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An analysis of the relationship of character strengths and quality of life in persons with multiple sclerosis

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Abstract

Purpose

To examine the relationship of character strengths and quality of life (QOL) in persons with multiple sclerosis (MS). Specifically, this study examined the relationship of the 24 character strengths in Peterson and Seligman’s model with QOL and three negative effects of MS (disability, fatigue, and depression). It also investigated whether the three negative effects of MS mediate the relationship of each of the character strengths and QOL.

Methods

Six hundred and twenty-four individuals with MS completed an online survey measuring character strengths, QOL, as measured by the Leeds Multiple Sclerosis Quality of Life Scale, disability, fatigue, and depression. SPSS was used to complete the correlational analysis, and Hayes’ PROCESS macro for SPSS was used to conduct the mediation analyses.

Results

The strengths endorsed most frequently by the participants were honesty, kindness, and fairness. The least-endorsed strengths were self-regulation, zest, and spirituality. The strengths with the strongest association with QOL were zest, hope, and gratitude. Disability was not found to mediate any of the relationships between character strengths and QOL. Many of the character strengths were associated with QOL both directly and indirectly through fatigue and depression.

Conclusions

Many of the character strengths in the Peterson and Seligman model enhance QOL in persons with MS, both directly and through their influence on negative effects of MS. The results provide support for the development of character strengths interventions to impact QOL, both directly and indirectly through improvements to MS-related symptoms such as fatigue and depression.

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Funding

This study was funded by the National Multiple Sclerosis Society (Grant Number PP-1803-30549)

Author information

Authors and Affiliations

  1. Department of Rehabilitation Psychology & Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Room 438, Madison, WI, 53706, USA

    Susan Miller Smedema

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  1. Susan Miller Smedema
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Correspondence to Susan Miller Smedema.

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Appendix

Appendix

Appreciation of beauty

The mediating role of fatigue (− .08 [− .14, − .03]) in the relationship between appreciation of beauty and QOL was confirmed. Given that the 95% CI does not include zero, the indirect effect is significant (P < .05). The indirect effects of disability (.00 [− .02, .00]) and depression (− .07 [− .15, .01]) were not significant. The direct effect of appreciation of beauty on QOL (c’) was no longer significant after controlling for the indirect effects (− .01 [− .14, .11]). These findings suggest the relationship between appreciation of beauty and QOL can be explained by fatigue.

Curiosity

The mediating roles of fatigue (.16 [.10, .24]) and depression (.25 [.16, .34]) in the relationship between curiosity and QOL were confirmed. The indirect effect of disability (.00 [− .02, .03]) was not significant. The direct effect of curiosity on QOL (c’) remained significant after controlling for the indirect effects (.17 [.04, .31]). These findings suggest the relationship between curiosity and QOL can be partially explained by fatigue and depression.

Forgiveness

The mediating role of depression (.12 [.05, .21]) in the relationship between forgiveness and QOL was confirmed. The indirect effects of disability (− .01 [− .04, .01]) and fatigue (.01 [− .04, .06]) were not significant. The direct effect of forgiveness on QOL (c’) remained significant after controlling for the indirect effects (.31 [.19, .43]). These findings suggest the relationship between forgiveness and QOL can be partially explained by fatigue and depression.

Gratitude

The mediating role of depression (.17 [.09, .26]) in the relationship between gratitude and QOL was confirmed. The indirect effects of disability (.00 [− .01, .01]) and fatigue (.05 [− .01, .11]) were not significant. The direct effect of curiosity on QOL (c’) remained significant after controlling for the indirect effects (.52 [.39, .65]). These findings suggest the relationship between gratitude and QOL can be partially explained by fatigue and depression.

Honesty

The mediating role of fatigue (.12 [.05, .21]) and depression (.22 [.10, .34]) in the relationship between honesty and QOL was confirmed. The indirect effect of disability (.00 [− .02, .01]) was not significant. The direct effect of honesty on QOL (c’) remained significant after controlling for the indirect effects (.22 [.04, .40]). These findings suggest the relationship between honesty and QOL can be partially explained by fatigue and depression.

