Background: Determining the relative importance of factors that predict quality of life (QoL) in people with multiple sclerosis (MS) must be addressed through multiple regression metrics, e.g. relative weights, which are designed to solve colinearity problems. Objective: We aimed to compare disease variables, Expanded Disability Status Scale (EDSS), depressive symptomatology (BDI-FS), cognitive performance and coping in predicting MS patients’ QoL, using relative weights. Methods: We assessed 97 patients with MS, using the Functional Assessment of MS (FAMS) as the criterion. Results: EDSS predicted global and physical QoL domains, whereas BDI-FS predicted general contentment and global QoL. Conclusion: EDSS and BDI-FS are relevant determinants of QoL in people with MS.

There have been a small number of investigations of alexithymia in multiple sclerosis (MS) using the 20-item Toronto Alexithymia Scale (TAS-20). However, the TAS-20 factor structure has not yet been evaluated in a MS patient sample, and earlier Spanish translations of this instrument require some improvement. We aimed to evaluate the factorial validity and reliability of an improved Spanish translation of the TAS-20 (the TAS-20-S). The TAS-20-S was completed by 221 MS patients. Confirmatory factor analysis was used to compare the fit of six different factor models. Internal consistency and retest reliability coefficients were also computed. The correlated three-factor model and the higher-order factor model made up of Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally Oriented Thinking achieved the best fit. Alpha coefficients ranged between .87 and .67; mean inter-item correlations ranged between .48 and .20; and retest correlations after 6 months ranged between .61 and .52. A high degree of alexithymia was present in 18.1% of the sample. Reliability and the traditional three-factor structure were demonstrated for the TAS-20-S, which can now be recommended for assessing an aspect of emotional processing in MS patients

Background: : Suicide attempt (SA) lethality is associated with heightened suicidal desires and social cognition deficits. Fearlessness about death (FAD) and hypomentalizing may play a role in SA and self-harm. Although studies have identified relationships between these constructs, this line of research is still limited. We aimed to explore the mediating role of FAD and mentalizing between suicidal ideation and both SA lethality and self-harm. Method: : 1,371 suicide attempters (70.1% women; = 40 years) from seven Spanish hospitals participated. We used the Fearlessness About Death (ACSS-FAD) subscale, the Reflective Functioning Questionnaire-8 (RFQ-8), and the Columbia Suicide Severity Rating Scale (CSSRS). We conducted serial multiple mediation analyses with suicidal ideation as exposure; FAD and mentalizing as mediators; SA lethality and self-harm as outcomes. Results: : Indirect effects were found of suicidal ideation on self-harm ( = 0.08, = 0.03-0.15) and SA lethality mediated by FAD ( = 0.02, = 0.001-0.04); indirect effects of suicidal ideation on self-harm through mentalizing ( = 0.10, = 0.04-0.167), and total indirect effects between suicidal ideation and self-harm through FAD and mentalizing ( = 0.18, = 0.11-0.27). Conclusions: : Interventions addressing mentalizing and FAD may help reduce SA lethality and self-harm risk.