Showing papers on "Physical disability published in 1985"

Long-term adjustment to physical disability: The role of social support, perceived control, and self-blame.

Abstract: One hundred middle-aged and elderly spinal-cord-injured persons were interviewed an average of 20 years after the disability occurred. Respondents answered questions concerning perceived control, attributions of blame, and the nature of the social comparisons they made. Three existing standardized instruments were used to measure adjustment: Index of Psychological Well-Being, Life Satisfaction Index, and the Center for Epidemiologic Studies Depression Scale. For all three outcome measures, respondents reported levels of well-being only slightly lower than population means of nondisabled persons of similar age. Controlling for health status and current income, we found that persons who have high levels of social support, who are satisfied with their social contacts, and who feel they have high levels of perceived control report high levels of well-being. Self-blame and the perceived avoidability of the cause of the disability correlated only moderately with the three measures of adjustment, suggesting that there are important differences between coping successfully immediately after a traumatic event has occurred and coping successfully many years later.

Psychiatric Disorder in Children with Physical Disabilities

Abstract: Psychiatric disorder in 304 children with four congenital conditions was compared with that of 360 normal children and across conditions, three that involve the brain and one that does not. Children with physical disability were at increased risk for psychiatric disturbance. Those with conditions involving the brain had greater psychopathology than children with cystic fibrosis. Severity of physical disability had little effect on psychopathology. The risk of psychiatric disturbance in children with conditions involving the brain varied directly with level of mental retardation. In addition, brain involvement conferred a risk of social isolation independent of mental retardation. The unique feature of severe psychopathology secondary to physical disorder was marked social isolation accompanied by a low level of aggressive behavior outside the home.

Framingham disability study: relationship of disability to cardiovascular risk factors among persons free of diagnosed cardiovascular disease

Abstract: The relationship between physical disability and cardiovascular risk factors among persons free of diagnosed cardiovascular disease was examined Between 1948 and 1951, a cohort of adult, Framingham, Massachusetts, residents was assembled for a longitudinal examination of cardiovascular disease Twenty-seven years after the participants' initial examination (between 1976 and 1978), members of the cohort who were still participating in the Framingham Heart Study were interviewed to ascertain their self-assessed ability to perform various physical activities A score on the cumulative disability index was assigned to 2,021 persons free of diagnosed cardiovascular disease Analyses controlled for noncardiovascular health conditions which were identified as related to disability Among women, both long-term and current hypertension and body mass index, as well as diabetes, were associated with disability Among men, long-term hypertension was related to disability Age-specific analyses indicated that, for women, current hypertension was statistically significantly related to disability in the middle and oldest age groups; long-term hypertension was related to disability in the middle age group Both long-term and current measures of diabetes in the oldest age group and long-term measure of cigarette use in the middle age group of women were also related to disability Age-specific analyses among men indicated that the only statistically significant risk factor was long-term hypertension in the youngest age group Cholesterol was not related to disability Results suggest that certain cardiovascular risk factors should be considered in efforts to understand further the development of disability

Psychosocial Responses to Traumatic Physical Disability

Abstract: Victims of traumatic physical disability experience disruptions of normal affective functioning. The sense of body image and body ego are altered in ways that are frightening or confusing to the patient. The subjective experience of time becomes present-oriented, with time moving slowly. Grief or depression, clinically distinct responses, may further debilitate the individual. Anxiety, guilt and rage are additional emotional responses. Patients use previously existing coping patterns to manage the crisis of sudden disability. It is not the nature or the severity of the injury that exclusively influences the psychological response, but rather, it is the interaction of the person and the total environment that determines behavior.

Mental disorders among physical disability determination patients.

Abstract: Persons claiming physical disability who were evaluated at a primary care health center in a small southern city were administered the Diagnostic Interview Schedule. Fifty-six per cent of the 43 patients were found to have one or more psychiatric disorders. The relationship between physical disability and psychiatric disorders needs to be recognized in the disability evaluation system.

