Disability-related Variables Research Articles

Do Reactions of Adaptation to Disability Influence the Fluctuation of Future Time Orientation Among Individuals with Spinal Cord Injuries?

Rehabilitation counseling involves the construction of vocational goals, which involves future-oriented thinking. Yet, research indicates that time orientations may change after the experience of a trauma. Due to the potential importance of a future time orientation (FTO) in rehabilitation counseling, predictors of an FTO were examined among 317 veterans and civilians with spinal cord injuries using spinal cord injury clinics. Results indicated that after controlling for the demographic and disability-related variables, reactions of adaptation to disability explained 24% of the variance in FTO. Shock, depression, and acknowledgment were significant predictors of FTO. The facilitation of greater FTO in clients may be integral to achieving the long-term, career-focused planning that is emphasized in rehabilitation counseling.

DEATH ANXIETY AS A PREDICTOR OF POSTTRAUMATIC STRESS LEVELS AMONG INDIVIDUALS WITH SPINAL CORD INJURIES

Because the onset of a spinal cord injury may involve a brush with death and because serious injury and disability can act as a reminder of death, death anxiety was examined as a predictor of posttraumatic stress levels among individuals with disabilities. This cross-sectional study used multiple regression and multivariate multiple regression to examine whether death denial and death awareness predicted posttraumatic stress disorder (PTSD) among veterans and civilians with spinal cord injuries (N = 313). The results indicated that death anxiety (after controlling for demographic and disability-related variables) predicted a significant amount of the total levels of posttraumatic stress reactions among individuals with spinal cord injuries. Further, death awareness, pain level, and spiritual/religious coping significantly predicted the posttraumatic stress clusters of reexperiencing, avoidance, and hyperarousal. Death denial significantly predicted only hyperarousal. Because death anxiety predicts various aspects of PTSD reactions, one possible therapeutic implication is that addressing death-related topics may help to reduce PTSD reactions. Further research is needed to better ascertain the possible causality among these variables.

Coping Strategies as Predictors and Mediators of Disability-Related Variables and Psychosocial Adaptation

This study examined the relationships among four predictors (functional limitations, perceived visibility of condition, and two disability-associated affective responses— anxiety and depression), coping strategies, and two outcome measures of psychosocial adaptation to disability (disability-specific psychosocial adjustment and life satisfaction). Based on responses from 121 university students with disabilities, two models (additive and mediational) were tested to investigate the contribution of coping strategies to psychosocial adaptation to disability. The findings of this exploratory study suggest that coping strategies add significantly to the variance in both outcome measures after controlling for the contribution of disability-related factors. The role of coping strategies as mediators between the set of predictor and outcome variables was mostly unsupported in this sample, however. Reasons for the latter finding are briefly outlined, along with the implications for rehabilitation research and practice.

Death anxiety as a predictor of future time orientation among individuals with spinal cord injuries

Purpose: The purpose of this study was to examine therelationship between death anxiety and future time orientationamong individuals who sustained spinal cord injuries (SCI). Methods: Participants were 317 individuals with SCI, of whom57.4% were US veterans. Data were obtained by means ofmailed questionnaires and included responses to the DeathAnxiety Scale (DAS), the Future Time Orientation (FTOS)measure, as well as information on participants’ personal anddisability-related characteristics. Results: A hierarchical multiple regression analysis wasconducted to examine the influence of a set of demographicvariables, followed by a set of disability-related variables, andfinally two factorially-derived measures of death anxiety(denial of death and distressed awareness of death) on futuretime orientation. Two disability-related variables (pain leveland existence of pressure ulcers) and one of the two deathanxiety measures (distressed awareness of death) significantlypredicted future time orientation. A post-hoc analysis, addingdepression as a predictor, was also significant, indicating thatan increased level of depression uniquely contributed to atruncated future time orientation. Conclusions: Distressed anxiety and depression may be importantfactors affecting goals and plans of people with SCI.Future research should attempt to clarify the intricaterelationships among negative affectivity, future time orientation,and psychosocial adaptation to SCI.

A conjoint analysis of factors influencing American and Taiwanese college students' preferences for people with disabilities.

Objective: To determine the effect of demographic variables on attitudes toward disability. Participants: Eighty-three female American and 89 female Taiwanese college students. Outcome Measure: A conjoint measurement of 16 stimulus cards (representing people with varying disability labels, severity of disability, age, gender, and education). Procedures: The participants were asked to sort the stimulus cards according to their personal preferences for working with people with disabilities. Results: Younger and higher educated women with milder disabilities were preferred by both Taiwanese and American students. Preference formation is affected by both disability-related variables and other demographic variables (e.g., educational levels). Conclusion: The use of conjoint analysis to examine multiple attributes of persons with disabilities may have higher external validity than single-attribute-design studies.

