The Relationship of Anxiety on Visual Learning in Multiple Sclerosis
Anxiety is common among individuals living with MS, with prevalence rates ranging from 19% to 57%. Anxiety in the MS population has been found to be associated with depression, pain, fatigue, stress, and lower self-efficacy and quality of life. Research has shown that anxiety in the general population is also associated with impairment in cognition, particularly in processing speed, attention, and visual memory. Studies have not yet examined the effect of anxiety in visual learning in the MS population. The present study wishes to address this gap, and hypothesizes that anxiety is associated with impairment in visual learning in patients with multiple sclerosis.
Objectives: This study tested the relationship of anxiety on three trials of visual learning.
Data was collected from 133 MS patients who underwent full neuropsychological evaluation at the MS Center at Holy Name Medical Center in Teaneck, NJ. Anxiety was measured using the self-report measure, Hospital Anxiety and Depression Scale (HADS), a well-validated measure in the MS population. Patients were also administered the Brief Visuospatial Memory Test-Revised (BVMT-R), a neuropsychological measure of visual learning and memory. A multivariate general linear model was conducted using SPSS 24.0 to test the hypothesized relationship. Specifically, anxiety was entered as the predictor variable and BVMT Trial 1, Trial 2, and Trial 3, were entered as the outcome variables. Age, education, and years of education were entered to control for confounding effects.
When controlling for education, age, and years of education, there was a significant effect of anxiety on visual learning (Wilks' Lambda= .931 , F(3,126)=3.093,p=.029). Anxiety had a significant effect on BVMT Trial 1 (F=8.813, p=.004) and BVMT Trial 2 (F= 5.714, p=.018); whereas there was not a significant effect on Trial 3 (F= 3.249, p=.074).
Anxiety was found to have an effect on MS patients' visual learning. Specifically, anxiety had an effect on patient's learning for Trials 1 and 2, whereas there was not a significant efffect of anxiety on Trial 3. Anxious MS patients on average scored lower on all three visual learning trials than non-anxious patients.