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Disability and stress: A study in perspectives
Abstract
In today's society, having a disability can add enrichment and challenge to aspects of life. It can also increase the likelihood of marginalisation within society as people have been shown to react to disability in many discriminatory and stereotypic ways. People with disability often have to face feelings of fear, guilt, pity or discomfort in others in addition to physical barriers and limitations that may be inevitable consequences of some forms of disability. These authors hypothesise that, because of additional challenges in life, people with a disability may report higher than average stress levels. The study aimed to reveal what aspects of life bother people with different forms of disability. Ninety-nine adults with a visual, intellectual or physical disability completed a self-report stress scale. Contrary to expectation, total stress levels did not seem to be unusually high. All participants acknowledged their disability, but only half regarded it as a stressor in itself. Participants with a visual, physical or intellectual disability reported similar levels and patterns of stress with no highly significant differences between the groups. In accord with general research findings, significantly higher stress scores were found for females, those feeling unhealthy, those experiencing a recent major life event and those who found no time to relax. Although not definitive, this study provides preliminary evidence that people with various types of disability do not report particularly high levels of stress despite having to come to terms with particular hardships associated with their disability.
... The most widely studied outcome of the stress is emotional distress, sometimes referred to as 'nonspecific psychological distress' (Aneshensel, 1992) that results from an overload of stressful events. It has been shown that persons with locomotor disability are at a higher risk of psychological distress than those with other disabilities (Bramston and Mioche, 2001). Stressors related to physical disability were found to be chronic in nature which gets further intensified by factors specific to one's disability (Groomes and Leahy, 2002). ...
... Physical restriction due to disability is an inevitable consequence of the disability that induces distress that gets further intensified because of architectural barriers. Locomotor disability induces higher level of physical restriction as compared to other disabilities and it is linked with feeling of inadequacy, loss of control and helplessness (Bramston and Mioche, 2001). Similarly, negative attitudes of others also lead to distress experience. ...
... Due to architectural and mobility barriers persons with locomotor disability differ in their disability experience from those suffering from other kind of disabilities. Bramston and Mioche (2001) compared three different types of disabilities (physical, visual and intellectual) and found that in response to a question about whether participants perceived their disability as a source of distress, majority of the participants with physical disability reported their disability as distressing. Also a number of participants discussed their dependency on others as a major stressor. ...
This paper critiques the social policies related to physical disability in India and shows how psychology
can occupy a centre stage in the disability discourse. While framing social policies, it is required that all
aspects of the issue are considered to render a policy more comprehensive. The paper reviews
psychological studies on physical disability and critiques major disability initiatives of the Government of
India, namely Persons with Disabilities Act 1995, National Policy for Disabled and community-based
rehabilitation, in terms of their objectives, implementations and outcomes. It suggests attitude change,
process documentation, asset mapping and creating learning communities as possible areas where the
much needed interface between psychology and disability-related policies can be created.
... The most widely studied outcome of the stress is emotional distress, sometimes referred to as 'nonspecific psychological distress' (Aneshensel, 1992) that results from an overload of stressful events. It has been shown that persons with locomotor disability are at a higher risk of psychological distress than those with other disabilities (Bramston and Mioche, 2001). Stressors related to physical disability were found to be chronic in nature which gets further intensified by factors specific to one's disability (Groomes and Leahy, 2002). ...
... Physical restriction due to disability is an inevitable consequence of the disability that induces distress that gets further intensified because of architectural barriers. Locomotor disability induces higher level of physical restriction as compared to other disabilities and it is linked with feeling of inadequacy, loss of control and helplessness (Bramston and Mioche, 2001). Similarly, negative attitudes of others also lead to distress experience. ...
... Due to architectural and mobility barriers persons with locomotor disability differ in their disability experience from those suffering from other kind of disabilities. Bramston and Mioche (2001) compared three different types of disabilities (physical, visual and intellectual) and found that in response to a question about whether participants perceived their disability as a source of distress, majority of the participants with physical disability reported their disability as distressing. Also a number of participants discussed their dependency on others as a major stressor. ...
