Psychological interventions for post stroke pain: A systematic review.

Chronic pain is prevalent after stroke and has a significant impact on quality of life. Research demonstrates the efficacy of psychological interventions for mixed chronic pain conditions. This review aimed to assess evidence on the effectiveness of psychological interventions for chronic pain in people with stroke. PubMed, PsychINFO, Embase, and CINAHL were searched from inception to 31 January 2021 at all levels of evidence. Psychological interventions assessing chronic pain in adults following stroke as a primary outcome were included. All outcomes related to pain quality were included (e.g., intensity, frequency, duration). Study quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and Risk of Bias in N-of-1 Trials (RoBiNT) Scale. Three single n case reports were included. A narrative synthesis was performed, indicating that psychological interventions may reduce chronic post-stroke pain; however, overall quality appraisal of the included studies was poor, owing to the low internal validity found in the single-n case report designs. The limited evidence suggests that psychological interventions may have clinical utility in reducing chronic post-stroke pain. However, owing to the paucity and quality of studies found, the results must be treated with caution. More rigorous research is needed.

Relaxation and related therapies for people with multiple sclerosis (MS): A systematic review.

OBJECTIVE: To establish the effectiveness of relaxation and related therapies in treating Multiple Sclerosis related symptoms and sequelae. DATA SOURCES: PsycINFO, PubMed, Embase, CINAHL, ProQuest Dissertations and Theses Global databases were searched. METHODS: We included studies from database inception until 31 December 2021 involving adult participants diagnosed with multiple sclerosis or disseminated sclerosis, which featured quantitative data regarding the impact of relaxation interventions on multiple sclerosis-related symptoms and sequelae. Studies which examined multi-modal therapies - relaxation delivered in combination with non-relaxation interventions - were excluded. Risk of bias was assessed using the Revised Risk of Bias tool for randomised trials - ROB2, Risk of Bias in Non-Randomised Studies of Interventions ROBINS-I), and within and between-group effects were calculated (Hedges' g). RESULTS: Twenty-eight studies met inclusion criteria. Twenty-three of these were randomised controlled trials, with 1246 total participants. This review reports on this data, with non-randomised study data reported in supplemental material. Post -intervention relaxation was associated with medium to large effect-size improvement for depression, anxiety, stress and fatigue. The effects of relaxation were superior to wait-list or no treatment control conditions; however, comparisons with established psychological or physical therapies were mixed. Individual studies reported sustained effects (≤ 6 months) with relaxation for stress, pain and quality of life. Most studies were rated as having a high/serious risk of bias. CONCLUSION: There is emerging evidence that relaxation therapies can improve outcomes for persons with multiple sclerosis. Given the high risk of bias found for included studies, stronger conclusions cannot be drawn.

Schema in older adults: does the schema mode model apply?

BACKGROUND: The relevance of schema theory to psychopathology, in particular personality disorder, in younger adults is established. Investigations into the relevance of schema theory to older adults, however, is highly limited. AIMS: To consider the relationship of schema modes to psychopathology in older adults and establish whether maladaptive schema modes are associated with unmet needs and that this relationship is mediated by the healthy adult mode of responding in this population. METHOD: One hundred and four older adults were recruited from an established database. Participants completed questionnaires assessing psychopathology, schema modes (YAMI: Young-Atkinson Mode Inventory) and basic psychological needs (BPNS: Basic Psychological Needs Scale - autonomy, competence and relatedness). Ninety-four responses were included after applying exclusion criteria. RESULTS: The healthy adult schema mode was found to be associated with reduced psychopathology, and maladaptive child modes (angry and vulnerable child) to increased psychopathology. The healthy adult schema mode mediated the relationship between maladaptive child modes and needs satisfaction. CONCLUSIONS: As predicted by schema theory, the presence of one of the maladaptive child modes makes it difficult for an older individual to have their needs met, but the presence of healthy adult mode works to support this process.

Validation of the Emotion Regulation Questionnaire in older community-dwelling adults.

