Lauren B Strober

Kessler Foundation · Center for Neuropsychology & Neuroscience Research

Objective Social support is an emerging protective factor against cognitive decline. However, the relationship between social support and cognitive functioning in the multiple sclerosis (MS) population is not well understood. The present study aimed to investigate the associations between different aspects of social support and cognitive performanc...

Objective The role of social support or connectedness on health is profound. While this has been known for some time, recent reports of the role of social activity on mortality, general health, cognition, and well-being have suggested that it may play a larger role than the known culprits of poor outcomes (e.g., smoking, diet, exercise). The presen...

Objective To explore self-efficacy as a possible mediator in the relationship between adaptive coping and psychological well-being (PWB) in persons with relapsing–remitting multiple sclerosis (RRMS). Method 174 persons with RRMS (95% Female) completed an online survey consisting of psychosocial questionnaires. The COPE Inventory was used to create...

Objective: Although language is often considered to be largely intact in multiple sclerosis (MS), word-finding difficulties are a common complaint. Recent work suggests that declines in language are not solely the result of motoric and cognitive slowing that is most strongly associated with MS. Network science approaches have been effectively used...

Background: Social support is a protective factor against cognitive decline in the general population. However, the relationship between social support and cognitive functioning among persons with multiple sclerosis (MS) is not well understood. Objective: The present study aimed to investigate the associations between different aspects of social...

Background The consequences of spinal cord injury (SCI) can place significant demands on an individual’s coping mechanisms. Interventions to promote psychological adjustment and coping are often included in inpatient rehabilitation programs; however, following discharge, many individuals with SCI do not receive ongoing counseling or education about...

While assessment of cognitive functioning is an essential feature of most neuropsychologists’ work, little attention has been paid to evaluating lifestyle factors known to positively impact brain and cognitive health. This chapter considers multiple strategies to clarify patients’ engagement in lifestyle activities such as exercise, socialization,...

Research indicates that people with multiple sclerosis (MS) are more likely to report poorer health and well‐being than their peers without MS. Fortunately, it is also known that an individual's social and lifestyle factors play a great role on maintaining and promoting one's health and overall well‐being. The present study aimed to examine the rol...

Background The Multiple Sclerosis Performance Test (MSPT) is a self-administered, iPad®-based, computerized system for quantifying neuroperformance (cognition, upper and lower extremity motor function, and vision) in patients with multiple sclerosis (MS). Objective The goal of the study is to provide regression-based norms for the four MSPT test m...

Background The world has been experiencing one of the most significant worldwide health pandemics in modern history. The result has been increased depression, anxiety, and loneliness in the general population. However, populations who demonstrated pre-pandemic emotional disturbance and social isolation, such as individuals with multiple sclerosis (...

The aim of the study is to investigate the impact of coping strategies on Health-Related Quality of Life (HRQoL) and physical disability assessed with the Expanded Disability Status Scale (EDSS) of people with multiple sclerosis (pwMS). PwMS were asked to focus on “MS diagnosis” as the core stressor. One hundred eight pwMS completed the Coping Resp...

Background : The Symbol Digit Modalities Test (SDMT) has been recommended for use in clinical trials and outcome studies to monitor cognitive change. However, defining what is a meaningful change has been elusive for several years. Objective : The present investigation aimed to develop methods for assessing individual-level statistically significa...

Research Objectives To examine psychometric properties of a COVID-19 Impact Scale among individuals with disabilities. Design Cross-sectional analysis. Setting Web-based survey. Participants A sample of 418 individuals with multiple sclerosis (62.68%), traumatic brain injury (n=15.07%), and spinal cord injury (22.25%) completed a survey about ex...

Background: Information processing speed is often impaired in neurological disorders, as well as with healthy aging. Thus, being able to accurately assess information processing speed is of high importance. One of the most commonly used tests to examine information processing speed is the Symbol Digit Modalities Test (SDMT), which has been shown t...

Background While cognitive deficits in memory and processing speed have been well-documented in individuals with multiple sclerosis (MS), language is largely considered to be intact. Verbal fluency deficits observed in MS are often attributed to impaired processing speed and executive functions rather than language ability. The current study evalua...

Background : Reliably monitoring changes in fatigue is an ongoing concern. Objective : Evaluate reliable change using the Modified Fatigue Impact Scale 5-item version (MFIS-5) in people with MS (PwMS). Methods : The MFIS-5 was administered at three time points in 157 PwMS. Test-retest reliability and reliable change scores were calculated at the...

Background : The Modified Fatigue Impact Scale (MFIS) is one of the most common self-report measures used to assess fatigue in multiple sclerosis (MS). Despite its widespread use, there are no existing normative data for the MFIS. Objective The present investigation aimed to develop normative data for the MFIS in a large community sample, stratifi...

Background: Rates of unemployment among individuals with multiple sclerosis (MS) are as high as 80%. Objective: This study examines disease, person-specific factors (e.g., personality, self-efficacy), and health-related behaviors, which may account for individuals leaving the workforce. Method: 252 individuals with MS were enrolled in a prospe...

