This thesis broadly concerns quality of life (QoL) and wellbeing in people with a diagnosis of Multiple Sclerosis (MS). It begins with a systematic review into the effects of menopause on QoL in MS, followed by an empirical study exploring the experience of attending an online Acceptance and Commitment Therapy (ACT) group for people with MS, and its impact on QoL and wellbeing. The thesis concludes with a discussion relating to how findings might impact on future research and clinical practice.
Firstly, a systematic review investigated the potential dual-impact of menopause on MS. Hormone reduction during perimenopause can cause symptoms of depression and anxiety in the general population, sometimes triggering first-episode psychosis and major depression. Perimenopause in MS may lead to additional difficulties: reproductive hormones have anti-inflammatory properties, reductions of which can impact on MS severity and course, further impacting mental health. This review attempted to investigate this and assess how many studies approach the matter from a psychological perspective. Evidence of dual-impact of menopause was observed in the majority of the 13 papers included in this review. Only four of the 13 studies employed psychological measures; none approached the matter from a purely psychological perspective.
Secondly, people with MS were asked about their experience of attending an online ACT group. Reasons for engaging were explored, along with maintenance and attrition processes. Possible mechanisms behind changes in the way people experienced their diagnosis were discussed, and general feedback was summarised. Findings suggested that the group was generally well-accepted. ACT concepts appeared to facilitate psychological flexibility and bring about acceptance, which positively impacted wellbeing.
Lastly, both studies’ findings and implications were brought together and discussed in the final chapter, followed by reflections on the research process.