OBJECTIVE: To examine the psychometric properties of the Emotion Regulation Questionnaire (ERQ) among a sample of older community-dwelling males and females and to also assess gender differences in the association between emotion regulation and positive and negative affect. METHOD: The ERQ and the Positive and Negative Affect Schedule-10 were administered to 252 older adults (age range 60-89 years; 48.4% female). RESULTS: The two ERQ subscales, reappraisal and suppression, were internally consistent. Reappraisal was positively correlated with positive affect among both genders, and negatively correlated with negative affect among older women only. Suppression was positively correlated with negative affect among older men only and unrelated to positive affect for both genders. Confirmatory factor analysis showed that a two-factor solution fits the data from both genders. CONCLUSION: The results provide evidence to support the ERQ for use with older adults, while identifying clinically important gender differences in the associations between emotion regulation tendencies and affect in older age. PRACTITIONER POINTS: Reliability and validity of the 10-item Emotion Regulation Questionnaire is supported for use among older adults. Suppression positively correlated with negative affect among older men but not older women. Reappraisal negatively correlated with negative affect among older women but not men. The current data from a community-dwelling population may not generalize to older adults with clinical disorders.

Young Schema Questionnaire - Short Form Version 3 (YSQ-S3): Preliminary validation in older adults.

OBJECTIVES: The aim of the current study was to establish the reliability and validity of one of the most used schema questionnaires, Young Schema Questionnaire Short Form Version 3 (YSQ-S3) in older adults. METHOD: 104 participants aged 60-84 years were recruited. They were administered a battery of questionnaires, including the YSQ-S3, Young-Atkinson Mode Inventory (YAMI), Germans (Personality) Screener, the Geriatric Depression Scale (GDS), The Geriatric Anxiety Inventory (GAI) and the Basic Psychological Needs Scale (BPNS). The YSQ-S3 was completed a second time by 83 participants a median of 12 days later. RESULTS: Satisfactory internal consistency reliability was found for 13 of the 18 early maladaptive schemas (EMS) of the YSQ-S3. Test-retest reliability was satisfactory for 17 of 18 EMS. Convergent validity was evident from significant correlations between the EMS of the YSQ-S3 and the vulnerable child and angry child schema modes from the YAMI. Congruent validity was evident from correlations of the majority of the EMS with the GDS, the GAI, German's (Personality) Screener and the BPNS measure. CONCLUSIONS: By and large the YSQ-S3 demonstrates internal and test re-test reliability in as well as congruent and convergent validity, in older adults. This suggests the YSQ-S3 may be of use in work establishing the utility of schema therapy in this population, and that schema therapy with older people warrants further exploration. Notwithstanding this some re-development of some EMS items appears to be required for the YSQ-S3 to be more relevant to older people.

Falls self-efficacy and falls incidence in community-dwelling older people: the mediating role of coping.

ABSTRACTBackground:A cognitive behavioral model predicts that coping responses mediate the relationship between falls related psychological concerns and falls incidence, in community-dwelling older people. If empirical support could be found for this pathway then interventions could be developed to reduce falls risk by targeting coping strategies. Therefore, this study aimed to begin the process of testing whether coping responses mediate the association between falls self-efficacy (a principal element of falls related psychological concerns) and falls incidence, in community-dwelling older people. METHOD: In a cross-sectional design, 160 community-dwelling older people (31 male, 129 female; mean age 83.47 years) completed the Falls Efficacy Scale-International, the Revised-Ways of Coping Questionnaire, the Turning to Religion subscale of the COPE, and a falls questionnaire. Data were analyzed via mediation analysis using a bootstrapping approach. RESULTS: Lower falls self-efficacy was associated with higher falls incidence, and more self-controlling coping was found to be a partial mediator of this association, with a confidence interval for the indirect effect of (0.003, 0.021) and an effect size of κ2 = 0.035. The association was not mediated by the other measured coping responses; namely, turning to religion, distancing, seeking social support, accepting responsibility, escape-avoidance, planful problem-solving, and positive reappraisal. CONCLUSIONS: Self-controlling coping may mediate the association between falls self-efficacy and falling. If longitudinal studies confirm this finding then coping could be targeted in interventions to reduce falls.

A review of cognitive impairments in children with intellectual disabilities: Implications for cognitive behaviour therapy.