This paper presents findings of two studies that investigated coping with physical disability within the multivariate transactional model of stress. In the first study, 30 persons with locomotor disability were interviewed to explore the nature of stressors and coping strategies. In the second study, five scales were administered on a sample of 120 persons with locomotor disability to investigate the role of personal and situational variables in determining the extent of perceived distress and its relationship with coping. The manner in which anāsakti and positive life orientation moderated the relationship between perceived distress and coping was also investigated. The findings revealed that the major stressors which led to distress were ego related stressors, inability to fulfill traditional gender roles, problems in interpersonal relationships with family and others, physical barriers and deformed body image. Education was found to be the strongest predictor of perceived distress and problem focused coping was significantly related to lower levels of distress. Moderation analyses showed that with stronger belief in the philosophy of anāsakti and higher positive life orientation, lower levels of distress was strongly related to problem focused coping. The implications of these findings for psycho-social rehabilitation of persons with physical disability are discussed.
... However, people with disabilities are at a higher risk of stress than those without disabilities (Bramston & Fogarty, 2000;Henderson & Bryan, 2004). People with disabilities often face unique challenges related to their disability (Bramston & Mioche, 2001;. For example, Annison (1996) identified potential stressors such as a feeling of neglect, insecurity, exclusion, and loss of control. ...
... Furthermore, individuals with disabilities may experience interpersonal conflicts with their family members and professional caregivers who assist with addressing their personal needs Lund, 2020). Consequently, disabled individuals often identified their disability as a direct source of stress (Bramston & Mioche, 2001;Hwang & Park, 2011). ...
Leisure is considered an effective means to relieve stress. However, limited research has explored its roles in the stress-coping processes of people with disabilities, especially those living in non-western contexts. This study explores the relationship between leisure time (LT) and leisure repertoire (LR) and perceived stress from disability (PSD) through leisure satisfaction (LS), while using perceived discrimination (PD) as a moderator. Data were collected from the 2016 and 2017 Panel Survey of Employment for the Disabled created by a Korean government agency. A total of 1,443 respondents with physical disabilities were selected. The results showed LT and LR have somewhat different associations with LS and PSD. Moreover, PD was only a moderator of the relationship between LT, LS, and PSD. The present study emphasizes the importance of quality of leisure experiences, rather than simply engaging in leisure, and the efficacy of LR as a stress coping skill.
... Hughes et al.'s (2005) work on social buffering underscores the importance of social context for mitigating or exacerbating the relationship between stress and physical disability (Cohen & Wills, 1985). Some studies report that disability in humans is not associated with higher levels of stress (Bramston & Mioche, 2001). ...
Glucocorticoids (GCs) are hormones released in response to stressors and can provide insight into an organism's physiological well-being. Experiencing chronic challenges to homeostasis is associated with significant deviations from baseline fecal GCs (fGCs) in many species, providing a noninvasive biomarker for assessing stress. In the group of free-ranging Japanese macaques (Macaca fuscata) at the Awajishima Monkey Center in Japan, ~17% have congenital limb malformations. We collected 646 fecal samples from 27 females over three consecutive birth seasons (May-August) and analyzed them using enzyme immunoassay to extract fGCs. We explored the relationship between fGC levels and individual (physical impairment and reproductive status), social (dominance rank and availability of kin for social support), and ecological variables (exposure to potential predators, rainfall, and wild fruit availability). A disabled infant was associated significantly with higher fGC in the mother; however, physical impairment in adult females was not significantly related to fGC levels. Females with higher dominance rank had significantly lower fGC levels than lower ranking females. Other factors did not relate significantly to fGC. These results suggest that providing care that meets the support needs of disabled infants poses a physiological challenge for mothers and suggests that physically impaired adults are able to effectively compensate for their disabilities with behavioral plasticity. Once an individual with congenital limb malformations survives infancy through their mother's care, physical impairment does not appear to influence fGC values, while social variables like dominance rank significantly influenced cortisol values in free-ranging female Japanese macaques.
