Physical Disability, Unemployment, and Mental Health.

Objective: Assess the joint mental health effects of unemployment and physical disability. Study Design: Face-to-face interviews with participants screened for the presence of a physical disability and a matched comparison sample obtained from the same geographic area. Participants: Five hundred fifty-six community-based physically disabled persons and 460 matched comparison participants. Outcome Measures: Mastery (L. I. Pearlin & C. Schooler, 1978) and self-esteem (M. Rosenberg, 1979), financial strain, and depression (L. S. Radloff, 1977). Results: Persons with disabilities are 5 times more likely than their nondisabled counterparts to be involuntarily unemployed. However, this difference accounts for only about 30% of the elevations in depression among the former. Furthermore, the emotional impact of unemployment appears to be greater among those with disabilities. Conclusions: There appears to be no overlap in the psychological impacts of physical disability and unemployment-the 2 stressors representing cumulative, and even synergistic, adversity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correlates of Functional Disability in Patients With Postural Tachycardia Syndrome: Preliminary Cross-Sectional Findings.

The study investigated correlates of functional disability in 94 patients (89.4% women, 10.6% men; mean age=34.2 years) with postural tachycardia syndrome (POTS), a clinical syndrome of orthostatic intolerance characterized by significant functional limitations. Path analysis supported a model in which, controlling for demographic and disease variables, catastrophic cognitions were directly related to the latent variable functional disability, whereas somatic vigilance, anxiety sensitivity, and neuroticism were indirectly associated with functional disability through their relationship with catastrophic cognitions. Results suggest that modifiable psychological factors play a role in the functional limitations experienced by patients with POTS. Longitudinal research is necessary to confirm these relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of valued activity disability, social comparisons, and satisfaction with ability on depressive symptoms in rheumatoid arthritis.

This longitudinal study identified a model through which function affects the psychological well-being of individuals with rheumatoid arthritis (RA). Results of hierarchical linear regression analyses (N = 436) demonstrated that greater physical impairment resulted in greater disability in valued activities and engagement in unfavorable social comparisons. All 3 factors--greater physical impairment, greater disability in valued activities, and unfavorable comparison evaluations--predicted low satisfaction with abilities. Low satisfaction with abilities was the most important predictor of higher depressive symptoms and mediated the impact of physical impairment, valued activity disability, and unfavorable comparisons on depressive symptoms. Results highlight the role of personal meaning attached to changes in functional status in predicting the long-term psychological well-being of individuals with chronic illnesses such as RA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can disability studies and psychology join hands?

Although the field of disabilities studies incorporates psychology within its interdisciplinary purview, it embodies a distinct perspective consonant with the new paradigm of disability. This perspective is contrasted with that of psychology, and the place of disability within psychology is examined. Although psychology has begun to embrace diversity, disability has remained marginalized. Four areas are presented in this article: (a) the foundational ideas of disability studies, (b) training in disability within psychology, (c) the paradigms of disability reflected in research on disability, and (d) future research directions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between level of disability, psychological problems, social activity, and social networks.

Objective: To test a theoretical model on the relationship between level of disability, psychological problems, social activity, and social networks. Study Design: A repeated cross-sectional study included in 2 representative studies in the general population in Norway. Structural equation modeling was applied to test different models. Results: Activity limitations contribute to the prediction of psychological problems and level of social activity over time, whereas the reverse effects were not demonstrated. However, cross-sectional associations between psychosocial variables and activity limitations were found. Conclusions: The study confirms that activity limitations predict level of psychosocial problems. Although the reverse longitudinal effect from psychosocial problems on activity limitations was not demonstrated, short-term effects cannot be ruled out with the current study design. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Siblings of adults with mild intellectual deficits or mental illness: Differential life course outcomes.