OBJECTIVE: Nearly half of children with intellectual disability (ID) have comorbid affective disorders. These problems are chronic if left untreated and can significantly impact upon future vocational, educational, and social opportunities. Despite this, there is a paucity of research into effective treatments for this population. Notably, one of the most supported of psychological therapies, cognitive behaviour therapy (CBT), remains largely uninvestigated in children with ID. The current review considers the neuropsychological profile of children and adolescents with mild to moderate ID, with a view to informing how CBT might best be adapted for children and adolescents with ID. METHOD: Narrative review of literature considering the neuropsychological profiles of children and adolescents with ID, with specific focus upon attention, memory, learning, executive functioning, and communication. Studies were identified through SCOPUS, PsycINFO, and PubMed databases, using combinations of the key words 'intellectual disability', 'learning disability', 'neuropsychology', 'attention', 'learning', 'memory', 'executive function', 'language', and 'reading'. RESULTS: Children with ID have significant deficits in attention, learning, memory, executive functions, and language. These deficits are likely to have a negative impact upon engagement in CBT. Suggestions for adapting therapy to accommodate these wide ranging deficits are proposed. CONCLUSIONS: There are multiple cognitive factors which need to be considered when modifying CBT for children who have ID. Furthermore, research is required to test whether CBT so modified is effective in this population. PRACTITIONER POINTS: Clinical implications Effective ways of providing cognitive behavioural therapy (CBT) to children with intellectual disability (ID) is unclear. This study provides a framework of potential adaptations for clinical practice As rates of mental illness for children with intellectual disability are high, and rates of treatment provision low, it is hoped that the recommendations provided in this study will encourage more mental health practitioners to provide CBT to children with ID. Limitations These recommendations are based only upon neuropsychological literature. Trialling the effectiveness of an adapted form of CBT for children and adolescents with ID is required. There are varying causes of intellectual disability, with differences in cognitive profiles. The utility of the recommendations made here may vary according to specific aetiologies.

An Examination of the Nature of Erotic Talk.

Using a mixed-methods study, we provided the first systematic documentation and exploration of erotic talk. In Study 1 (N = 95), participants provided 569 erotic talk statements in an anonymous online survey, which we classified, using a modified thematic analysis, as being representative of eight themes. In Study 2 (N = 238), we quantified individual differences in these themes, subjected them to factor analysis, and examined the nomological network surrounding them with measures of relationship and sexual satisfaction, sociosexuality, and personality. The eight initial categories represented two higher order factors, which we call individualist talk and mutualistic talk. These factors were orthogonal in factor analysis and distinct in their nomological network. While the majority of people reported using erotic talk, we found few sex differences in its use.

A study of the validity and the reliability of the Geriatric Anxiety Inventory in screening for anxiety after stroke in older inpatients.

OBJECTIVES: To investigate the validity and reliability of the Geriatric Anxiety Inventory in screening for anxiety in older inpatients post-stroke. DESIGN: Longitudinal. SUBJECTS: A total of 81 inpatients with stroke aged 65 years or older were recruited at four centres in England. MAIN MEASURES: At phase 1 the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale were administered and then the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 4th edition (phase 2). The Geriatric Anxiety Inventory was repeated a median of seven days later (phase 3). RESULTS: Internal reliability of the Geriatric Anxiety Inventory was high (α = 0.95) and test-retest reliability acceptable (τB = 0.53). Construct validity was evident relative to the Hospital Anxiety and Depression Scale - Anxiety subscale (τB = 0.61). At a cut off of 6/7, sensitivity of the Geriatric Anxiety Inventory was 0.88, specificity 0.84, with respect to the Structured Clinical Interview anxiety diagnosis. Hospital Anxiety and Depressions Scale - Anxiety subscale sensitivity was 0.88, specificity 0.54 at the optimum cut off of 5/6. A comparison of the areas under the curve of the Receiver Operating Characteristics for the two instruments indicated that the area under the curve of the Geriatric Anxiety Inventory was significantly larger than that of the Hospital Anxiety and Depressions Scale - Anxiety subscale, supporting its superiority. CONCLUSIONS: The Geriatric Anxiety Inventory is an internally consistent, reliable (stable) and valid instrument with acceptable sensitivity and specificity to screen for anxiety in older inpatients with stroke.

Cognitive and Emotional Factors Influencing the Incorporation of Advice Into Decision Making Across the Adult Lifespan.