... Adults with MID experience more stress in daily life than people without intellectual disabilities (Bramston & Mioche, 2001;Emerson, 2003;de Witte, Spruit, et al., 2020;World Health Organization [WHO], 2010). Moreover, they have been shown to have more difficulties coping with their daily stress than adults without intellectual disabilities (APA, 2013), which fits with the theory of who defined psychological stress as the extent to which persons perceive that demands exceed their ability to cope. ...
The goal of this dissertation is to contribute to the body of scientific knowledge on music interventions for stress reduction. To cope with the negative impact of stress, millions of people around the world use tranquilizing medication, which in turn is associated with numerous contraindications and negative side effects. Therefore, there is an urgent need to develop and examine innovative and non-pharmacological interventions for stress reduction, especially for patient populations known to be more vulnerable to stress such as those with mild intellectual disabilities (MID). Moreover, the stress-reducing qualities of music have been associated with a broad range of positive outcomes in both medical and mental healthcare settings. This dissertation therefore aims to increase scientific knowledge on (a) the effects of different types of music interventions on stress-related outcomes, (b) how and why music interventions may specifically lead to stress-reducing effects, and (c) how stress can be accurately assessed, specifically in people with MID. Overall, this dissertation demonstrates that music interventions in the form of both music listening interventions and in the context of music therapy can greatly benefit patients in medical and mental health care settings. Furthermore, the added value of a qualified music therapist offering the music interventions is emphasized, which can be explained by the personalized, tailored approach of the music therapist. Despite the difficulty of examining these music therapy interventions, more robust research is needed, especially in patient populations proven to be more vulnerable to stress as those with cognitive impairments. The results of this dissertation also highlight the need for continued efforts to develop high-quality self-report stress measures for people with the MID to assess stress-related outcomes as valid and reliable as possible. Future research that focuses on both efficacy and hypothesized therapeutic factors is crucial to the further implementation of music therapy interventions in healthcare settings, particularly when it comes to stress reduction.
... Adults with MID experience more stress in daily life than people without intellectual disabilities (Bramston and Mioche, 2001;Emerson, 2003;Hatton and Emerson, 2004;Schuengel and Janssen, 2006;World Health Organization, 2010;Casey, 2017;de Witte et al., 2020b). Daily life stressors that impact many lives of people with MID include difficulties with social interactions, experienced lack of control over minor daily and major life decisions, and occupational stress (Hartley et al., 2009b;Dulin et al., 2013;Scott and Havercamp, 2014). ...
Stress has a major negative impact on the development of psychopathology and contributes to the onset of adverse physical conditions. Timely recognition and monitoring of stress-related problems are therefore important, especially in client populations that are more vulnerable to stress, such as people with mild intellectual disabilities (MID). Recent research on the use of physiological measures to assess stress levels emphasize that, in addition to these measures, self-report instruments are necessary to gain insight into the individual perception and impact of stress on daily life. However, there is no current overview of self-report stress measures that focus on the experience of stress in the present moment or in daily life. To provide an overview of the existing self-report stress measures for clinicians and researchers, a scoping review was conducted. In addition, to advise clinical professionals on the use of self-report measures of stress for people with MID, the results of an expert consultation were used to refine the preliminary findings. A systematic scoping literature search resulted in a total of 13 self-reported stress measures that met the final inclusion criteria, of which three were developed specifically for assessing stress in adults with MID (GAS-ID, LI, and SAS-ID). For each included self-report stress measure, the psychometric quality, assessment procedure, and suitability for adults with MID were reported. These were supplemented by the findings from the expert consultation. Implications for clinical practice on the use of self-report stress measures, particularly for people with MID, are discussed. Recommendations for future research and development are given.
