Effects of assertion training on acceptance of disability by physically disabled university students.

This pilot study focused on the effects of assertion training on 14 physically disabled undergraduates' acceptance of disability. A pretest–posttest control group design was utilized. Ss were randomly assigned to either a treatment group or a no-treatment control group. The hypotheses analyzed were that Ss given assertion training would show increases in Acceptance of Disability Scale scores, self-concept/esteem scores (Rathus Assertiveness Scale), and social interaction skills scores (Behavioral Observation Scale) when compared with individuals who did not experience assertion training. Significant results were obtained for all hypotheses indicating that the groups differed in acceptance of disability, self-concept, and social interaction. The study suggests that assertion training may be effective for increasing acceptance of disability in physically disabled students. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective analysis of acceptance of pain and values-based action in patients with chronic pain.

Objective: Acceptance of pain and values-based action appear important in the emotional, physical, and social functioning of individuals with chronic pain. The purpose of the current study was to prospectively investigate these combined processes. Method: 115 patients attending an assessment and treatment course for chronic pain in the U.K. completed a standard set of measures on two occasions separated by an average of 18.5 weeks. Results: Correlation analyses showed that acceptance of pain and values-based action measured at Time 1 were significantly correlated with pain, pain-related distress, pain-related anxiety and avoidance, depression, depression-related interference with functioning, and physical and psychosocial disability measured at Time 2. Multiple regression analyses, in which pain and relevant patient background variables were controlled, showed that the combined acceptance and values measures accounted for between 6.5% and 27.0% of variance in six key measures of patient functioning later in time. Conclusion: These results support the importance of acceptance and values-related processes in relation to chronic pain. These results also encourage continued applications of a functional contextual model of psychopathology, the model underlying Acceptance and Commitment Therapy and related approaches such as Contextual Cognitive-Behavioral Therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Goal instability and adjustment to physical disability.

Few studies have examined psychoanalytic constructs in the adjustment of individuals who incur physical disability. According to H. Kohut (1977), optimal adjustment during life transitions is contingent on the individual's capacity for maintaining and pursuing meaningful goals, which reflects a stable sense of self. A series of studies was conducted to determine if goal instability would predict adjustment and health following disability. Goal instability was predictive at depressive behavior and acceptance of disability among individuals with recent-onset disability. Goal instability predicted subjective well-being 1 year later. Among community residents with a disability, goal instability was associated with life satisfaction; this relationship was not mediated by perceived stigma or community mobility. These findings indicate that a flexible yet durable goal orientation is associated with optimal psychological adjustment among individuals with a physical disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hope and manifest anxiety: Motivational dynamics of acceptance of disability.

Examined the motivational significance of hope and anxiety for the process of acceptance of disability. 48 physically disabled rehabilitation clients aged 18–22 were tested. Hope, an expectancy of future goal success, was measured by the Self-Anchoring Striving Scale. Defined as an index of emotional arousal, anxiety was measured using the short form of the Taylor Manifest Anxiety Scale. Acceptance of disability, a learning process involving value change, was measured by the Acceptance of Disability Scale. Results indicate that hope and anxiety were independent constructs, both of which were related to acceptance of disability in a curvilinear manner. Therefore, a multivariate model of acceptance of disability is presented. Including hope, anxiety, and time since onset of disability, the multivariate model accounted for a large percentage of variance in acceptance of disability (R–2?=?.69). Further research is needed to replicate the multivariate model. Given adequate cross validation, the model has implications both for predicting and enhancing client acceptance of disability. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictive factors of physical disability in a cohort of retired persons in Paris followed during 10 years

OBJECTIVE: The objective of the present study was to examine predictors of physical disability in a survey of retired men and women living in the Paris area followed-up longitudinally for 10 years. METHODS: Subjects were randomly selected in a supplementary retirement pension fund. In all 627 subjects took part in the first phase of the survey (1982-83) and 392 in the follow-up phase (1992-93). At the 10-year follow-up, there were 185 confirmed deaths and 50 subjects refused to participate or could not be traced. Physical disability was measured by difficulties reported by the subjects for seven basic activities of daily life. Possible predictors, socio-demographic, impairments, physical activities, working conditions during working life were explored at T1. RESULTS: The incidence of physical disability was 41.4% for men and 57.6% for women. For disability in mobility, the incidence was 37.1% for men and 54.7% for women. In multivariate analysis, predictors of physical disability were social category (clerks), no physical activities, use of medicine, mental impairment. The predictors of disability in mobility were sex (women), social category (clerks), use of medicine, cardio-respiratory and sensory impairments. On the contrary, subjects with mental impairment had a lower incidence of disability in mobility than subjects without mental impairment. CONCLUSION: The results confirm the two poles of disability: biomedical and social. Working conditions during working life do not seem to play a direct part in incidence of disability at ten years follow-up.     

