Structural Equation Modeling of Neuropsychological Functioning and Quality of Life in MS Patients: The Mediating Role of Distress Tolerance
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Objective: This study examined the structural relationships between neuropsychological functioning and QoL in MS patients, with distress tolerance as a mediating factor.
Methods and Materials: This descriptive-correlational study utilized structural equation modeling (SEM) to analyze data from 390 MS patients affiliated with the MS Society in Sari, Iran, selected through purposive sampling. Participants completed the Neuropsychological Functioning Questionnaire (Najati, 2013), Multiple Sclerosis Impact Scale (MSIS-29) (McGuigan & Hutchinson, 2004), and Distress Tolerance Scale (Simons & Gaher, 2005). Data were analyzed using SPSS 24 and Amos 22, assessing model fit through CFI, RMSEA, and Chi-square/df indices.
Findings: Neuropsychological functioning had a direct, positive effect on QoL (β = 0.22, p < 0.01), and distress tolerance also had a significant direct effect on QoL (β = 0.39, p < 0.001). Mediation analysis confirmed that distress tolerance partially mediated the relationship between neuropsychological functioning and QoL (Sobel test = 4.58, p<0.001). Model fit indices indicated an acceptable fit (CFI = 0.91, RMSEA = 0.066, Chi-square/df = 2.23).
Conclusion: Findings highlight the role of neuropsychological functioning and distress tolerance in predicting QoL in MS patients. Psychological interventions targeting cognitive function and distress regulation may improve patients' well-being. Further research should explore how MS subtypes influence these relationships.
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