Campus Location

Abilene Campus (Residential)

Date of Award


Document Type




Degree Name

Master of Science

Committee Chair or Primary Advisor

Scott Perkins

Second Committee Member or Secondary Advisor

Richard Beck

Third Committee Member or Committee Reader

John Casada


Despite increasing scientific interest over the past few decades in the neurobehavioral aspects of multiple sclerosis (MS), there has been relatively little systematic study of MS patients’ awareness of psychological problems. Even fewer data are currently available providing a direct comparison of the national prevalence rates of psychological problems among MS patients by country. This study was intended to address this question by comparing MS patients from Germany and the United States (US). Patients were asked to provide ratings of their psychological symptom severity, cognitive functioning, and overall quality of life (QoL) on six assessment instruments designed to assess depression, anxiety, hypomania, fatigue, cognitive functioning, and QoL. Patient ratings were compared to determine the degree to which geographical location is significantly associated with emotional and mental wellness, along with the self-reported QoL in MS patients. Data were analyzed using independent samples t-tests and a chi-square test. The results suggest that MS patients in the US experience significantly lower concurrent psychological symptomatology and signs of fatigue. Cognitive functioning is also reported as significantly better among MS patients in the US. There is no significant difference in the prevalence of psychological disorder diagnosis between MS patients in Germany and the US. QoL domains differed between the two groups, with MS patients in the US reporting higher QoL on the mental health and the overall QoL subscale, whereas MS patients in Germany reported higher QoL on the satisfaction with sexual function subscale. However, no significant difference was observed in QoL scores for the physical health and change in health subscales. Recommendations for future research and potential implications for medical and clinical assessments and interventions are explored.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.



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