Personality Organization in Individuals with Multiple Sclerosis

Abstract

Background: Multiple sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system that may also influence psychological functioning, personality organization, coping strategies, and the sense of self. Objectives: This study aimed to identify the core dimensions and underlying components of personality organization in individuals with MS in Tehran. Methods: This applied qualitative study used a meta-synthesis design combined with the Delphi technique. The meta-synthesis phase comprised a systematic review of theoretical foundations and prior studies in national and international databases. Eighteen scholarly works were purposively selected according to the PRISMA flowchart. In the Delphi phase, 15 theoretical and clinical experts were recruited through purposive sampling. Meta-synthesis data were analyzed thematically, and expert consensus was evaluated using Kendall's coefficient of concordance. MAXQDA Analytics Pro 2018 and IBM SPSS Statistics 23 were used for data management and analysis. Results: Six dimensions of personality organization were identified: 1) personality traits, including neuroticism, extraversion, and conscientiousness; 2) coping styles, including active, emotional, and spiritual coping; 3) psychological quality of life, encompassing mental, social, and physical health; 4) reality testing, including differentiation between reality and imagination, social understanding, and cognitive adaptability; 5) primitive defenses, including denial, projection, and splitting; and 6) identity confusion, characterized by identity incoherence, a negative self-image, and efforts to reconstruct a positive identity. Conclusions: Personality organization in individuals with MS appears complex and involves interactions among coping styles, defense mechanisms, and identity processes. Examining these dimensions may improve understanding of emotional adaptation and psychological needs and inform more comprehensive psychological care for individuals with MS.