OBJECTIVES: The present study sought to investigate the influence of advice on decision making in older age, as well as the potential influence of depressive symptoms and age-related differences in the cognitively demanding emotion regulation on advice-taking. METHOD: A nonclinical sample (N = 156; 50% female; 47 young: M age = 29.87, standard deviation [SD] = 5.58; 54 middle-aged: M age = 50.91, SD = 7.13; 55 older: M age = 72.51, SD = 5.33) completed a judge-advisor task to measure degree of advice-taking, as well as measures of fluid intelligence, depressive symptoms, confidence, perceived advice accuracy, and emotion regulation. RESULTS: Age did not influence degree of advice-taking. Greater depressive symptoms were associated with more reliance on advice, but only among individuals who identified as emotion regulators. Interestingly, older age was associated with perceiving advice to be less accurate. DISCUSSION: The study contributes to the sparse literature on advice-taking in older age. Cognitive and emotional factors influence the degree to which advice is incorporated into decision making in consistent ways across the adult lifespan. A key difference is that older adults take as much advice as younger adults despite perceiving the advice to be less accurate.

Anxiety, depression, and fall-related psychological concerns in community-dwelling older people.

OBJECTIVES: Establish the association between affect and fall-related psychological concerns (fear of falling, fall-related self-efficacy, balance confidence, and outcome expectancy). METHODS: A total of 205 community-dwelling older people (mean age 81, SD 7.5 years) completed the Geriatric Depression Scale-15, Geriatric Anxiety Inventory, Modified Survey of Activities and Fear of Falling, Falls-Efficacy Scale- International, Activity-Specific Balance Confidence Scale, and the Consequences of Falling Scale. RESULTS: Hierarchical regression models showed that anxiety was independently associated with all fall-related psychological concerns; depression was only associated with falls efficacy. Associations between fall-related psychological concerns and age, gender, accommodation,medications, self-rated physical health, falls history, mobility, and sensory aids are also discussed. CONCLUSION: This is the first study that investigates the association between affect and the four fall-related psychological concerns. Anxiety was a significant factor associated with all four, whereas depression was only associated with activity avoidance. Implications for healthcare providers are discussed.

Treating anxiety after stroke using cognitive-behaviour therapy: two cases.

Anxiety disorders are common after stroke. However, information on how to treat them with psychotherapy in this population is highly limited. Modified cognitive-behaviour therapy (CBT) has the potential to assist. Two cases of individuals treated with modified CBT for anxiety after stroke are presented. The modification was required in light of deficits in executive and memory function in one individual and in the context of communication difficulties in the other. The anxiety symptoms were treated over seven and nine sessions, respectively. Both participants improved following the intervention, and these improvements were maintained at 3 month follow-ups. Further case-series and randomised controlled designs are required to support and develop modified CBT for those with anxiety after stroke.

A systematic review of non-drug interventions to prevent and treat anxiety in people with aphasia after stroke.

PURPOSE: To investigate the effectiveness of non-drug interventions for people with aphasia in the prevention and/or treatment of anxiety post-stroke as either a primary or secondary outcome. MATERIALS AND METHODS: A systematic search of Medline, CINAHL, PsycINFO and Cochrane Library up to March 2021 was carried out. Studies of stroke populations were included if people with aphasia represented 25% or more of the enrolled participants. Quality of the evidence was assessed. A narrative synthesis of results is presented. The PROSPERO record ID for this study is 106451. RESULTS: Ten studies were included: five randomised controlled trials (RCTs), a single case experimental design, and four pre-post studies. The quality of the RCT trials was at least adequate but none demonstrated a benefit to anxiety outcomes. Those studies that reported benefit were of lower-level evidence with respect to National Health and Medical Research Classifications. No studies were found that evaluated the prevention of anxiety after stroke for people with aphasia. CONCLUSION: Definitive conclusions about the effectiveness of non-drug interventions for the prevention and/or treatment of anxiety in people with aphasia post-stroke cannot be made. Interventions that may show promise for those with aphasia and symptoms of anxiety include mindfulness meditation, modified cognitive behaviour therapy, unilateral nostril breathing, and the "Enhance Psychological Coping after Stroke" programme. Further high-quality research with better reporting of the inclusion of participants with aphasia and their specific sub-group results are required.Implications for RehabilitationIt is important for rehabilitation professionals to consider prevention of anxiety post-stroke as well as treatment.Mindfulness meditation, modified cognitive behavioural therapy, unilateral nostril breathing, and the and the "Enhance Psychological Coping after Stroke" programme may be of benefit to people with aphasia post-stroke.Adapting intervention protocols to be more communicatively accessible and training health professionals in supported communication may help people with aphasia engage in psychological therapies.

