Multiple Sclerosis (MS)
MS is a chronic degenerative neurological disease that produces demyelination of the central nervous system. Onset is typically early adulthood. Although rarely fatal, MS produces a range of unpleasant and disabling symptoms. The course of MS is idiosyncratic and unpredictable and there is no known cure. Professor Moss-Morris and her team have an on-going programme of work on MS, largely funded through the MS society. Past projects have focused on developing theoretical models of fatigue, in MS and adjustment to MS and pain. Our theoretical models have been used to develop CBT based interventions which have demonstrated potential effectiveness in carefully controlled RCTs. Click links below to hear more.
Adjusting to MS: What do we know and can we help
CBT for adjustment to early stage MS
PDFs of CBT patient and partner manuals
Other past projects have looked at the impact of MS on partners and children. All our studies are conducted in close collaboration with people with MS. Example publications from these projects are listed below.
Developing a biopsychosocial model and self-management treatment for fatigue in paediatric multiple sclerosis:
Fatigue is one of the most common and disabling symptoms of MS, affecting up to 76% of children and adolescents with MS (caMS). This project aims to develop a biopsychosocial model of fatigue in caMS and a related self-management treatment by carrying out a series of projects within three years.
The specific objectives are:
- To determine biological, psychological and social factors associated with fatigue in caMS by carrying out a systematic review.
- To conduct in-depth qualitative interviews with caMS and their primary caregivers to gain an understanding of the impact of fatigue and how children and their caregivers respond to fatigue.
- To compare caMS with fatigue, caMS without fatigue, children with chronic fatigue syndrome (CFS) and children without a chronic illness on measures of fatigue, cognitive functioning and psychosocial factors.
- To use the findings from 1-4 to develop a theoretical biopsychosocial model of fatigue in caMS.
- To develop a self-management intervention based on this model and to test the potential efficacy of the intervention through replicated single case studies of caMS with significant fatigue.
Which treatments are effective for fatigue in people with multiple sclerosis (MS): A systemic review with process and meta-analyses.
The aim of this project is to systematically review the research evidence for behavioural and exercise interventions in MS to determine what characterises the most effective interventions for fatigue in MS. The review process has five key stages:
- A systematic review with meta-analysis of randomised controlled trials (RCTs) of exercise and behavioural interventions for MS fatigue. This will allow us to compare effective sizes across different types of interventions at end of treatment, and where possible, at follow up.
- A detailed process (e.g. mode and setting of delivery, intensity and frequency of intervention) and component analysis of the complex interventions will be embedded in the systematic review so the different interventions can compared and contrasted.
- A meta-synthesis and narrative review of published qualitative and quantitative secondary analyses from the RCTs included in the systematic review will be included to assess acceptability of the interventions, theoretical underpinnings of interventions, and possible moderators and mediators of change.
- A scoping review of (a) recent non-randomised trials of exercise and behavioural MS fatigue interventions which may show promise and (b) the broader literature on exercise and behavioural interventions to treat fatigue in other neurological or inflammatory long term conditions.
- A consultation and stakeholder event to get feedback of the interventions which appear to show the most promise to date. We will explore acceptability of these interventions to pwMS and service providers
CURRENT & RECENT GRANTS
Oct 2015 - Sep 2016 £79,964 Which treatments are effective for fatigue in people with multiple sclerosis (MS): A systematic review with process and meta-analyses. MS Society (Award Reference 26) (Moss-Morris, R., Thomas, S., Mercer, T., White, C., van der Linden, M.)
Oct 2014 - Sep 2017 £76,279 Developing a biopsychosocial model and self-management treatment for fatigue in children and adolescents with MS. MS Society (Moss-Morris, R., Chalder, T., Heyman I., Hemingway, C.)
June 2014 - May 2016 £100,000 'MS and me': Online self-management tools for people newly diagnosed with Multiple Sclerosis (MSers) (Shift.ms) Nominet Trust (Yauner, F., Pepper, G., Hackett, J., Porter, B., Davie, C., Potts, H., Moss-Morris, R., Petty, J., Jenkins, S.)
2013-2016 £164,243 A longitudinal mixed methods approach to the study of adjustment to primary and secondary progressive Multiple Sclerosis (MS) (Ref: 4) Multiple Sclerosis Society (Angeliki Bogosian (PI), Rona Moss-Morris, Chadwick, P., Sam Norton)
2012-2015 £77,942 Development and preliminary evaluation of a self-management programme for different types of pain in MS (Ref: 967/12) Multiple Sclerosis Society Studentship Award (Rona Moss-Morris, Anthony Harrison, Lance McCracken and Angeliki Bogosian)
2012-2013 £20,000 Mindfulness Intervention for Multiple Sclerosis: Measuring MRI related changes. National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre (Rona Moss-Morris, Angeliki Bogosian, Elena Antonova, Andy Simmons and Paul Chadwick)
2012-2013 £91,655 The development and pilot evaluation of mindfulness based cognitive therapy delivered by telephone for people affected by primary and secondary progressive Multiple Sclerosis (Ref: 961/11) Multiple Sclerosis Society (Rona Moss-Morris, Angeliki Bogosian, Paul Chadwick and Paul McCrone)
RELEVANT RECENT PAPERS.