The present study contrasted the later life sibling relationships, patterns of family formation, and psychological distress and well-being of siblings of adults with disabilities to a nondisabled normative group. The authors identified 268 siblings of adults with mild intellectual deficits (ID) and 83 siblings of adults with mental illness (MI) from the Wisconsin Longitudinal Study (R. M. Hauser & W. H. Sewell, 1985; R. M. Hauser, J. Sheridan, & J. R. Warren, 1998), a prospective longitudinal study that followed participants from age 18 years to age 64 years. Compared with the norm (n = 791), siblings of adults with mild ID had more contact with family members and were more likely to live in the same state as the sibling with the disability but reported less affective closeness. Siblings of adults with MI reported more psychological distress, less psychological well-being, and less adaptive personality characteristics compared with the norm, particularly for siblings of men with MI. There were no differences between groups in the patterns of marriage and childbearing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The experience of disability: A challenge for psychology.

Presents data on the handicapped population in the US and demonstrates how social psychological theories explain the experience of disability. It is contended that disability is associated both with race and income and is more prevalent among those with less than an 8th-grade education than among those with a college education. A disability compounds the effects of sex and race on economic status. Stereotyping and prejudicial attitudes (including self-images of the disabled) limit the opportunities for disabled people. It is suggested that in addition to biological differences, the attitudes and behavior of the nonhandicapped toward the handicapped person, the values of appearance and independence that underlie these attitudes, and the power of prejudice and discrimination must be examined. It is concluded that the existence of disabilities compels people to confront what it means to be human. New directions for psychological research and service in light of the changing situation of handicapped people in today's society are proposed. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of disability claimants' coping styles on judgments of pain, disability, and compensation: A vignette study.

Because insurance adjusters' decisions about whether to grant compensation to disability claimants are often based on subjective criteria, such decisions may be susceptible to the influence of factors irrelevant to the claimant's disabling condition. This study examined whether judgments about compensation claimants are affected by the claimants' way of coping with pain and by claimant sex. Ss were 200 undergraduates. Ss made judgments about vignettes describing fictitious compensation claimants with differing strategies of coping with pain. The main analytic approach involved a multivariate ANOVA with 5 within-subject factors (i.e., coping style described in each of 5 vignettes) and 2 between-subject factors (i.e., sex of claimant described in the vignettes). Coping style was significantly related to perceptions of pain severity and disability and to beliefs about whether compensation should be awarded. Claimants who were described as engaging in catastrophizing or in praying and hoping were more likely than other claimants to be perceived as disabled and as deserving compensation for their injuries. Decisions about disability compensation could be influenced by claimant coping styles… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The psychology of disability.

Reviews the book, The psychology of disability by Carolyn L. Vash (see record 1978-12832-001). The goal of this book, according to the author is "to dislodge preconceptions, thus opening up new ways of looking at the disability experience." This book was designed as a textbook for students in rehabilitation training programs and as a resource for practitioners in the various rehabilitation professions. This book is a one person's view of the meaning of disability, based on personal experience and professional observations. It also contains suggestions and recommendations for rehabilitation practitioners and disabled people as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why Senate hearings on psychological tests in government.

As Chairman of the Constitutional Rights Subcommittee, Sen. Sam J. Ervin (D-N. C.) has paid particular attention to the procedural rights of Federal employees. He has helped establish the rights of employees to appeal and the rights of employees and their attorneys to see their own personnel files under appropriate circumstances. Investigation by the Constitutional Rights Subcommittee disclosed that psychological test scores and psychiatric evaluations are frequently relied upon by a number of Federal Government departments and agencies in employment situations which radically affect the lives of the individuals involved. We have received numerous complaints that some of the questions contained in the personality inventories relating to sex, religion, family relationships, and many personal aspects of the employee's life constitute an unjustified invasion of privacy. Furthermore, the charge has been made that aside from the invasion of privacy, the procedures surrounding the testing and the use made of the test results present serious due process questions. The Senator commends the American Psychological Association for its testimony at the Constitutional Rights Subcommittee hearings and for its well-considered suggestions of methods for reviewing the procedures and practices of psychological testing in the Government. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catastrophizing mediates associations between pain severity, psychological distress, and functional disability among persons with spinal cord injury.