... Coping is "the methods that a person undertakes to deal with stressors" (13). The coping strategies that disabled persons use to cope with disability-related problems are diverse depending on the personality traits and socio-cultural context (14). ...
Background: Globally, people living with spinal cord disability experience more limitations in an individual and social life. In many cases, this leads to complex psychological and social problems that may also affect the adaptation to the conditions. The aim of the study was to explore the experience of living and coping with disability in people with spinal cord disability due to road traffic accidents in Iran's cultural context.
Methods: This is a qualitative study with a phenomenological approach on ten Iranian people with spinal cord disability due to road traffic injuries. Data collection and analysis were performed from September to March 2019. Data were collected by individual, face-to-face in-depth interviews, and the experience of living with disability and adaptation strategies were explored. Van Manen’s methodical activities were used to guide the study's process.
Results: ‘victim of destiny’ was the main theme extracted from three themes and nine sub-themes. The disabled people viewed life as a prison that destiny had ordained for them and trapped them in the fences of isolation, anger, regret, anxiety, sorrow, pity, and futility such that they require assistance from others as dependent individuals. Religious recourse, satisfaction with God's expediency, and change of life values were the participants' coping strategies to adjust to their difficulties.
Conclusions: The study clarified the permanent constraints, needs, barriers and adaptation strategies of disabled people.
... Thus, they are at risk for a range of health problems. Because limitations in decision-making and cognitive functions (Bramston and Mioche 2001) can lead to difficulties coping with activity-induced stress, people with ID need additional support during such exercises (Temple 2007;Bodde and Seo 2009). In addition, performing physical activity could evoke stress for people with ID, for example, because of the requirement to follow rules during sports participation or a perception of the activity as boring (Hutzler and Korsensky 2010). ...
Background:
Moving around and being physically active can often be challenging for people with a visual impairment. The combination of a visual and intellectual disability can make being physically active even more difficult. The aim of the current study was to examine whether a technological device for physical activity promotion would be associated with more movement and whether using it would be experienced as enjoyable for people with visual and intellectual disabilities.
Methods:
A randomised multiple baseline design was used for this study. The participants were nine adults with a visual impairment and an IQ between 20 and 50. As participants interacted with the Light Curtain, movement was measured with triaxial accelerometers embedded in the Empatica E4 wristband. Independent observers scored activity, alertness and well-being from video-recordings using the following observation lists: the Happiness Feature Score (HFS) and the Arousal and Valence Scale (AVS).
Results:
Physical activity measured with the accelerometer and positive excitement measured with the AVS significantly increased among participants when they were engaged with the Light Curtain compared with care-as-usual activities. Well-being measured with the HFS did not show a significant difference between the baseline and intervention phases.
Conclusions:
Engagement with the Light Curtain increased physical activity and positive excitement in persons with visual and intellectual disabilities, but more research is necessary to understand how the Light Curtain might affect happiness and well-being.
... Stress has also been linked to the development and maintenance of mental health disorders in people with and without intellectual disabilities (Hastings, Hatton, Taylor, & Maddison, 2004;Marin et al., 2011;Scott & Havercamp, 2014). People with an intellectual disability report levels of stress similar to or higher than that of people with other types of disabilities (Bramston, Fogarty, & Cummins, 1999;Bramston & Mioche, 2001). This is troubling as people with intellectual disabilities have been found to have fewer resources available to help cope with stress, and a history of negative coping experiences (Hastings et al., 2004;Lunsky & Benson, 2001). ...
Background:
The intellectual disability field has learned about the lives of people with intellectual disabilities (ID), largely from the perspective of their family and caregivers. Information from caregivers has been critical to scientific advancement, especially when caregivers are engaged on behalf of individuals with significant language impairment. On the other hand, the perspective of individuals with ID themselves is critical for internal subjective content such as thoughts and feelings.
Methods:
Participants were 90 adults with ID and a proxy of their choosing.
