Loneliness in Multiple Sclerosis: Putative Antecedents and Manifestations

Background: Multiple sclerosis (MS) and its consequences can be considered both antecedents and manifestations of loneliness. However, loneliness has received limited research attention in persons with MS, and further has been evaluated with questionable measures of the construct. 

Objectives: This study was guided by Peplau and Perlman’s (1979) theory of loneliness and included the UCLA Loneliness scale. We examined the prevalence of loneliness in MS, and personal characteristics, disability and functional limitations as antecedents of loneliness.  Depression, anxiety, fatigue, and QOL were examined as possible manifestations of loneliness.  

Methods: Sixty-three participants with MS and 21 healthy controls completed self-report measures (demographics scale, UCLA Loneliness Scale, Hospital Anxiety and Depression Scale (HADS), Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Impact Scale-29 (MSIS-29), and the Late Life Functional and Disability Instrument (LL-FDDI)). The data were analyzed using bivariate correlations, ANOVA, and stepwise regression in SPSS Statistics 22.0.

Results: The MS sample had significantly higher UCLA Loneliness Scale scores than healthy controls (F[1,81]=4.52, p=0.04). There were statistically significant negative correlations with upper extremity function (r_p=-0.29, p=0.02), social disability frequency (r_p=-0.44, p =0.00), social disability limitations (r_p=-0.37, p =0.00), and personal disability limitations (r_p=-0.30, p=0.02) and Loneliness scores. There were statistically significant positive correlations between loneliness and anxiety (r_p=0.25, p=0.05), depression (r_p=0.49, p=0.01), cognitive fatigue (r_p=0.31, p=0.01), and psychosocial fatigue (r_p=0.31, p=0.01). Loneliness was further associated with physical (r_p=0.26, p=0.04) and psychological QOL (r_p=0.44, p=0.00). Regression analyses indicated that marital status (beta =-0.42, p < .05) and social disability frequency (beta =-0.23, p < .05) accounted for 25% of the variance in Loneliness scores. 

Conclusions: Our results indicate that: (1) persons with MS reported higher loneliness than controls; (2) marital and employment status, age, and functional and disability frequency and limitations represented possible antecedents of loneliness in MS; and (3) anxiety, depression, fatigue, and QOL represented possible manifestations of loneliness in MS.