1.1Core self-evaluations

Core self-evaluations (CSE) is a positive human trait construct that has received considerable attention as a positive person (P) variable in ICF research. It is defined as the overall, fundamental perception that people have about their worth and capability as human beings (Judge, Locke, Durham, & Kluger, 1998). The CSE construct was first developed as part of a theoretical framework to explain dispositional influences on job satisfaction (Judge, Locke, & Durham, 1997) and then extended to explain life satisfaction (Judge, Bono, Erez, & Locke, 2005). CSE is a higher order construct comprised of four lower-order traits: self-esteem, self-efficacy, locus of control, and emotional stability (Judge et al., 1998). Self-esteem is defined as a global appraisal of one’s self-worth (Rosenberg, 1965). Self-efficacy is defined as one’s belief in his or her ability to produce desired outcomes when performing specific activities and pursuing goals (Bandura, 1977). Emotional stability is defined as the tendency to feel calm and secure (Eysenck, 1990). The final CSE trait is locus of control, which is defined as one’s belief that he or she has personal control over events in life, rather than believing that events are controlled by others or fate (Rotter, 1966).

Judge et al. (2005) noted that individuals’ fundamental evaluations of themselves impact all their beliefs about their lives. Judge et al. (1998) notes that people who consider themselves to be good or competent will react differently to obstacles in life than individuals who believe they are incompetent. Correspondingly, people with MS who consider themselves to be competent and worthy might cope more adaptively to the symptoms associated with their condition and, believing themselves to be capable of working, put more effort into pursuing employment. Conversely, people with MS who feel they are incompetent or lacking value may succumb to their symptoms, concluding that any attempt they make at pursuing employment will result in failure. Therefore, individuals with high CSE may have higher levels of employment than those with low CSE. There have not been any studies of the relationship between CSE and employment for individuals with MS. However, Smedema, Chan, and Phillips (2014) performed a study analyzing the relationship between CSE and participation for individuals with spinal cord injury and found that CSE contributes to life satisfaction and participation, including work participation. The study also found that CSE has a unique role in increasing motivation to pursue goals, which also predicts participation and life satisfaction. Research has also shown that CSE contributes to life satisfaction for college students with disabilities because they are better able to cope with stress, maintain a positive mood, and build social supports (Smedema et al., 2015).

1.2Social support

Social support is a positive environment (E) construct that performs a vital role in an individual’s health and well-being (Chronister, Johnson, & Berven, 2006; Chronister, Chou, Frain, & Cardoso, 2008; Wilson et al., 2013). Social support is defined as the social network in which an individual interacts, maintains contact, and shares with others (Costa et al., 2012). Social contacts are among the most important resources for promoting resilience in coping because they function as a buffer to mediate the impacts of stress (Martin & Martin, 2002). The benefits of strong social support for individuals with MS include reduced medical impairments, mortality, and increased quality of life, and community participation (Schwartz & Frohner, 2005; Yamout et al., 2013). Social support is also a facilitator to well-being and improved daily functioning for individuals with MS (Hamed, Tariah, & Hawamdeh, 2012). Although there is a paucity of studies regarding the relationship between social support and employment for individuals with MS, it is likely that having strong social support and the related benefits would increase the likelihood of employment for individuals with MS.

1.3Purpose of the study

To iterate, the positive effect of employment is well documented in the literature. However, the employment rate of people with MS is notoriously low. It is hypothesized that positive P-E factors could reduce the adverse effect of MS cluster symptom on employment. CSE and social support have been found to be effective P-E contextual factors for predicting community integration and participation in several disability groups (e.g., people with SCI and college students with disabilities). The purpose of the present study is to evaluate CSE and social support as P-E mediators for the relationship between symptom cluster and employment for persons with MS.

2.1Participants

One hundred and fifty-four prime working-age adults with MS participated in the present study. Participants were recruited from two regional chapters of the National Multiple Sclerosis Society (NMSS) including the Greater Washington D.C./Maryland Chapter in Washington D.C. and the Wisconsin Chapter in Hartland, Wisconsin. Inclusion criteria required individuals to be (a) diagnosed with multiple sclerosis, (b) between the ages of 25 and 54 (prime working-age), and (c) currently living in the community. The mean age of the participants was 41.03 years (SD?=?8.04). Most of the participants were women (87%), married (53%), and white (83%). Participants in the current study were relatively well-educated with 88% having some college education, two- or four-year college degrees, or graduate degrees. Fifty-nine percent of the participants were employed either part-time or full-time. The average age of MS diagnosis was 32.28 years old (SD?=?8.56), with the majority of participants (86%) experiencing relapsing-remitting multiple sclerosis (RRMS). A detailed description of participant characteristics is presented in Table 1.

2.2Measures

2.3Procedures

Participants were recruited by advertisements through monthly electronic newsletters and through a single round of direct email solicitation sent by NMSS chapters to their members. Participants who completed the online survey received a US$15 gift card upon completion of the study. The University of Wisconsin-Madison Institutional Review Board (IRB) approved this study.

2.4Data analysis

The Statistical Package for the Social Sciences (SPSS) version 24.0 was used to compute descriptive statistics. The SPSS INDIRECT macro written by Preacher and Hayes (2008) was used to compute the mediation analysis.

3.1Correlation analysis

Multiple sclerosis symptom cluster was found to be negatively associated with CSE (r?=?–0.70, p?r?=?–0.23, p?r?=?0.31, p?r?=?–0.26, p?r?=?–0.29, p?

3.2Mediation analysis

Two simple mediation analyses were computed to evaluate the relationship between MS symptom cluster and employment status using CSE and social support as mediators.