Statement of beliefs and objectives of APA Division 22 (Rehabilitation psychology).

Discusses concerns of Division 22 of the American Psychological Association (APA) with the problems of disability and deprivation. The Division needs to promote (1) the study of social psychological networks in regard to disability and deprivation, (2) ways to improve social-emotional relationships between handicapped and nonhandicapped people, and (3) free movement in physical and social environments of the disabled and deprived, as well as opportunities for needs satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and physical disability in older people after hospitalization: A prospective study.

This prospective study examined the effects of social support on physical disability in 269 older people (aged 65–97 yrs). Hospital monitoring identified longitudinal study participants who were admitted for hip fracture, stroke, or myocardial infarction. Interviews before the illness and at 6 wks and 6 mo after admission assessed social support and physical disability; medical records indicated illness severity and comorbidity. The number of emotional support providers and the adequacy of task support were higher after hospitalization. Medical factors and premorbid emotional support predicted disability at 6 wks; not needing support was associated with less disability than needing and receiving adequate support. Task support adequacy at 6 wks predicted less disability at 6 mo. The results reveal a dynamic relationship between social support and recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability and identity: A study of identity patterns in adolescents with hearing impairments.

Some children with physical disabilities are encouraged to identify exclusively with nondisabled persons, relinquishing any identity with others who have disabilities. The implications of such a personal identification on adjustment were examined by measuring identity choice in 111 students (aged 15–19 yrs) at a state school for persons with hearing impairments. Ss were classified into 3 groups: those with a predominant hearing identity (able-bodied identity), those with a primary deaf identity (disabled identity), and those who identified with both groups (dual identity). Analyses focused on the relationship between the Ss' identity and indicators of the Ss' social relations, self-evaluations, academic achievement, and perceived family acceptance of their disability. Data indicate that an able-bodied identity was consistently associated with poorer outcomes and a dual identity with better outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Urachal remnants

OBJECTIVE: Three a priori hypotheses were tested: (1) There are significant differences in sociosexual behaviors of women with physical disabilities compared with women without disabilities; (2) the sexual functioning of women with disabilities is significantly related to age at onset of disability; (3) psychological factors explain more of the variance in the sexual functioning of women with physical disabilities than do disability, social and environmental factors. DESIGN: Case-comparison study using written survey. SETTING: General community. PARTICIPANTS: The questionnaire was mailed to 1,150 women with physical disabilities who were recruited as volunteers or through independent living centers. Each woman gave a second copy of the questionnaire to an able-bodied female friend, which comprised the comparison group. The response rate was 45%, with 475 cases and 425 comparisons eligible to participate. The most common disability type was spinal cord injury (24%), followed by polio (18%), muscular dystrophy (11%), cerebral palsy (11%), multiple sclerosis (10%), joint disorders (7%), and skeletal abnormalities (5%). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Sexual-functioning, consisting of four factors: (1) sexual desire, (2) sexual activity, (3) sexual response, (4) sexual satisfaction. RESULTS: Highly significant differences were found in level of sexual activity (p = .000001), response (p = .000009), and satisfaction (p=.000001) between women with and without disabilities. No significant differences were found between groups on sexual desire. Severity of disability was not significantly related to level of sexual activity. CONCLUSIONS: Psychological and social factors exert a strong impact on the sexual functioning of women with physical disabilities. Further investigations is needed of the effect of social environment on development of self-esteem and sexual self-image, and how these influences affect levels of sexual functioning in women with physical disabilities.     

The structure of attitudes toward persons with a disability, when specific disability and context are considered.

Examined the structure of the Disability Social Relationship (DSR) scale developed by S. A. Grand et al (1982) with data from 259 university students in 5 health care areas: occupational therapy, physical therapy, medicine, nursing, and clinical psychology. Data support the multidimensionality of attitudes toward persons who have a physical disability and the interaction influence of specific target disability and social situation on these attitudes. Attitudinal components, as measured by the DSR scale, reflected the importance of perceived limitations of particular disabilities, apprehensions concerning social stigmatization, situational constraints, and Ss' perceptions of functional limitations as interfering with relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment of adolescents to chronic disability.