Objective: To examine associations between pain severity, psychological distress, catastrophizing, and indices of functional disability in a sample of persons with spinal cord injury (SCI). Catastrophizing was examined as a potential mediator of associations between pain severity, psychological distress, and functional disability. Design and Participants: Questionnaires assessing pain severity, psychological distress, catastrophizing, pain interference, and community integration were completed by 237 persons with SCI. Results: Psychological distress and pain severity were associated significantly with greater functional disability. Moreover, the association between pain severity and functional disability was strongest among persons with high psychological distress. Catastrophizing appeared to mediate the associations between pain severity, psychological distress, and functional disability. Conclusions: Pain severity and psychological distress have the potential for both direct and interactive effects on functional disability, possibly through the mediating effects of catastrophizing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability and autonomy: Priming alternative identities.

Objective: Despite the broad stigmatization that people with disabilities experience, the ways they respond as targets of prejudice have received little attention in the psychological literature. The present study examined the reactions of college students with disabilities to being primed with different aspects of their identity and how individual differences in stigma consciousness moderate this effect. Design: After being primed with their identity as a person with a disability or a student, college students with disabilities (n = 116) completed measures of autonomy-related thoughts, help-seeking, and stigma consciousness. Results: Students primed with their disability status activated autonomy-related thoughts less than the participants primed with their student identity. Moreover, as predicted, the priming manipulation had a stronger impact for participants higher in stigma consciousness. Across all participants, greater activation of autonomy-related thoughts was associated with a lower likelihood of seeking help. Conclusion: Depending on the aspect of their identity that is most salient in a given context and their level of stigma consciousness, people with disabilities can access autonomy-related thoughts to a greater or lesser extent. The theoretical and practical implications of these findings are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Are physical activity and symptoms correlates of functional limitations and disability in multiple sclerosis?

Objective: This study examined physical activity and symptoms as correlates of functional limitations and disability among individuals with multiple sclerosis (MS). The authors hypothesized that physical activity and symptoms would be interrelated and that physical activity would be indirectly associated with disability through a pathway that involved functional limitations, whereas symptoms would be directly associated with both functional limitations and disability. Methods: Individuals with MS (N=133) who were recruited through a community organization wore an accelerometer for a 7-day period and completed a paper-and-pencil survey containing the Godin Leisure-Time Exercise Questionnaire (G. Godin & R. J. Shephard, 1985), Symptom Inventory (C. E. Schwartz, T. Vollmer, & H. Lee, 1999), MS-Related Symptom Checklist (E. E. Gulick, 1989), and abbreviated Late-Life Function and Disability Inventory (E. McAuley, J. F. Konopack, R. W. Motl, K. Rosengren, & K. S. Morris, 2005). The data were analyzed using structural equation modeling in AMOS 6.0. Results: The standardized coefficients indicated that (a) physical activity and symptoms were negatively correlated (Φ=-.59); (b) those who were more physically active had better function (γ=.40); (c) those with fewer symptoms had better function (γ=-.46) and less disability (γ=-.29); and (d) those with better function had less disability (β=.63). Conclusion: Findings indicate that physical activity is associated with reduced disability through a pathway that is consistent with S. Z. Nagi's disablement model in individuals with MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists and the economics of Social Security Disability programs.

Disability status is an important characteristic of the diverse populations that psychologists serve. Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are vital resources for people with disabilities. Access to healthcare is facilitated by Medicare that is provided by SSDI; and SSI affords a small income to eligible beneficiaries. Both programs are administered by the United States Social Security Administration and they have created an important role for psychologists. This article is intended to serve a practical guide that encourages greater and more effective participation by psychologists in the disability determination process. It provides beginning resources on the process of application and review for SSDI and SSI, roles for treating psychologists and reviewers, and basic skills and resources for psychologists who may be involved in disability determinations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital closeness, functional disability, and adjustment in late life.