Effects of coping on psychological outcome when controlling for background variables: a study of traumatically spinal cord lesioned persons.

Cross-sectional. In a previous study we found spinal cord lesion (SCL)-related coping factors to be distinctly related to levels of SCL-related psychological outcome. However, we did not control for other potentially confounding variables. In this study we investigated effects of coping strategies on psychological outcome reactions in traumatically spinal cord lesioned persons controlling for sociodemographic, disability-related and social support variables. The Gothenburg Spinal Injuries Unit in Sweden. The study sample comprised 255 persons and a subsample of 157 persons. A series of stepwise multiple regression analyses were performed. SCL-related coping factors clearly predicted psychological outcome even when background variables were controlled. Higher levels of acceptance coping predicted decreased psychological distress and increased positive morale. Elevated social reliance coping predicted heightened distress. Higher levels of social support predicted lower feelings of helplessness. Sociodemographic and disability-related variables were weak predictors of psychological outcome with one exception: higher education predicted less bitterness and brooding. SCL-related coping remained the most important predictor of psychological outcome even when a wide range of variables was controlled. Thus we conclude that psychosocial interventions aimed at helping individuals develop their coping strategies might be of substantial value in their adjustment to SCL.

Correlates of depression in adults with severe traumatic brain injury and their carers

Although it is generally accepted that social support plays a role in the maintenance of psychological well-being, there has been relatively little direct investigation of the role that social support may play in affecting post-injury depressive symptoms and mediating the effects of traumatic brain injury (TBI). Consequently, social support was selected as the framework within which to investigate possible indicators of depression in adults with severe TBI and their carers. The authors were interested in the degree of association between social support and the criterion variable of depression in the context of demographic and disability-related variables that have been identified as significant correlates of depression. Thirty-five adults with severe TBI (PTA > 7 days) and their primary carers participated in the study. Time post-injury ranged from 3.5-10 years and all the participants were living in the community. Fifty-seven per cent of the adults with TBI and 60% of their carers were classified as showing significant symptoms of depression. As hypothesized, social support contributed significantly to the prediction of depression. In particular, strong-tie support appeared to be an important indicator of well-being for both the participants with TBI and their carers.

Psychological Adjustment and Coping in Adults With Prosthetic Limbs

The potential mediating effects of different coping strategies on the adjustment to living with a prosthetic limb were investigated in 44 adult amputees. Participants completed a questionnaire inquiring about coping, pain, emotional well-being, demographics, and disability-related variables. The coping strategy adopted and the extent of the adjustment to the prosthetic limb varied with age, site of limb loss, and cause of amputation. Furthermore, coping style mediated the adjustment to wearing a prosthetic limb. The results are discussed in terms of future applications and research.

Depression and life satisfaction in aging polio survivors versus age-matched controls: Relation to postpolio syndrome, family functioning, and attitude toward disability

Objective: To compare depressive symptoms and life satisfaction in aging polio survivors with age-matched controls and to relate these outcomes to scores to psychosocial and disability-related variables. Design: A planned medical, functional, and psychosocial study with multivariate analyses. Setting: A large, urban rehabilitation center. Participants: A volunteer sample of 121 polio survivors and an age-matched control group of 60 people with similar sociodemographic backgrounds. Main Outcomes: Depression as measured by the Geriatric Depression Scale and an 11-item life satisfaction scale. Results: The prevalence of depressive disorders was not significantly different in the two groups, although the postpolio group tended to have more symptomatology and an overall depressive disorder prevalence of 28%. Some life satisfaction scale scores were significantly lower in the postpolio group, especially those concerned with health. People with postpolio syndrome scored significantly higher on depression scales and lower on some life satisfaction scales than people with a history of polio but without postpolio syndrome. Several psychosocial variables, most notably family functioning and attitude toward disability, helped to mediate this effect. Among people with significant depression, there was little evidence of adequate treatment in the community. Conclusions: Postpolio by itself does not relate to higher depression scores or lower life satisfaction. Postpolio syndrome has some relation to depression, but family functioning and attitude toward disability are more important. There is a need for better community-based psychological services.

Employment rates among the disabled in Israel

Seven hundred sixty two disabled individuals were interviewed. Of these, 220 were found to be working or to have done so in the past three years. The remaining 542 were unemployed and had been so for at least that long. Employment status was found to be related to a number of demographic and disability related variables: sex, with whom the subject lived, country of origin, father's country of origin, and SES. The employed were more likely to be male, to live in an upper middle or upper class neighborhood, to be Israeli born, have European or American born fathers, and to be living with someone else. They were also likely to be more educated, younger, have a lower disability degree, a less serious medical disability, and have more recent disabilities. The other variables studies, including place of residence, family status, year of immigration, number of children, and several specific disability related measures, were not related to employment status. The findings are in keeping with those of previous studies. Their implications for improving employment rates among the disabled are discussed.