Results:
Overall, self and caregiver report were significantly related for subjective health but varied for physical activity, social support and stress.
Conclusions:
These findings add to the growing literature establishing the importance of considering the self-report of adults with ID, particularity when the subject matter focuses on internal thoughts or feelings. Clinical considerations for the use of self and proxy report are discussed.
... According to the rehabilitation literature (Falvo, 2005;Livneh & Antonak, 1997), people with disability face an increase in both the frequency and severity of stressful situations. Among the more commonly recognized disability-related factors that create increased demands on the lives of individuals with disability are: limitations in functional ability, prolonged course of medical or psychiatric treatment, dealing with medication side-effects, and financial concerns involving the cost of health insurance and health care (Bramston & Mioche, 2001;Falvo, 2005). ...
... Chaney (1996) showed that individuals with profound ID showed a physiological stress response to changes in their environment. People with an intellectual disability report levels of stress similar to that of people with other types of disabilities and to the general population (Bramston & Mioche, 2001;Bramston, Fogarty, & Cummins, 1999). Stress is an important determent of physical and mental health in the general population, so too it is important for individuals with ID. ...
... In fact, individuals with ID may be at a greater risk for experiencing stress than their counterparts without a disability (Hatton & Emerson, 2004) and likely have fewer resources available to help cope with that stress (Lunsky & Benson, 2001). Some research has suggested that people with ID report levels of stress similar to that of people with other types of disabilities and to the general population of people without disabilities (Bramston, Fogarty, & Cummins, 1999;Bramston & Mioche, 2001). Other research, such as a study by Hartley & MacLean (2009), found that compared to a matched sample of adults from the general population, 47 depressed adults with ID at the upper end of the spectrum had frequent stressful social interactions, experienced more stress, and used fewer active coping skills. ...
A large, nationally representative sample from a preexisting dataset, the National Core Indicators, was used to examine the impact of stress and social support on the mental health of adults with intellectual disability (ID). Stress was significantly correlated with both mental illness and severity of behavior problems, with each additional stressor increasing the odds of poor mental health by 20%. This relationship held, even after controlling for level of ID, gender, and place of residence. Lack of social support was associated with having a mental illness; individuals who lacked social support were twice as likely to have a mental illness. The importance of considering these factors in the prevention, diagnosis, and treatment of mental health in this population is discussed.
... However, when it comes to applying this body of knowledge to activity programmes in persons with ID, it may be asked whether these cognitive aspects are applicable, or should other approaches be preferred. For example, Bramston & Mioche (2001) argued that persons with ID are restricted in their ability to cope with a stress situation, such as those evoked during participation in certain physical activities (e.g. adherence to boring exercise, conforming to rules during competition), because of their limited decision-making and other cognitive functions. ...
The purpose of this study is to systematically retrieve, examine and discuss scientific studies focusing on motivational correlates that both contribute to, and can be assumed to be effects of, participation in sport, recreation, or health-related physical activities in persons with intellectual disability (ID).
A systematic analysis of the literature retrieved through electronic databases and other resources was performed, covering articles published from 1980 through 2009. Inclusion criteria were based on terms referring to the participants, the psychosocial correlates and the type of activity.
Twenty-three articles satisfied the inclusion criteria, and were divided into four categories of studies: (1) cross-sectional designs, (2) experimental prospective one-group designs, (3) longitudinal comparative intervention designs, and (4) qualitative designs. The level of quality regarding the intervention studies was assessed using four different scales, and on average they depicted a moderate level of evidence.
Both exercise and sport-related activities seem to contribute to well-being. Improved physical fitness and elevated skill level gained during exercise and sport activities appear to serve as mediators for increased perceptions of self-efficacy and social competence. Peer modelling, as well as video and audio reinforcement, appear to be important modalities in maintaining compliance to exercise programmes.
