Emotional Abuse and Psychological Distress in Individuals with Multiple Sclerosis: The Mediation Role of Internalized Shame and Chronic Illness Stigma

Multiple sclerosis (MS) is a debilitating neurological condition that affects several do- mains of individuals’ lives, making those affected particularly vulnerable to psychological distress. The visible nature of many MS symptoms may increase self-consciousness, thereby fostering feelings of shame and perceived stigma. Previous research has shown that self-related perceptions are shaped by early interpersonal relationships, rendering emotional trauma particularly relevant in this context. The present study sought to test whether an association between emotional abuse and psychological distress (Depression, Anxiety, and Stress) in individuals with MS would be mediated by internalized shame and perceived stigma. A total of 171 individuals with a clinical diagnosis of MS (85% women; M = 30.04, SD = 10.01) were recruited and completed a set of validated question- naires assessing the variables of interest. Structural Equation Modeling was used to test the proposed model. Significant paths emerged from emotional abuse to internalized shame and from emotional abuse to internalized shame. In addition, internalized shame was significantly associated with psychological distress, and a further significant path was observed from perceived stigma to psychological distress. Moreover, significant indirect effects were found from emotional abuse to psychological distress via internalized shame and via perceived stigma.