Objective Engagement in physical and intellectual activity has been found to exert an impact on processing speed and executive functioning. One critical issue that remains unclear is at what point in the lifespan self-reported lifestyle factors impact cognition. Method A community sample of nondepressed adults aged 18–74 (N = 176) was administered...

Background Individuals with multiple sclerosis (MS) are often plagued by the unpredictability of their disease and have to contend with uncertainty in their life and significant life changes. This can lead to high levels of stress, perceived lack of control, helplessness, and anxiety. Despite these circumstances, anxiety disorders are often oversha...

Background : The Symbol Digit Modalities Tests (SDMT) is the most sensitive measure to multiple sclerosis (MS)-related cognitive dysfunction. However, existing normative data has been under scrutiny. Specifically, they are outdated, do not take into account gender, and are poorly stratified by education. More importantly, there exists no oral only...

Sensory processing patterns may predict health-related quality of life. This study examined this relationship in persons with multiple sclerosis considering trait anxiety as a potential mediator. Participants ( n = 94) completed the Adolescent/Adult Sensory Profile and other self-report measures at one time point. Sensory processing patterns were s...

Rates of unemployment in multiple sclerosis are high. Certain disease, psychological, and person-specific factors contribute to these high rates. The present study examined these factors and associated risk of unemployment by age. Participants ( n = 221) completed an online survey on employment. Participants were broken down by decade of life. Seve...

Objectives To explore whether patients in an adherence trial who appeared not to take disease modifying therapy (DMT) for avoidance reasons could be reliably identified, by observational coding, for their main reason of not taking DMT. To determine whether reason groups could be distinguished by clinical and self‐report psychological characteristic...

Background: The need for more robust outcomes in multiple sclerosis (MS) clinical trials has been a main priority of the field for decades. Dissatisfaction with existing measures has led to several consensus meetings and initiatives over the past few decades in hopes of defining and gaining acceptance of measures that are valid, reliable, sensitiv...

Objective: We examined the efficacy of a 12-wk educational socialization program, Community Reintegration for Socially Isolated Patients (CRISP), in improving self-efficacy for people with multiple sclerosis (MS). We also examined whether participants in the experimental group with increased self-efficacy experienced reduced loneliness and depress...

Objective: Increased age is associated with improved subjective well-being in the general population. However, there are conflicting findings regarding this association in individuals with multiple sclerosis (MS). In the present study, we examined differences in depression and quality of life (QOL) among 3 age groups of individuals with MS. Metho...

Multiple sclerosis (MS) is a neurological condition associated with a wide variety of physical, cognitive, and mood-related symptoms. While disease-modifying treatment has been shown to reduce the severity and frequency of MS symptom relapses, engagement in certain daily activities holds promise as an adjunctive treatment to better manage disease s...

Background: Reductions in quality of life (QOL) exist among individuals with multiple sclerosis (MS). Objective: The present investigation aimed to adopt a biopsychosocial model in examining QOL in the early stages of MS. Methods: Individuals with MS (34 with average to low QOL and 35 with high QOL) were compared on measures of disease symptom...

Fatigue is one of the most disabling symptoms of multiple sclerosis (MS). While progressive resistance training (PRT) has been shown to reduce fatigue in persons with MS, it is not clear why these reductions occur. One hypothesis is that PRT may induce functional changes to the caudate, a region highly implicated in MS fatigue. The aim of the curre...

Background: Rates of unemployment among individuals with multiple sclerosis (MS) are as high as 80%. While several factors for such high rates of unemployment have been identified, they do not account for the majority of the variance. Objective: This study examines person-specific factors such as personality and coping, which may better account...

Objectives: Depression is common in epilepsy, with rates ranging from 20 to 55% in most samples and reports as high as 70% in patients with intractable epilepsy. However, some contend that depression may be over- and/or under-reported and treated in this population. This may be due to the use of common self-report depression measures that fail to...

Patients with multiple sclerosis (MS) are often nonadherent to their disease modifying therapy (DMT). While recent studies demonstrate enhanced DMT adherence following intervention grounded in motivational interviewing (MI), little is known about how to address DMT reinitiation among MS patients who have prematurely discontinued DMT against medical...

Objectives: Personality is known to have a substantial impact on health and overall well-being. Neuroticism, extraversion, and conscientiousness in particular have been shown to be strongly correlated with subjective well-being (SWB), psychological well-being (PWB), and overall health. The present study aimed to examine the role of personality and...

Introduction: Nearly 50 % of patients with chronic medical illness exhibit poor treatment adherence. When making treatment decisions, these patients must balance the probability of current side effects against the probability of long-term benefits. This study examines if the behavioral economic construct of probability discounting can be used to e...

Much like delay discounting, probability discounting may be related to a host of pro-health behaviors. In a recent report, a Medical Decision Making Questionnaire (MDMQ) was developed that leveraged this insights of probability discounting to both describe ways that multiple sclerosis (MS) patients weigh costs and benefits when making adherence cho...