The Structured Water Dance Intervention (SWAN) is a dance-oriented aquatic group activity directed to give opportunities for the joy of movement, relaxation, and reduced stress. This study aimed to evaluate the effects of SWAN on salivary cortisol and stress in adults with profound intellectual and multiple disabilities (PIMD). A total of 34 adults with PIMD at four habilitation centres in Sweden completed the SWAN intervention. The intervention was administered for 40 min once a week during a 12-week period. Saliva cortisol was collected in the morning and evening at baseline one week before the intervention, thrice during the intervention period, and one week after the intervention. Moreover, in connection with the SWAN sessions, the participants’ level of stress was also assessed by the accompanying assistants. The results showed that salivary cortisol and participants stress decreased significantly, directly after the SWAN sessions compared with measures directly before sessions. The study demonstrates that adults with PIMD have diurnal salivary cortisol patterns consistent with those observed in adults without disability and that the SWAN reduces salivary cortisol levels and stress in people with PIMD; this justifies that SWAN could be considered in the choice of interventions to reduce stress in adults with PIMD.
Trial registration: This study is registered 09/04/2019 on ClinicalTrials.gov (ID: NCT03908801).
The problem of the lack of inclusive public space in the fringes of Bangkok, Thailand, is related to multiple factors in urban development. The study-area of the Pathum Thani province offers a summary of the critical consequences of the urban development in the past decades. The partial transformation of some environmental tracks onto an urbanized system allows the creation of a nonhomogeneous privatized continuous built surface. The conditions of these urban areas suffer from vehicular traffic, car dependency, absence of differentiated mobility, limited walkability, and lack of public spaces. The research aims to bring these areas to a higher level of inclusion, accessibility and overall quality by rethinking the existent public spaces, creating the grounds for the design of inclusive and accessible park. To reach this objective, the study explores the topics of public space, park, accessibility and inclusivity for disabilities to establish some principles for future design approach for Thaklong-Klongluang, a study-area located in the Pathum Thani Province. Characteristics, features, weaknesses and existing parks of the study area are demonstrated in the subsequent section. The results' discussion relates all the aforementioned topics, defining the guidelines for the creation of inclusive and accessible parks in the six existent sites of the study area. Because of its premises, besides being based in a specific location, the article aims to be a valid reference for the areas which present similar features and critical points.
Introduction
Globally, people living with spinal cord disability experience more limitations in an individual and social life. In many cases, this leads to complex psychological and social problems that may also affect the adaptation to the conditions. The aim of the study was to explore the experience of living and coping with disability in people with spinal cord disability due to road traffic accidents in Iran’s cultural context.
Methods
This is a qualitative study with a phenomenological approach on 10 Iranian people with spinal cord disability due to road traffic injuries. Data collection and analysis were performed from September to March 2019. Data were collected through individual, face-to-face in-depth interviews, and the experience of living with disability and adaptation strategies were explored. Van Manen’s methodical activities were used to guide the study’s process.
Results
“Victim of destiny” was the main theme extracted from three themes and nine sub-themes. The disabled people viewed life as a prison that destiny had ordained for them and trapped them in the fences of isolation, anger, regret, anxiety, sorrow, pity, and futility such that they require assistance from others as dependent individuals. The participants’ coping strategies to adjust to their difficulties were religious recourse, satisfaction with God’s expediency, and change of life values.
Conclusions
Spinal cord disability imposed irreversible restrictions on the participants’ lives. Providing social support, empowering disabled people to overcome their limitations, and adopting religious recourse can help them to recover their mental health and better cope with their conditions.
This article reflects on the process of incorporating an evidence base into clinical practice. What began as an arbitrary comment from a staff member developed into a multi-level piece of work with a lasting impression on the procedures of our organisation.