Attributional intervention for depression in two people with multiple sclerosis (MS): single case design.

BACKGROUND: Depression is common in those with MS. The hopelessness theory of depression, emphasizing the role of attributional style, is supported in this population. Cognitive behaviour therapy (CBT) that can affect attributional style can reduce depression in people who have MS. AIMS: The present study aimed to consider whether changing attributional style would reduce depression in two people with MS, thereby supporting the importance of this component of CBT with this population. METHOD: Two female participants with MS were offered a 5-session intervention designed to alter attributional style. The study followed an ABA design. Attributional style and depressive symptoms were the principal measures considered. Negative life events and MS related stresses were also monitored. RESULTS: The intervention appeared effective for one of the participants, with predicted changes in attributional style and sizeable reductions in depressive symptoms from pre- to post-treatment that were sustained at 3-month follow-up. Improvement was still evident at 6 months, although with some reduction of effect. The intervention was less successful for the other participant who declined further treatment after three sessions. CONCLUSIONS: Some support for the hopelessness theory of depression was found, indicating its relevance to CBT interventions for those who have MS and depression.

The factor structure of the Center for Epidemiological Study - Depression Scale in people with multiple sclerosis.

Background: Depression is common in multiple sclerosis (MS); however, its assessment is complicated by biological processes. In this context it is important to consider the performance of depression screening measures including that their factor structure is consistent with expectation.  This study sought to identify the factor structure of the Center for Epidemiological Study - Depression Scale (CES-D) in people with MS (PwMS). Methods: Participants (N = 493) were those who had consented to take part in a large three-phase longitudinal study of depression in PwMS. CES-D questionnaires completed at phase 1 of the study were utilised. An error in the questionnaire meant it was most appropriate to consider data for 19 of the 20 CES-D questionnaire items. The data was split into two samples by a random selection process to create an exploratory, model development sample and a validation sample. The first sample was subject to confirmatory factor analysis. Following examination of model fit and specification errors, the original model was modified. The revised model was tested in the confirmation sample to assess reproducibility. Results: The analysis results supported the original four factor solution for the CES-D, that is: Depressed Affect, Positive Affect, Somatic Complaints/Activity Inhibition, and Interpersonal Difficulties. Conclusions: The CES-D appears to have a coherent structure with which to examine depression in PwMS.

Receiving Bad News: A Thematic Analysis of Stroke Survivor Experiences.

BACKGROUND: Breaking bad news to patients may be required in service provision to stroke survivors. While challenging, it may be critical to the retention of optimism and participation in rehabilitation. OBJECTIVES: To explore the experience of stroke survivors when receiving bad news (RBN) from medical practitioners. METHODS: Data were obtained via 1:1 interviews conducted at stroke support groups with survivors at least 12 months into recovery and subsequently transcribed for thematic analysis and coded using NVivo. RESULTS: Eight of 10 participants experienced RBN, and 2 participants did not. The themes of being "lucky to be alive" and waiting for "delayed information" were expressed by all participants early in the interviews. Three sub-themes emerged and were labelled alliance, dissent, and dissatisfaction, each with a further 3 contextual themes. The perception of RBN was marked amongst the dissent and dissatisfaction groups, with the latter reporting negative implications for their rehabilitation as well as negative emotions, such as anger and anxiety. The perception of a poor-quality relationship with medical practitioners was said to impede rehabilitation and recovery processes. The dissent group was characterized by initial disbelief after RBN and consequently poorer long-term outcomes, whilst the Alliance group experienced very good quality of care due to existing personal knowledge and therefore did not perceive RBN during their early medical meetings. CONCLUSIONS: In the period soon after their stroke, survivors required their medical practitioners to not only communicate knowledge and information, but also needed validation of their hopes and fears for the future from an empathically attuned clinician.

Patient experience of neurologic rehabilitation: a qualitative investigation.

