Plusieurs études récentes démontrent que les personnes souffrant d'une déficience physique présentent un risque accru d'être atteintes de troubles d'anxiété. Cependant, on connaît encore très peu les éléments jouant un rôle clé dans le développement de symptômes d'anxiété dans cette population. La présente étude vise à évaluer la présence de symptômes d'anxiété et de processus cognitifs associés chez des individus atteints de sclérose en plaques, d'une autre maladie dégénérative ou d'une maladie non dégénérative. Cinquante-huit adultes ont rempli un ensemble de questionnaires mesurant l'anxiété, l'inquiétude, l'intolérance à l'incertitude, l'évitement cognitif, les croyances erronées et l'acceptation de la limitation physique. Il ressort que le type de limitation physique (dégénérative ou non) ne permet pas de distinguer les individus quant aux symptômes anxieux et aux processus cognitifs associés. Par contre, le degré d'acceptation de la limitation fait émerger des différences significatives en ce qui concerne l'anxiété, la tendance à s'inquiéter et l'intolérance à l'incertitude, un processus cognitif fortement associé à l'inquiétude. Selon ces résultats, l'acceptation de la limitation physique jouerait un rôle plus important dans le maintien des manifestations d'anxiété que le type de déficience vécue.

Psychological problems affecting physically handicapped individuals are understudied. However, some studies suggest a higher risk of developping an elevated level of anxiety among these individuals. A previous study reported that people with multiple sclerosis show more anxiety than patients suffering from another type of physical limitations. These results raise questions about the specificity of the link between anxiety and some medical conditions. The aim of the present study is to increase our understanding of manifestations of anxiety associated with degenerative illnesses. Three groups of patients with different physical limitations were compared on their level of anxiety and on various cognitive process. Groups were composed as : 1) 20 patients suffering from multiple sclerosis, 2) 18 patients diagnosed with another degenerative illness (either arthritis, muscular dystrophy or ataxia), and 3) 20 participants presenting a non-degenerative handicap. The 3 groups were not significantly different on age, sex and duration of the physical limitations. Symptoms of anxiety were measured with 3 questionnaires :1) the Hospital Anxiety and Depression Scale, 2) the Penn State Worry Questionnaire, used to assess the tendency to worry, and 3) the Worry Domains Questionnaire, assessing diversity and intensivity of worry themes. In turn, cognitive processes were evaluated with 4 questionnaires : 1) the Acceptance of Disability scale, used to assess the person's level of acceptance regarding a disability, 2) the Interpretation of Disturbing Thoughts questionnaire, an idiographical measure about the interpretation of thoughts associated with a physical handicap, 3) the Intolerance of Uncertainty scale, presenting beliefs about uncertainty and its consequences, and 4) the Cognitive Avoidance questionnaire, to evaluate the tendency of avoiding disturbing thoughts and images. Participants completed all questionnaires alone and the experimenter was available to answer any questions. MANOVAs were used to compare the 3 groups on the studied variables. Statsical analysis revealed no significant differences among groups for symptoms of anxiety and depression, tendency to worry and worry themes. Similarly, no significant differences were obtained on cognitive processes. The multiple sclerosis group and the other degenerative illness group were combined and compared to the non-degenerative handicap group. MANOVAs conducted on symptoms and cognitive processes did not yield any significant differences. Results of the present study seem to indicate that the type of physical limitations is not an indicator of the presence of specific anxiety symptoms or cognitive processes. On an exploratory basis, all participants were compared according to their level of acceptance of disability. Results indicated that a lower level of acceptance was significantly associated with more anxious and depressive symtoms, excessive worries, and a greater intolerance of uncertainty. It seems that acceptance of disability plays a key role in maintaining psychological distress among people with a physical handicap. The influence of intolerance of uncertainty on acceptance of disability needs to be further explored.