Between 30 and 50 % of MS patients may prematurely discontinue disease modifying therapies. Little research has examined how to best talk with patients who have discontinued treatment against medical advice. The aim of this pilot study was to determine whether telephone counseling increases disease modifying therapy (DMT) re-initiation among nonadh...

Personality has long been considered a factor that can account for differences in health, well-being, and overall quality of life (QOL). A 'Distressed or Type D Personality' has been studied in medical populations as a predictor of several outcomes. The purpose of the present investigation was to determine the presence of Type D Personality in mult...

Background: Cognitive dysfunction affects approximately 43% to 70% of individuals with multiple sclerosis (MS) and is an important determinant of several functional outcomes in MS and quality of life. Brief neuropsychological test batteries have been developed specifically for use in MS and are widely used to aid clinicians in assessing levels of...

Unemployment is high among individuals with multiple sclerosis (MS). Certain disease variables and demographics have been found to distinguish employed and unemployed individuals. However, these variables only account for 14-20% of the variance. Other factors, such as coping, perceived stress and social support, in the workforce have been proposed,...

The ultimate objective of the present investigation was to improve the detection of depression in multiple sclerosis (MS) by comparing common self-report depression measures to a new, modified measure, which takes into account the contribution that symptoms of MS may have on individuals' reports. There has been a longstanding concern regarding the...

We examined the variables most associated with activity limitation (i.e., cooking) and participation restriction (i.e., employment) in 72 people with multiple sclerosis (MS). Participants underwent a comprehensive neuropsychological test battery assessing memory, executive functions, visual perception, and processing speed and completed questionnai...

Fatigue is a frequent and debilitating symptom of multiple sclerosis (MS) with rates ranging anywhere from 53 to 90%. Despite its high prevalence and grave impact on overall functioning and quality of life, the accurate definition, quantification, and etiology of fatigue have plagued the MS literature and clinical care for decades. With regard to i...

While a body of literature relating cognition and oculomotor performance exists, a better understanding of these processes would help facilitate the development of effective treatments for patients suffering various neurological disorders, such as Multiple Sclerosis (MS), Huntington's Disease, or a traumatic brain injury. To examine the relationshi...

Multiple sclerosis (MS) mostly affects young and middle-aged adults and is known to be associated with a host of factors involved in overall quality of life and well-being. The biopsychosocial model of disease takes into account the multifaceted nature of chronic illness and is commonly applied to MS. The present investigation examined the effectiv...

The role of personality in multiple sclerosis (MS) has received great attention recently. In particular, personality factors have been shown to be associated with several outcomes in MS such as adherence, coping, cognitive complaints, and employment. Certain personality factors (i.e., neuroticism) are also known to be associated with greater physic...

Objective: While there is an emerging interest in examining effects of health-related and lifestyle activities on cognition, few existing self-report measures target such domains. The present study was designed to provide initial psychometric data on the Cognitive Health Questionnaire (CHQ), a recently developed measure assessing frequency of vario...

Cognitive impairment occurs in 40-65% of patients with multiple sclerosis (MS). Less is known about the rate and pattern of cognitive decline over the course of the illness. To examine long-term changes in cognition among patients enrolled in the phase III clinical trial of intramuscular interferon beta-1a (IM IFNβ-1a). Twenty-two patients underwen...

Unemployment is a significant concern among individuals with multiple sclerosis (MS). Determinations regarding ability to work are highly dependent on measurement tools used by neurologists and allied professionals. However, little is known of the usefulness of these tools when determining issues pertaining to employment status. The purpose of the...

Multiple sclerosis (MS) is the leading cause of neurological disability among young and middle-aged adults. One of the most devastating consequences of MS in this relatively young population group is unemployment. Although certain demographic and disease factors have been associated with employment, few studies have examined the contribution of per...

Multiple sclerosis (MS) is the most common nontraumatic neurological condition of early and middle adulthood. Cognitive and neurobehavioral problems associated with this disorder are common. Approximately 50% of MS patients experience lifetime clinical depression, and at least 50% will experience significant cognitive difficulties. Fatigue is also...

The objective of the present investigation was to improve the detection of depression in multiple sclerosis (MS). It has been hypothesized that the overlap of MS symptomatology and neurovegetative depression symptoms may lead to an over-diagnosis of depression in MS. Discerning what is depression and what is more attributable to the disease renders...

Cognitive impairment is common in multiple sclerosis (MS) affecting roughly 45-60% of patients. Because memory deficits have significant impact on employment, caregiver burden, and social functioning, neuropsychological (NP) assessment is often recommended. Two widely used and validated NP batteries for MS are the Rao Brief Repeatable Neuropsycholo...

Prevalence rates of depression in medically ill elderly people are strikingly high. In particular, the prevalences of depression at any given time in Alzheimer's, Parkinson's, and stroke are as high as 87%, 75%, and 79%, respectively. Proper detection and management of depression in primary care is imperative. The present review examines the risk f...

Fatigue is a common symptom of multiple sclerosis (MS) that is purported to cause significant distress and have detrimental effects on daily functioning, social and occupational obligations, and overall well-being. The prevalence of fatigue in MS is high, with 53-87% of patients reporting significant problems with fatigue across different studies r...