Cognitions and emotions as predictors of recovery in conditions involving physical disability

Abstract: Patients with conditions involving physical disability vary considerably in the course of their recovery. Initial severity as judged by clinical examination is the usual baseline for predicting eventual outcome but considerable variability has been observed in the process of recovery in patients with conditions of similar initial severity. Recognizing the many potential influences on the process of recovery, medical, personal, environmental and social, this study investigated psychological factors as predictors of different aspects of recovery. The hypotheses tested were that cognitions, such as the patients' perceptions of their condition and its implications for them, their perceptions about their control over their own recovery, the attributions made about their condition and events in their recovery, the ways in which they coped with the problems imposed by their condition and their emotional responses, would be more reliable predictors of different aspects of recovery from physical disability than initial clinical severity. Physical disability was conceptualized at two levels, as restriction in the performance of movements and restriction in the performance of functions and activities. The investigation was undertaken in four stages. Early exploratory work of the first two stages studied over 100 patients with physical disability during the process of their recovery, by observation, semi-structured interviews and videorecording. In the third stage methods of measurement of clinical indices of the selected conditions were developed and tested with the study population. Psychometric methods were also tested and where necessary developed. In the fourth stage hypotheses about the relationships between clinical indices and psychological factors were tested with 40 subjects with physical disability, 20 with stroke, 20 with a wrist fracture. There was considerable support for the overall hypothesis that psychological factors would be reliable predictors of different aspects of recovery. Initial clinical severity was a poor predictor of outcome in terms of performance of movements and functions, and individual perceptions of severity of condition showed little relationship to objective measurements of severity. Perceptions of personal control over recovery were associated with more effective recovery in terms of performance, and general level of raised emotional response with some less effective levels of performance. These results need to be re-examined using larger groups of subjects, and including those with other conditions involving physical disability to find if results can be generalized. The results provide information about factors influencing the process of recovery from conditions involving physical disability.

The relationship between physical disability and narcissism: A critique of the literature

Abstract: This article critically examines some of the major psychoanalytic writings on the relationship between physical disability and narcissism. Tracing the evolution of thought about narcissism from Freud's original formulation to a self-psychological approach, it considers and contrasts pain, illness, and adult disability on the one hand and early onset disability on the other. The conclusion reached is that disability and narcissism are related in complex ways, depending on a variety of physical, developmental, and environmental factors. Thus, clinicians must avoid making a priori assumptions in work with disabled patients, for such assumptions may be countertransferential.

A developmental approach to physical disability in childhood.

Abstract: The reasons for advocating a developmental approach to physical disability in childhood are stated. Relevant characteristics of the developmental periods—antenatal, neonatal, early infancy, late infancy, preschool and school age—are described. Diagnosis, treatment and prognosis are then discussed in this developmental context.

Media Review: Books: Physical Disability—A Psychosocial Approach (2nd Ed.)

Abstract: If a book can be said to attain the level of a \"classic\" in its field, then it can be said without equivocation that Wright's 1st edition, Physical Disability-A Psychological Approach has attained that status. Now, more than two decades later, the second edition has emerged on the scene with an altered, but certainly an all telling, title: the \"Psychological Approach\" has been changed to \"A Psychosocial Approach.\" Clearly this new edition is another \"classic\" in the making. More than a reworking of the former title, this new book has a distinct emphasis on the psychosocial aspects of disability. There is still the conceptual base illustrated in the first edition of the impact of the somatopsychological relationship in the \"way disability as a value loss is perceived and reacted to by other people, as well as the self.\" This interactive process is a paramount feature in the understanding of and adjustment to a disability. The 19-chapter 2nd edition includes sections on the characteristics of reaction formations to disability by self and others, the impact of individual and social values as well as concerns relating to children, adolescents, and adults with disabilities, and parents as a key factor in the rehabilitative process. What makes this current volume so useful to the reader is the liberal .use of what might be described as case examples to illustrate a key point or concept. These case examples are, however, more in the realm of published personal situations that illustrate the theoretical point at hand. Two highlights of Wright's work can be used to illustrate the focus of her presentation-the importance of the individual over the disability and the similarity between groups with and without a disability. In the first instance, the emphasis of the

The sexual side of physical disability

Abstract: This article describes the format and evaluation of a study day on the sexual side of physical disability. Many staff, such as social workers, occupational therapists, doctors and nurses, who work with disabled people, feel that there is a need to discuss with them how their disability may affect sexual and emotional relationships and what can be done to overcome any problems which might arise. They are, however, reluctant to raise the subject of sexuality, first because they have insufficient information, so have no positive suggestions to offer, and second because of feelings of embarrassment and other, perhaps unexplored, feelings about sexuality and disability. The study day was designed to help social workers and other staff to feel comfortable enough to raise this important topic with their clients.