Alexithymia and attachment on mental health of people with multiple sclerosis: The mediating role of perceived social support and loneliness.

Background: Multiple sclerosis and its progressive relapsing-remitting nature for MS patients is challenging and significantly affects the mental health of people with MS. We examined the direct effects of alexithymia and attachment on mental health and the indirect effect of attachment, alexithymia, loneliness, and perceived social support on the mental health of people with MS.

Materials And Methods: Three hundred and forty-five diagnosed with multiple sclerosis (MS) were deemed eligible for inclusion in the study and selected through the Iranian MS Association. Measures included the Toronto Alexithymia Scale (TAS20), Attachment Style Questionnaire (ASQ), General Health Questionnaire (GHQ28), Social and Emotional Loneliness Scale for Adults (SELSA-S), and Perceived Social Support from Family and Friends Questionnaire (PSS-FA and PSS-F). The mental health of MS patients was analyzed using structural equation models (SEM), examining how alexithymia, attachment, social support, and loneliness, directly and indirectly, affect their mental health. The fit of the model to the data was analyzed using the discrepancy function divided by degrees of freedom (CMIN/DF), Normed Fit Index (NFI), Tucker-Lewis Index (TLI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA).

Results: The results showed that the model fit was good. Furthermore, findings indicate that 28% (R = 0.28) of the mental health changes are explained via study predictors. Alexithymia and attachment directly affect mental health. Attachment style indirectly affects social support and loneliness, while loneliness and family support indirectly affect the mental health of MS patients.

Conclusion: The study findings provide valuable insights into the fundamental structures that influence the mental health of individuals with MS. Loneliness and social support are critical mediating factors that significantly impact the mental well-being of these patients. In the times ahead, healthcare professionals must prioritize attachment, alexithymia, social support, and loneliness in their medical and psychological interventions for individuals diagnosed with multiple sclerosis.