Unit:
Department of PsychologyLibrary of the School of Philosophy
Dissertation committee:
Άννα Χριστοπούλου, αναπληρώτρια καθηγήτρια, τμήμα Ψυχολογίας, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Λίσσυ Κανελλοπούλου, αναπληρώτρια καθηγήτρια, τμήμα Ψυχολογίας, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Βασίλης Παυλόπουλος, αναπληρωτής καθηγητής, τμήμα Ψυχολογίας, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Ευφροσύνη Μόττη, καθηγήτρια, τμήμα Ψυχολογίας, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Αικατερίνη Γκαρή, καθηγήτρια, τμήμα Ψυχολογίας, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Ευάγγελος Καραδήμας, καθηγητής, τμήμα Ψυχολογίας, Πανεπιστήμιο Κρήτης
Αλεξάνδρα Οικονόμου, αναπληρώτρια καθηγήτρια, τμήμα Ψυχολογίας, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Original Title:
Ψυχολογικά και σωματικά συμπτώματα, συμβολική λειτουργία και ρύθμιση του συναισθήματος σε ασθενείς με σκλήρυνση κατά πλάκας.
Translated title:
Psychological and physical symptoms, symbolic function and affect regulation in multiple sclerosis patients.
Summary:
Multiple sclerosis (MS) is the most common cause of neurological disability not induced by trauma, and affects all facets of patients’ lives. The psychological state of patients, particularly as regards emotion, stress, and psychopathology, is considered particularly important for their prognosis and quality of life. MS as well as other chronic physical conditions have been of interest to psychoanalysis but have been the subject of empirical investigations to a very limited degree within this framework. The purpose of the present investigation was to explore the effect of the capacity for symbolization and alexithymia on the clinical condition and disease course of MS patients, from a psychoanalytic perspective. Sixteen MS patients were administered the Rorschach Inkblot Test, the Toronto Alexithymia Scale, the Hospital Anxiety-Depression Scale and the Expanded Disability Status Scale. Moreover, patients kept a diary twice weekly for three months consisting of the Multiple Sclerosis Impact Diary, the Perceived Stress Scale and the Positive Affect-Negative Affect Scale. It is the first time that the methodology used in this paper has been applied in studies of MS, particularly with respect to the specific variables under investigation. The data was analysed using Multilevel Hierarchical Linear Modelling. (1) Alexithymia and psychopathology predicted MS symptoms of mobility and fatigue, the impact of these symptoms on the patients’ life, and disease related quality of life. Higher levels of alexithymia and more severe psychopathology were associated with an increase in these MS symptoms, greater impact of these symptoms on the patients’ life and worse quality of life. (2) Imaginal capacity predicted symptomatology whereby insufficient or excessive was associated with more symptoms of mobility and fatigue. (3) Negative affect and perceived stress were associated with MS mobility and fatigue symptoms, impact of fatigue and quality of life through circular causality. The impact of mobility symptoms was predicted by positive affect, which was predicted by mobility symptoms themselves. (4) Difficulty in symbolic function and alexithymia were found to increase the effect of negative affect and perceived stress on the MS condition’s progress, yet aspects of operative or even normopathic thought and fantasy suppression were detected to decrease the effects of negative affect on patients’ lives. Thus this study confirms that perceived stress, negative affect and problems with symbolic functioning exacerbate not only the psychological, but also the physical condition of patients, while positive affect acts protectively with respect to psychological and physical well-being. Nevertheless, suppression and avoidance of affect and fantasy serve a protective function, reducing the conscious impact of negative affect and stress. However, they also reduce the beneficial effect of positive affect. Problems with symbolic functioning seem to directly exacerbate MS disease course, yet may well also function as defenses against stress and emotion dysregulation. Despite the having exceptionally important effects of perceived stress and negative affect on MS, further research must take into consideration the interaction between stress and emotion, and other factors with respect to their impact on the physical and psychological well being of patients with MS.
Main subject category:
Philosophy - Psychology
Keywords:
multiple sclerosis, psychoanalytic psychosomatics, symbolization, symbolic function, alexithymia, affect, stress
Number of index pages:
10
Number of references:
493