OBJECTIVE: To understand the experiences of patients who had undergone neurologic rehabilitation. DESIGN: An interpretative phenomenological analysis of semistructured interviews. SETTING: Neurologic rehabilitation unit. PARTICIPANTS: A purposive convenience sample of 8 past patients. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Participants' reports of neurologic rehabilitation obtained via in-depth semistructured interviews. RESULTS: Participants predominantly described positive experiences of rehabilitation. The superordinate theme person-centeredness was developed, which included 4 key themes: ownership, personal value, holistic approach, and therapeutic atmosphere. These reflected patients' perceptions of choice and control and feelings of personal respect and self-worth. These appeared to be promoted through the multidimensional benefits of the unit (eg, the understanding and friendly nature of staff and other patients, physical improvements, psychologic gains) as well as the unit's informal, relaxed environment. When present, these factors created a positive rehabilitation experience; when absent, a negative experience. CONCLUSIONS: These findings support those from other literature, which has identified person-centered care as a core element of successful rehabilitation and linked its absence to dissatisfaction with health care. This research has increased our understanding of patients' experience of neurologic rehabilitation, and could inform the development of a patient-centered assessment instrument for neurologic rehabilitation.

Predictors of mental health literacy in older people.

OBJECTIVES: Older adults exhibit poorer mental health literacy than younger adults, including less accuracy at identifying symptoms of mental disorders, and endorsing fewer sources of treatment for a mental disorder. The current study's intention was to determine if the executive component of cognition is associated with mental health literacy in older adults, when controlling for other established predictors (sex, age, education, and proximity to someone with a mental disorder). METHOD: The sample included 85 cognitively healthy adults aged 60 and over. Participants completed the Mini-Addenbrooke's Cognitive Examination III, the Trail Making Test, a Phonemic Verbal Fluency Test, and the Mental Health Literacy Scale. RESULTS: A multiple regression indicated that age and mental health proximity significantly and uniquely predicted total mental health literacy (Age: ß = -0.22, t = -2.04, p < 0.05; Proximity: ß = 0.31, t = 2.78, p < 0.01). Older age predicted poorer PTSD mental health literacy (ß = -0.31, t = -2.90, p < 0.01). CONCLUSION: In neurologically healthy older adults, level of executive function did not contribute to mental health literacy. Older adults in closer proximity to someone with a mental disorder were more likely to have better mental health literacy, a finding that has the potential to inform mental health education and promotion strategies in this population.

Systematic review and meta-analysis of age-related differences in instructed emotion regulation success.

The process model of emotion regulation (ER) is based on stages in the emotion generative process at which regulation may occur. This meta-analysis examines age-related differences in the subjective, behavioral, and physiological outcomes of instructed ER strategies that may be initiated after an emotional event has occurred; attentional deployment, cognitive change, and response modulation. Within-process strategy, stimulus type, and valence were also tested as potential moderators of the effect of age on ER. A systematic search of the literature identified 156 relevant comparisons from 11 studies. Few age-related differences were found. In our analysis of the subjective outcome of response modulation strategies, young adults used expressive enhancement successfully (g = 0.48), but not expressive suppression (g = 0.04). Response modulation strategies had a small positive effect among older adults, and enhancement vs suppression did not moderate this success (g = 0.31 and g = 0.10, respectively). Young adults effectively used response modulation to regulate subjective emotion in response to pictures (g = 0.41) but not films (g = 0.01). Older adults were able to regulate in response to both pictures (g = 0.26) and films (g = 0.11). Interestingly, both age groups effectively used detached reappraisal, but not positive reappraisal to regulate emotional behavior. We conclude that, in line with well-established theories of socioemotional aging, there is a lack of evidence for age differences in the effects of instructed ER strategies, with some moderators suggesting more consistent effectiveness for older compared to younger adults.

Reliability and validity of the Attributional Style Questionnaire- Survey in people with multiple sclerosis.

BACKGROUND: The current study aimed to examine the psychometric properties of an attributional style measure that can be administered remotely, to people who have multiple sclerosis (MS). METHODS: A total of 495 participants with MS were recruited. Participants completed the Attributional Style Questionnaire-Survey (ASQ-S) and two comparison measures of cognitive variables via postal survey on three occasions, each 12 months apart. Internal reliability, test-retest reliability and congruent validity were considered. RESULTS: The internal reliability of the ASQ-S was good (α > 0.7). The test-retest correlations were significant, but failed to reach the 0.7 set. The congruent validity of the ASQ-S was established relative to the comparisons. CONCLUSIONS: The psychometric properties of the ASQ-S indicate that it shows promise as a tool for researchers investigating depression in people with MS and is likely sound to use clinically in this population.