- Carroll, S., Chalder, T., Hemingway, C., Heyman, I., Moss-Morris, R. (2015). Understanding fatigue in paediatric multiple sclerosis: a systematic review of clinical and psychosocial factos. Developmental Medicine & Child Neurology. DOI: 10.1111/dmcn.12964
- Van Kessel, K., Wouldes, T., Moss-Morris, R. (2015). A New Zealand pilot randomized controlled trial of a web-based interactive self-management programme (MSInvigor8) with and without email support for the treatment of multiple sclerosis fatigue. Clinical Rehabilitation. DOI: 10.1177/026921551558480
- Harrison, A.M., Silber, E., McCracken, L., Moss-Morris, R. (2015). Beyond a physical symptom: the importance of psychosocial factors in multiple sclerosis pain. European Journal of Neurology. DOI: 10.1111/ene.12763
- Bogosian, A., Hadwin, J., Hankins, M. and Moss-Morris, R. (2015). Parents' expressed emotion and mood, rather then their physical disability are associated with adolescent adjustment: A longitudinal study of families with a parent with multiple sclerosis. Clinical Rehabilitation. DOI: 10.1177/0269215515580600
- Bogosian, A., Chadwick, P., Windgassen, S., Norton, S., McCrone, P., Mosweu, I., Silber, E., Moss-Morris, R. (2015). Distress improves after mindfulness training for progressive MS: A pilot randomised trial. Multiple Sclerosis Journal. DOI: 10.1177/1352458515576261
- Harrison, A., Bogosian, A., Silber, E., McCracken, L., & Moss-Morris, R. (April 2014). "It feels like someone is hammering my feet": Understanding pain and its management from the perspective of people with Multiple Sclerosis. Multiple Sclerosis. 21 (4) 466-76, DOI: 10.1177/1352458514544538
- Harrison, A.M., McCracken, L.M., Bogosian, A. and Moss-Morris, R. (Jan 2014). Towards a Better Understanding of MS Pain: A Systematic Review of Potentially Modifiable Psychosocial Factors. Psychosomatic Research. 78(1) 12-24, DOI: 10.1016/j.jpsychores.2014.07.008
- Dennison, L., Moss-Morris, R., Yardley, Kirby, S & Chalder, T. Change and processes of change within interventions to promote adjustment to Multiple Sclerosis; learning from patient experiences. Psychology and Health, 2013, DOI:10.1080/08870446.2013.767904
- Moss-Morris, R., Dennison, L., Landau, S., Yardley, L., Silber, E, & Chalder, T. Supportive adjustment for multiple sclerosis (the saMS trial)): a randomized controlled trial comparing cognitive behavioral therapy to supportive listening for adjustment to multiple sclerosis. Journal of Consulting and Clinical Psychology. Online First Publication, June 25, 2012. DOI: 10.1037/a0029132
- 3. Moss-Morris, R., McCrone, P., van Kessel, K., Yardley, L., Wills, G., & Dennison, D. A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue. Behaviour Research and Therapy, 50 ( 6), 2012, 415–421 DOI: 10.1016/j.bbr.2011.03.031
- Knoop, H., van Kessel, K., & Moss-Morris, R. Which cognitions and behaviours mediate the positive effect of cognitive behaviour therapy on fatigue in patients with Multiple Sclerosis? Psychological Medicine, 2012, 42:205-213 (doi:10.1017/S0033291711000924).
- Dennison, L., Yardley, L., Devereux, A., & Moss-Morris, R. Experiences of adjusting to early stage Multiple Sclerosis. Journal of Health Psychology, 2011, 16(3) 478–488. (DOI: 10.1177/1359105310384299)
- Bogosian A, Moss-Morris R, Bishop FL, Hadwin J. How do adolescents adjust to their parent's multiple sclerosis?: An interview study. British Journal of Health Psychology, 2010 DOI:10.1348/135910710X521492)
- Dennison, L and Moss-Morris, R. Cognitive behavioural therapy: what benefits can it offer people with Multiple Sclerosis? Expert Review of Neurotherapeutics, 2010, 10, (9), 1383-1390. (doi:10.1586/ern.10.111) (PMID:20819010)
- Dennison, L., Moss-Morris, R., Silber, E., Galea, I. and Chalder, T. Cognitive and behavioural correlates of different domains of psychological adjustment in early stage multiple sclerosis. Journal of Psychosomatic Research, 2010, 2010, 69 (4), 353-361. (doi:10.1016/j.jpsychores.2010.04.009).
- Bogosian, A., Moss-Morris, R., Bishop, F., Hadwin, J. Psychosocial adjustment in children and adolescents with a parent with Multiple Sclerosis: A Systematic Review. Clinical Rehabilitation. 2010, 24, 789-801. (doi.10.1177/0269215510367982).
- Bogosian, A, Moss-Morris, R., Yardley, L., & Dennison, L. Experiences of partners of people in early stages of Multiple Sclerosis. Multiple Sclerosis. 2009, 15 (7), 876-884. (doi:10.1177/1352458508100048)
- Dennison, L., Moss-Morris, R., & Chalder, T. A review of psychological correlates of adjustment in patients with multiple sclerosis. Clinical Psychology Review. 2009, 29, (2), 141-153. (doi:10.1016/j.cpr.2008.12.001)
- van Kessel, K., Moss-Morris, R, Willoughby, E, Chalder, T. Johnson, M.H., Robinson, E. Cognitive behavior therapy compared to relaxation training for multiple sclerosis fatigue: A randomized controlled trial. Psychosomatic Medicine, 70, 2008, 205-213. DOI: 10.1097/PSY.0b013e3181643065
- Skerrett, T.N. & Moss-Morris, R. Fatigue and social impairment in multiple sclerosis: The role of patients’ cognitive and behavioral responses to their symptoms. Journal of Psychosomatic Research, 61, 2006, 587-593.
- van Kessel, K. & Moss-Morris, R. Understanding multiple sclerosis fatigue: A synthesis of biological and psychological factors. Journal of Psychosomatic Research, 61, 2006, 583-585
IoPPN STAFF (Section of Health Psychology)
Prof Rona Moss-Morris
Prof Lance McCracken
Ms Susan Carroll
Other IoPPN Collaborators
Prof. Paul Chadwick