Investigated the relationship between adolescents' adjustment to a chronic disability and 8 demographic and attitudinal variables. Adjustment was defined as the total positive score on the Tennessee Self-Concept Scale. Ss were 59 12–18 yr old females with idiopathic scoliosis and their mothers. Analysis identified the following 4 variables, in decreasing order, that correlated with the adjustment of adolescents to scoliosis: (a) adolescents' tendency toward the container-isolator end of B. A. Wright's (1960) theoretical continuum of coping responses to a physical disability as measured by an attitude toward disability test, (b) a dimension of maternal attitude toward disability as measured by a disability factor scale, (c) a dependency factor of maternal attitude toward females and persons with scoliosis as measured by a factor analyzed 70-item semantic differential scale, and (d) a maternal high self-concept factor from the semantic differential scale. Ss did not differ significantly from peers on the adjustment measure, and implications for treatment and rehabilitation are discussed. (19 ref) (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)     

Acceptance and values-based action in chronic pain: A study of treatment effectiveness and process.

Developing approaches within cognitive behavioral therapy are increasingly process-oriented and based on a functional and contextual framework that differs from the focus of earlier work. The present study investigated the effectiveness of acceptance and commitment therapy (S. C. Hayes, K. Strosahl, & K. G. Wilson, 1999) in the treatment of chronic pain and also examined 2 processes from this model, acceptance and values-based action. Participants included 171 completers of an interdisciplinary treatment program, 66.7% of whom completed a 3-month follow-up assessment as well. Results indicated significant improvements for pain, depression, pain-related anxiety, disability, medical visits, work status, and physical performance. Effect size statistics were uniformly medium or larger. According to reliable change analyses, 75.4% of patients demonstrated improvement in at least one key domain. Both acceptance of pain and values-based action improved, and increases in these processes were associated with improvements in the primary outcome domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social disability.

Considers social disability as a form of deviance which refers to a broad class of social adaptations based on failures in the development of competence. The concept is related to R. White's biological conceptualization of effectance and competence motivation and to L. Phillips's developmental view of the origins of symptomatology. Empirical evidence is summarized in support of the position that the developmental failures of social disability in all their forms are linked to identifiable, broad, noninterpersonal dimensions of the physical as well as the social environment. Implications are discussed in terms of a reconceptualization of views of a variety of forms of deviance and related consequences for the present system of classification. Suggestions are made for a complex, multidimensional theoretical model which would accommodate the testing of etiological hypotheses linking the development of competence to the environment. It is also shown that the concept is useful as a unifying rationale for specifications of therapeutic and preventive environments and for providing a conceptual and organizing framework for training in the community mental health fields. (114 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body and sexual esteem as mediators of the physical disability-interpersonal competencies relation.

Objectives: To examine whether body and sexual esteem mediated the associations between sexual satisfaction, perceived disability severity, and social perceptions of the disability and interpersonal competencies. Research Method/Design: Web-based survey with 326 adults with a range of physical disabilities. Main Outcome Measures: Perceived interpersonal competence in initiating relationships and being assertive in negative situations. Results: For men, sexual satisfaction, social perceptions of the disability, and perceived severity of the disability significantly predicted competence with relationship initiation. Sexual satisfaction and social perceptions of the disability predicted competence with negative assertion. For women, social perceptions of the disability predicted both interpersonal competencies, and sexual satisfaction predicted competence with negative assertion. Aspects of body esteem mediated the relations between the predictor variables and the interpersonal competencies. Conclusions: Findings indicate the importance of perceived attractiveness to others in mediating the negative relations between impact of the disability and interpersonal competencies. Findings also suggest important gender differences in variables predictive of interpersonal competencies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of the accent method of voice therapy

