Personal and Familial Adaptation of Women with Severe Physical Disabilities: A Further Validation of the Double ABCX Model

Abstract

The Double ABCX model, developed by McCubbin and colleagues, served as a theoretical framework for examining the major variables that contribute to the psychosocial adaptation of women. Ninety-four women with severe physical disabilities and 94 healthy women who served as controls completed eight questionnaires dealing with stress, coping resources, and adaptation. The results indicate that a high level of stress and strain and a low level of individual resources contribute to a low personal and familial adaptation. The predicted causal relationships among the models' variables of stress and adaptation were similar in the two research groups, although the magnitude of these relationships differ. The results confirm the applicability of the theoretical model for understanding long-term adaptation of women with severe physical disabilities. In recent years, one of the major areas of interest of researchers and practitioners in social science has been coping and adapting to chronic stressful conditions. The professional literature analyzed stressor characteristics along three main dimensions: normative-nonnormative, acute-chronic, and predictable-unpredictable (Boss, 1987; McCubbin & Figley, 1983: Pearlin, 1989). One of the well-established groups of people who have to face continuous chronic stressful conditions consists of those with chronic disabling illnesses (Moos & Schaefer, 1984; Rolland, 1987; Turner & Noh, 1988). These people face nonnormative, chronic, and unpredictable stressors, stemming from the daily requirements and demands of living with physical disabilities, and they usually have to deal with negative social attitudes and reactions (Wright, 1983). Although a great deal of knowledge about the process of coping and adjustment to physical disability can be found in the professional literature, a careful examination reveals that most of these studies were carried out mainly on male subjects (Asch & Fine, 1988; Crewe & Krause, 1988; Moos b Schaefer, 1984). Both researchers and clinicians acknowledge the fact that much less is known about the special needs and difficulties encountered by women with physical disabilities (Asch & Fine, 1988; Britt, 1988). From the handful of studies conducted in the United States (Asch & Fine, 1988; Britt, 1988; Deegan, 1985), Canada (Ridington, 1989a, 1989b, 1989c), and England (Lonsdale, 1990; Morris, 1989), the following socioeconomic profile emerged: Women with physical disabilities live near or below the poverty line (Mudrick, 1988; Ridington, 1989b; Russo & Jensen, 1988). Fewer women with physical disabilities are married, more are separated and divorced, and if they have children, these women often raise them alone (Asch & Fine, 1988; Harrison & Wayne, 1986). When compared with other women, disabled women have a lower level of education (Asch & Fine, 1988). An extensive review of the literature discussing coping and adjustment of women to their chronic stressful situation revealed the following: (a) Usually research has dealt with a specific physical condition, the most frequent ones being rheumatoid arthritis (Allaire, 1992; Reisine, Goodenow, & Grady, 1987; Smith & Wallston, 1992) and spinal cord injury (Bonwich, 1985; Morris, 1989); (b) some studies examined only specific aspects related to the women functioning as housewives (Hafstrom & Schram, 1984), at work (Allaire, 1992), or as mothers; and (c) only a few studies attempted to assess factors that may contribute to women's adjustment, such as chronic stressors (Turner & Avison, 1992), perceived support provided by husbands (Goodenow, Reisine, & Grady, 1990), and appraisal of the illness' implications and coping (Smith & Wallston, 1992). Therefore, it seems that the picture depicted from these studies provides only partial information on the particular adjustment outcomes of specific groups of women with physical disabilities. …