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Summer June 1st, 2019 Cognitive Functioning, Depression, and Strengths as Predictors of Quality of Life in Multiple Sclerosis Tara Annthea Crouch Seattle Pacific nU iversity

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Recommended Citation Crouch, Tara Annthea, "Cognitive Functioning, Depression, and Strengths as Predictors of Quality of Life in Multiple Sclerosis" (2019). Clinical Psychology Dissertations. 33. https://digitalcommons.spu.edu/cpy_etd/33

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Cognitive Functioning, Depression, and Strengths as Predictors of Quality of Life in Multiple

Sclerosis

Tara Crouch, M.S.

A dissertation submitted in partial fulfillment

of the requirements for the degree of

Doctor of Philosophy

In

Clinical Psychology

Seattle Pacific University

School of Psychology, Family, & Community

Approved by: Reviewed by:

Thane Erickson, PhD Amy Mezulis, PhD Associate Professor of Clinical Psychology Chair, Clinical Psychology Dissertation Chair

Jacob Bentley, PhD Katy Tangenberg, PhD Assistant Professor of Clinical Psychology Dean, School of Psychology, Committee Member Family & Community

Michelle Toshima, PhD Clinical Rehabilitation Psychologist Committee Member

COGNITIVE FUNCTOINING IN MS ii

ACKNOWLEDGMENTS

I would like to extend my sincerest thank you to Dr. Thane Erickson, my mentor, for his encouragement, guidance, and support throughout this process. He was willing to take a chance on my desire to build this study with a Seattle Hospital and assisted me throughout the process. Dr. Erickson’s mentorship has allowed me to grow immensely as both a researcher and a clinician. He has helped me to build a growth mindset and push me to strive towards excellence in my clinical and academic pursuits.

I would like to thank Dr. Michelle Toshima, without whom this research would not have been possible. Dr. Toshima advocated for the current project and provided expertise and advisory throughout this process. I am incredibly grateful for her patience, guidance, and support. I cannot express my enough for Dr. Toshima’s role in my development as a clinician and a researcher.

I would like to thank Dr. Jacob Bentley for lending his expertise in rehabilitation psychology and his encouragement to engage in research within the field of health psychology. Dr. Bentley has been a great support throughout this dissertation study and I am thankful for his advisory role.

COGNITIVE FUNCTOINING IN MS iii

Tara Crouch Word count: 350

Abstract

Patients with multiple sclerosis (MS) are at significant risk for decreased quality of life, partly due to associated cognitive impairment (Højsgaard Chow et al., 2018). A discrepancy often exists between objective and perceived measures of cognitive impairment (Middleton et al.,

2006); the paths through which they predict quality of life for MS patients remain unclear

(Baumstarck-Barrau, et al., 2011). Objective cognitive functioning as well as one’s perceptions of it may differentially impact quality of life, and therefore may or may not act through the same mechanisms to impact quality of life. Depression is one possible mediator known to impact quality of life in MS patients (Göksel Karatepe et al., 2011). Additionally, strengths such