Socioemotional selectivity theory (SST) posits that emotionally close relationships are increasingly valued as people perceive constraints on time. Based on SST, this study of 1,532 older married persons hypothesized that emotional dimensions of marriage would more strongly predict adjustment at higher levels of functional disability. High levels of marital closeness were negatively associated with depression and anxiety and positively associated with self-esteem. Consistent with predictions derived from SST, marital closeness moderated the negative psychological effects of high levels of functional disability on depression, anxiety, and self-esteem. Results are discussed in the context of SST and traditional stress-buffering models of social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Disclosure Conundrum: How People With Psychiatric Disabilities Navigate Employment.

The vocational rehabilitation and mental health literatures usually urge people with psychiatric disabilities to disclose their disability at work. Reasons for preferring disclosure include the opportunity to invoke rights conferred by the Americans with Disabilities Act of 1990, the risk of losing federal disability benefits when earning a higher income, and the belief--held by many professionals--that people with psychiatric disabilities will experience permanently debilitating symptoms. However, a newer model of recovery from psychiatric disability challenges these assumptions. A qualitative study of people with psychiatric disabilities explored these issues. The participants were current or former recipients of social security benefits provided to persons with significant disabilities. Participants described complex situations around employment and disclosure, which were more difficult to resolve than disclosure advocates have recognized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology graduate student training in developmental disability: A Canadian survey.

Psychology graduate student training in developmental disability has received very little attention in North America, and no study has examined the state of training for clinical and counselling psychologists in Canada, despite their involvement in the controlled act of diagnosis and their use of standardised instruments used regularly with this population. This study sought to examine psychology graduate student training in the area of developmental disability across Canada. We invited students from every Canadian Psychological Association accredited Clinical Psychology, Clinical Neuropsychology, and Counselling Psychology program to participate in an online survey, distributed through university email lists. Three hundred and three students reported on the developmental disability content within their training and coursework, their perception of the adequacy of that content, and their ideas for program improvement. Results indicated that the majority of students believed it important to have training in developmental disability, yet struggled to obtain adequate didactic and experiential opportunities. The lack of sufficient training was most pronounced for students whose training was adult-focused, but was also high for students with a life span or child focus. We discuss different possibilities for increasing developmental disability training opportunities, including integrating its content within courses on assessment and diagnosis, psychotherapy, and ethics, and providing students with supervision from psychologists who work with this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability and rehabilitation research: Opportunities for participation, collaboration, and extramural funding for psychologists.

The National Institute on Disability and Rehabilitation Research (NIDRR) funds research and related activities that promote new knowledge that helps individuals with disabilities to perform regular activities in the community and increases the capacity of society to provide full opportunities and supports for individuals with disabilities. NIDRR achieves this goal by promoting interdisciplinary research and related activities. Psychologists play a key role in many of these activities and assist with improving understanding of disability and rehabilitation by participating in peer review of research proposals or by reviewing NIDRR's proposed research priorities. Psychologists also contribute by taking advantage of training and the many other opportunities for support outlined in this article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discourse on disability and rehabilitation issues: Opportunities for psychology.

There are noteworthy differences between the old and new paradigms of disability perspective, particularly in the way that disability is measured, defined, and understood. The new paradigm emphasizes the dynamic intersection of environmental factors and individual characteristics and the role this intersection plays in shaping the disability experience. In contrast, the old paradigm of disability is reductive to pathology and emphasizes individual disability characteristics and deficits. In addition to a discussion of the old and new paradigms of disability, the author summarizes the fundamental theoretical frameworks that have influenced the current state of the science in disability and rehabilitation and offers an overview of definitions, terminology, and models of disability. The author concludes with an overview of the articles in this section. (PsycINFO Database Record (c) 2010 APA, all rights reserved)