Paul R. Duberstein

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated with depression and pain interference. In mediation models, depression was not related to pain interference via spiritual well-being, or to spiritual well-being via pain interference. Pain interference was related to depression via spiritual well-being and meaning/peace, and to spiritual well-being and meaning/peace via depressive symptoms. Finally, spiritual well-being and meaning/peace were related to depression via pain interference, and to pain interference via depressive symptoms. For patients with MS, a multi-faceted approach to treatment that includes pain reduction and promotion of spiritual well-being may be beneficial, although amelioration of depression remains a critical task.

Original languageEnglish (US)
Pages (from-to)355-363
Number of pages9
JournalJournal of behavioral medicine
Issue number2
StatePublished - Apr 1 2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • General Psychology
  • Psychiatry and Mental health


  • Depressive symptoms
  • Multiple sclerosis
  • Pain interference
  • Spiritual well-being


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