Hope

The mediating role of fatigue (.17 [.11, .24]) and depression (.34 [.25, .43]) in the relationship between hope and QOL was confirmed. The indirect effect of disability (.00 [.00, .02]) was not significant. The direct effect of hope on QOL (c’) remained significant after controlling for the indirect effects (.55 [.42, .68]). These findings suggest the relationship between hope and QOL can be partially explained by fatigue and depression.

Judgment

The mediating role of fatigue (.09 [.03, .17]) and depression (.16 [.06, .27]) in the relationship between judgment and QOL was confirmed. The indirect effect of disability (.00 [− .01, .03]) was not significant. The direct effect of judgment on QOL (c’) was no longer significant after controlling for the indirect effects (− .04 [− .18, .09]). These findings suggest the relationship between judgment and QOL can be explained by fatigue and depression.

Leadership

The mediating role of fatigue (.08 [.03, .15]) and depression (.09 [.00, .19]) in the relationship between leadership and QOL was confirmed. The indirect effect of disability (.00 [.00, .01]) was not significant. The direct effect of leadership on QOL (c’) remained significant after controlling for the indirect effects (.16 [.02, .30]). These findings suggest the relationship between leadership and QOL can be partially explained by fatigue and depression.

Love

The mediating role of fatigue (.08 [.02, .14]) and depression (.20 [.11, .30]) in the relationship between love and QOL was confirmed. The indirect effect of disability (.00 [− .01, .01]) was not significant. The direct effect of love on QOL (c’) remained significant after controlling for the indirect effects (.37 [.24, .51]). These findings suggest the relationship between love and QOL can be partially explained by fatigue and depression.

Love of learning

The mediating role of fatigue (.06 [.02, .12]) and depression (.14 [.07, .22]) in the relationship between love of learning and QOL was confirmed. The indirect effect of disability (.00 [− .01, .00]) was not significant. The direct effect of love of learning on QOL (c’) was no longer significant after controlling for the indirect effects (.01 [− .09, .11]). These findings suggest the relationship between love of learning and QOL can be explained by fatigue and depression.

Perseverance

The mediating role of fatigue (.19 [.12, .27]) and depression (.26 [.18, .35]) in the relationship between perseverance and QOL was confirmed. The indirect effect of disability (.00 [− .01, .03]) was not significant. The direct effect of perseverance on QOL (c’) was no longer significant after controlling for the indirect effects (.01 [− .11, .13]). These findings suggest the relationship between perseverance and QOL can be explained by fatigue and depression.

Self-regulation

The mediating role of fatigue (.10 [.05, .16]) and depression (.20 [.13, .27]) in the relationship between self-regulation and QOL was confirmed. The indirect effect of disability (.00 [− .02, .00]) was not significant. The direct effect of self-regulation on QOL (c’) was no longer significant after controlling for the indirect effects (.05 [− .05, .15]). These findings suggest the relationship between self-regulation and QOL can be explained by fatigue and depression.

Social intelligence

The mediating role of fatigue (.08 [.03, .15]) and depression (.12 [.04, .21]) in the relationship between social intelligence and QOL was confirmed. The indirect effect of disability (.00 [− .01, .00]) was not significant. The direct effect of social intelligence on QOL (c’) remained significant after controlling for the indirect effects (.23 [.09, .36]). These findings suggest the relationship between social intelligence and QOL can be partially explained by fatigue and depression.

Spirituality

The indirect effects of disability (.00 [− .02, .01), fatigue (− .01 [− .04, .02]) and depression (.04 [− .01, .08]) in the relationship between spirituality and QOL were not significant. The direct effect of spirituality on QOL (c’) remained significant after controlling for the indirect effects (.09 [.11, .15]). These findings suggest the relationship between spirituality and QOL cannot be explained by disability, fatigue, and depression.

Teamwork

The indirect effects of disability (.00 [− .01, .00), fatigue (.03 [− .03, .10]) and depression (.07 [− .03, .17]) in the relationship between teamwork and QOL were not significant. The direct effect of teamwork on QOL (c’) remained significant after controlling for the indirect effects (.21 [.07, .36]). These findings suggest the relationship between teamwork and QOL cannot be explained by disability, fatigue, and depression.

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Smedema, S.M. An analysis of the relationship of character strengths and quality of life in persons with multiple sclerosis. Qual Life Res 29, 1259–1270 (2020). https://doi.org/10.1007/s11136-019-02397-1

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