There is an increasing need for studies of efficacy of behavior readjustment therapy procedures in human communicative disorders. Legal, social, scientific and professional considerations point up the need for more careful documentation of the effects of treatment techniques used by phoniatricians and speech-language pathologists. This study is conducted in order to evaluate the efficacy of the accent method of voice therapy (AM). The AM is one of the holistic approaches for behavior readjustment voice therapy. It tackles collectively and simultaneously the various parameters of voice such as pitch, loudness and timbre. The results of intervention utilizing the AM in this clinical trial are assessed in a relatively controlled setup. Patients with voice problems resulting from various etiologic vocal pathologies are distributed randomly into two groups. Group 1 (G1) is given the full aspect of the AM, that is, voice hygiene advice plus the accent exercises to correct the faulty vocal technique (habit). Group 2 (G2) receives only voice hygiene advice. The AM is administered in individual sessions 20 min each, twice a week, while the voice hygiene advice counseling is given once a week. The assessment of the vocal pathology is done following a diagnostic protocol utilizing subjective as well as quasi-objective measures of evaluation. The initial assessment presents the baseline (pretest) data for both groups. The follow-up evaluations are done at mid intervention (mid-test), that is, 10 sessions for G1 and 5 sessions for G2, and at the termination of intervention/therapy (post-test). The difference in improvement between G1 and G2 at the end of the observation was generally significant in favor of G1. There were significant improvements in G1 in certain items specific for the various etiologic categories. The improvement from pretest to mid-test to post-test values followed a linear tendency. The significance of the results is discussed and the conclusions are outlined and criticized.     

Women, sex roles, and alcohol problems.

Notes that, although the percentage of female social drinkers has risen, female intoxication still elicits more negative response then does male intoxication. The existing research on genetic/biological, psychological, and sociological explanations of alcoholism are examined expressly in light of the female perspective. Female alcoholic behaviors are identified in terms of initial intoxication, association with a stressful event, tendency to drink privately, nature of drinking habits, and tendency to use other drugs. The implications of research for clinical practice are seen to include consideration of related psychological and health problems, the need for adjunctive services, an emphasis on family treatment and restoration of social networks, and the therapist's need to achieve a balance between acceptance of the client and refusal to accept the client's acting-out behavior. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family burden following traumatic brain injury.

Investigated burden experienced by 60 spouses and 71 parents who served as primary caregivers to individuals with traumatic brain injury (BI). Burden levels, as assessed by the Questionnaire on Resources and Stress (QRS-SF), were compared for spouses and parents. Both parents and spouses exhibited high levels of burden. Relative to spouses, parents reported significantly greater burden related to lifespan care. Spouses reported significantly less personal reward than did parents. The presence of social aggression and cognitive disability in the individual with BI was found to have a greater association with subjective burden of caregivers than was the presence of physical disability or injury severity. Results of previous studies with QRS-SF scores show that the responsibility assumed by spouses and parents of persons with BI was as great as that experienced by families of people with severe chronic physical disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Verbal Learning Ability and Adjustment to Recent-Onset Spinal Cord Injury.

Objective: Investigate the relation between verbal learning and adjustment in individuals in inpatient spinal cord injury (SCI) rehabilitation. Setting: A rehabilitation hospital in the southeastern United States. Study Design: At admission, verbal learning ability and depressive behavior were evaluated. Prior to discharge, acceptance of disability was assessed. Participants: One hundred seven individuals (age range=18-65; 82 men, 25 women; 73 Caucasian, 34 African American). Results: Verbal learning ability accounted for 7% of the variance in acceptance of disability after controlling for demographic variables and depressive behavior. Higher levels of verbal learning ability were associated with disability acceptance. Conclusions: Verbal learning ability is associated with adjustment. Assessment of verbal learning abilities may provide useful information concerning individuals at risk for more complicated adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sexual and physical abuse in women with fibromyalgia: association with outpatient health care utilization and pain medication usage

OBJECTIVE: To evaluate the relationship between sexual and/or physical abuse and health care usage in patients with fibromyalgia (FM) and identify variables that may influence this relationship. METHODS: We assessed history of sexual/physical abuse, health care utilization, and medication usage, as well as related variables in 75 women with FM using standardized questionnaires, structured interviews, and laboratory pain perception tasks. RESULTS: Fifty-seven percent of FM patients reported a history of sexual/physical abuse. Compared to non-abused patients, abused patients reported significantly greater utilization of outpatient health care services for problems other than FM and greater use of medications for pain (P < or = 0.025). Consistent with our expectations, abused patients also were characterized by significantly greater pain, fatigue, functional disability, and stress, as well as by a tendency to label dolorimeter stimuli as painful regardless of their intensities (P < or = 0.05). Additional analyses suggested that the high frequency of sexual/physical abuse in our patients was associated primarily with seeking health care for chronic pain rather than the FM syndrome itself or genetic factors. CONCLUSION: There is an association in FM patients between sexual/physical abuse and increased use of outpatient health care services and medications for pain. This association may be influenced by clinical symptoms, functional disability, psychiatric disorders, stress, and abnormal pain perception. The relationships among these variables should be further tested in prospective, population-based studies.