MULTIPLE SCLEROSIS (MS) IS A FAMILY ILLNESS: AN ITALIAN STUDY ON FAMILY FUNCTIONING IN PEOPLE WITH MS AND THEIR RELATIVES

Multiple Sclerosis (MS) is a chronic, immune-mediated and neurodegenerative disorder of the central nervous system (CNS), characterized not only by neurological impairment but also by substantial psychological and relational consequences. Increasingly, the literature has shifted from an individual-centred perspective toward conceptualizing MS as a “family illness,” highlighting its systemic impact on family functioning (FF). Within this framework, the present doctoral dissertation aims to investigate FF in households where one member is affected by MS, adopting a multidimensional approach that integrates the perspectives of people with MS (PwMS) and their relatives. The study employed a cross-sectional, observational, multicentre design involving twelve Italian clinical and academic centres. Participants included PwMS, partners, children, and other significant family members. A comprehensive battery of validated self-report instruments was administered to assess family functioning (FAM-III-SF), dyadic adjustment (DAS), parental bonding (IPPA), psychological distress (HADS), alexithymia (TAS-20), and perceived social support (MSPSS). Findings indicate that MS significantly affects family dynamics, supporting the conceptualization of the disease as a systemic condition. Higher levels of psychological distress and alexithymia were consistently associated with poorer family functioning and relational adjustment, whereas perceived social support emerged as a key protective factor buffering these negative effects. In addition, strong associations were observed between dyadic relationship quality, individual psychological well-being, and perceived FF in both PwMS and their partners. Analyses across different family members revealed distinct psychosocial profiles. Parents showed elevated levels of psychological distress and alexithymic traits, while children, particularly adolescents, exhibited significant associations between family functioning, attachment quality, and emotional well-being. Difficulties in emotional awareness and communication emerged as central mechanisms influencing adaptation processes within the family system. Methodological limitations related to data collection required partial revision of the original analytical plan. Nonetheless, the study provides meaningful insights into the relational and psychological processes underlying family adaptation to MS. Overall, the findings underscore the importance of adopting a systemic and family-centred approach in clinical practice. Interventions aimed at enhancing social support, improving communication, and addressing individual psychological vulnerabilities may play a crucial role in promoting adaptive functioning and well-being at both individual and family levels.