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Sexual dysfunction, depression and anxiety are common symptoms for people living with MS and are more prevalent in MS relative to both the general population and other chronic disease populations. Recent findings emphasise the complex and multifactorial nature of sexual dysfunction in MS and suggest that the attribution of sexual dysfunction to disease factors (e.g., disability, location, or number of demyelinating lesions) may be overestimated. Sexual dysfunction, depression and anxiety are clinically significant as they have a range of complications. Sexual dysfunction can affect fertility and decrease general and sexual quality of life. Depression and anxiety have been shown to predict self-harm and suicidal ideation in MS, along with a host of negative prognostic factors such as increased hospitalisation, relapses, pain, fatigue and low adherence to disease-modifying treatments.
Despite evidence of sexual dysfunction, depression and anxiety significantly impacting people with MS, the psychological factors contributing to the development and continuation of these symptoms are unknown. This research study aims to identify modifiable psychological factors that contribute to sexual dysfunction, depression and anxiety in MS.
Following a systematic review of the literature, this study will develop the first models of sexual dysfunction, depression, and anxiety in MS. A ‘Model of Sexual Dysfunction’ and a ‘Transdiagnostic Model of Depression and Anxiety’ will be tested longitudinally and examined primarily in people living with MS, but will also be compared across other disease populations (i.e. endometriosis, cancer) to isolate important factors in MS. Findings from this research will address significant gaps in our understanding and inform directions for research and clinical practice. This will highlight important targets for psychological interventions that reduce the effects of sexual dysfunction, depression and anxiety in MS.
Ms Davenport’s comprehensive systematic literature review and meta-analysis included 99 studies with data from 13,502 people living with MS. Of the studies included in her review, 77 provided information on 24 personality and cognitive factors related to depression or anxiety. The combined findings of the studies suggest that depression and anxiety are linked to a set of common personality traits (neuroticism, extraversion and agreeableness) and cognitive factors (emotional dysregulation, difficulty expressing or recognising own emotions, serious perceived MS consequences, and strong disease identity). Factor such as difficulties with psychological flexibility (the ability to adapt and adjust thoughts) and low optimism were specific to depressive symptoms.
Early analyses of data from longitudinal studies and from 229 people living with MS showed strong relationships between neuroticism, cognitive factors and depression and anxiety. More analyses are underway to estimate how these factors may be related to each other over time. The level of disability, fatigue and current relapse status are being assessed as factors that interact along the path between cognitive factors and symptom development.
The collection of longitudinal data finished in August 2023 and is now being analysed in the first model of sexual dysfunction in MS. This model proposes that sexual dysfunction in MS may result from how the disease affects an individual’s internalised perceptions of their body manifesting as low levels of self-esteem, reduced sexual confidence and disrupted romantic attachment.
Over the next 12 months, Ms Davenport will continue data analyses for final studies, preparing manuscripts and writing her PhD thesis.
Davenport R.A., Krug I., & Kiropoulos, L. (2022). A Model of Sexual Dysfunction in Individuals with Multiple Sclerosis. Multiple Sclerosis Journal 28(1), 1-224.
Updated 31 March 2024Â
$105,000
2022
3 years
Current project
