Multitasking and Vocational Functioning in Multiple Sclerosis: A Performance Based Assessment.

摘要

Cognitive dysfunction in Multiple Sclerosis (MS) has been shown to be associated with difficulty maintaining employment. Previous domain-specific approaches to examining the effects of cognitive impairment on employment have not adequately explained the high unemployment rates in MS. A more complex construct that integrates multiple cognitive domains, known as multitasking ability, may be a more useful predictor of vocational functioning among individuals with MS. The current study examined the usefulness of an ecologically-valid performance based measure of multitasking to predict vocational functioning.;This study had two primary aims: 1) to develop and validate a performance based assessment of multitasking ability, termed the Vocational Multitasking Test (VMT), and 2) to evaluate the ability of the VMT to predict vocational outcomes.;To achieve these aims a pilot phase was first conducted with 10 healthy control (HC) participants to develop standardized administration and scoring procedures for the VMT. Next, a total of 18 participants with MS and 20 HC participants were recruited. These participants were administered a short battery of neuropsychological tests, self-report questionnaires of fatigue and depression symptoms, and two measures of multitasking ability.;Analysis of the psychometric properties of the VMT demonstrated good internal consistency, inter-rater reliability, and concurrent validity. Within MS participants, the VMT was significantly associated with processing speed and mental flexibility; whereas the VMT was only associated with processing speed in HC participants. Compared to the HC group, participants with MS completed fewer action steps of the VMT, made more errors, and engaged in fewer simultaneous task attempts. Performance on the VMT was significantly associated with vocational functioning and in a model predicting vocational group status, VMT performance and fatigue were able to predict group status with 69% accuracy.;The current study provides preliminary validation of the VMT as a performance based measure of multitasking ability. Results can be utilized in vocational rehabilitation efforts to both modify the structure of an individual's work environment and in making recommendations for vocational placement. Future research should continue to explore the usefulness of the VMT to predict vocational functioning and in informing cognitive rehabilitation strategies.