Relationship Functioning and Sexuality among People with Multiple Sclerosis
McCabe, Marita P., The Journal of Sex Research
Multiple Sclerosis (MS) is a disease of the central nervous system that may result in motor, sensory, and cognitive impairment. The progressive nature of the illness and the unpredictability of its development can lead to a high level of uncertainty in the lives of its victims and their families. The ratio of females to males affected is variously claimed to be somewhere in the range of 2:1 (Rolak, 1992) to 3:2 (Clayton, 1989), and onset of the illness generally occurs between 20 and 50 years of age. This is a crucial time of life for the formation of relationships and establishment of family life. The development of such an illness would therefore be expected to have a major impact on the nature and quality of social and intimate relationship. The present study was designed to determine how people with MS are different from people from the general population in the quality of their relationships and their sexuality. The nature of coping strategies employed by respondents and the effectiveness of these strategies in resolving problems was also evaluated.
MS frequently results in increasing dependence upon others for both social and practical support. Hakim et al. (2000) found that MS resulted in reduced social contacts and a shrinking circle of friends, particularly for people with severe disability. Poor mobility was the reason cited for this change. Although the above authors found no higher incidence of divorce among people with MS compared to people from the general population, a large proportion of people with MS had retired early due to the illness. This may explain the reduced social functioning of the respondents with MS. About one third of partners of people with MS also reported that their careers had been affected by the illness of their spouse. Partners also experienced psychological disturbances, with the severity of anxiety and depression showing a strong relationship to the level of disability of their spouse.
Since the family is often the most immediate and obvious source of support, the development of MS has a significant effect on family dynamics. The increased dependence, particularly on the spouse, can place a huge strain on relationships (De Loach & Greer, 1981). One would expect that this strain would relate to the level of disability and to the length of time the person had MS. However, Wollett and Edelmann (1988) found no relationship between levels of disability and marital and life satisfaction of respondents with MS. Whether these finding also applied to partners of people with MS is not known. Wollett and Edelmann (1988) also found that there was no relationship between level of disability and the level of social support from a broader social network. However, respondents in this study may have adjusted to their disability, since it had been in place for at least ten years. Further research should evaluate the extent to which problems and adjustment strategies in relationships occur at different stages of the illness, and how people with MS are different from people in the general population.
Deterioration in relationship functioning following the development of MS does not appear to occur for all people. McCabe, McDonald, Deeks, Vowels, and Cobain (1996) found that about one third of respondents demonstrated a deterioration in their relationship, one third showed no change, and one third showed an improvement in the quality of their relationship. Further, Mohr et al. (1999) found that the prominent response to the development of MS among 94 patients was a deepening in the quality of their relationships and an enhanced appreciation of life ("benefit finding"; p. 380). This response was experienced by a substantially higher number of respondents than was the response of becoming demoralized or experiencing deteriorated relationships.
Mohr et al. (1999) found that the positive reaction of benefit finding was related to the positive coping strategies of positive reappraisal and seeking social support. …