Background Research has established a clear relationship between life events and psychopathology amongst children generally, but this relationship has not been investigated in children with intellectual disabilities.Methods A secondary analysis of data collected by the 1999 ONS survey of the Mental Health of Children and Adolescents in Great Britain, investigating associations between adverse life events and psychopathology amongst 264 children with intellectual disabilities and 10 040 children without intellectual disabilities.Results Children with intellectual disabilities were more likely to experience a greater number and range of adverse life events than children without intellectual disabilities, a difference partly accounted for by family poverty. For children with and without intellectual disabilities, there were robust associations between several life events and child psychiatric disorders, most strongly emotional disorder. There also appeared to be a cumulative effect of life events on the psychopathology of children with intellectual disabilities.Conclusions Adverse life events play an important role in the psychopathology of children with intellectual disabilities and require further research attention. Policy interventions to reduce family poverty may have an indirect effect upon child psychopathology.
Interpretive ethnography was used as a framework to examine perceptions of physical activity behavior of 12 adults with mild mental retardation. Four parents and two job supervisors also agreed to participate. Multiple data sources included in-depth interviews, diaries, accelerometry, and informal observations. Participants reported many physical activity barriers, benefits, and leisure choices similar to the general population; however, two particularly salient themes related to negative influences and lack of guidance from support systems were apparently unique to this group. Results suggest that (a) adults with mental retardation need specially designed physical activity education and training programs and (b) supports system providers should be educated regarding the importance of physical activity to health for these individuals.
Likert-type scales are increasingly being used among people with intellectual disability (ID). These scales offer an efficient method for capturing a wide range of variance in self-reported attitudes and behaviours. This review is an attempt to evaluate the reliability and validity of Likert-type scales in people with ID.
Fifty-one studies reporting response rates, response bias, reliability and validity of Likert-type scales among adolescents and adults with ID were reviewed.
Low response rates were found among adolescents and adults with moderate to profound ID, when pictorial representations of response alternatives were not employed, and for Likert-type scales with self-descriptive statements. Response bias was evident, particularly among adolescents and adults with moderate to profound ID. Likert-type scales have better reliability and validity among adolescents and adults with borderline IQ or mild ID. Pretests and clarifying questions increase reliability and validity.
Likert-type scales should include pictorial representations of response alternatives, a single set of one or two word response descriptors, clarifying questions, and pretests, and are best used with adolescents and adults with borderline IQ to mild ID.
To measure disability-related stress through the development of the Physical Disability Stress Scale (PDSS) for wheelchair users.
Cross-sectional.
General community.
Sample of 119 wheelchair users with an acquired physical disability.
Not applicable.
General Health Questionnaire-28 (GHQ) and the World Health Organization Quality of Life (WHOQOL-BREF) (Australian version).
Factor analysis of PDSS items revealed 4 main factors of disability-related stress: access accounted for 33.7% of the variance, physical for 8.4% of the variance, social for 7.9% of the variance, and burden of care for 7.2% of the variance. Internal consistencies for the 4 factors were within acceptable ranges (alpha range, .78-.83). Concurrent validity was shown with the PDSS factors predicting 7% to 23% of the variance in GHQ subscales and total score and 12% to 31% of the WHOQOL-BREF subscales. Participants scoring in the GHQ psychiatric group showed significantly higher stress levels on the physical, social, and burden of care factors of the PDSS compared with the GHQ nonpsychiatric group.
The results suggest the PDSS factors are valid measures of disability-related stress with potential for clinical and research applications. Confirmatory factor analyses with larger sample sizes of wheelchair users are required to establish consistency in the measurement of disability-related stress.
The effects of smoking on heart rate (HR) and emotional processes during social interactions were assessed in 12 smokers. Smoking was associated with less anxiety and with enhanced feelings of being successful both in changing the opinions of others and in expressing one''s own point of view. These findings are consistent with others in the literature. The increase in HR during social interactions in which the participants smoked was similar in magnitude to the HR increase associated with speaking versus listening during conversation. The effects of smoking and social interaction on HR appeared to be additive. Smoking during the social interaction increased HR only about half as much as is typically reported for smokers seated quietly in nonsocial situations
There has been little research on stress as perceived by people with an intellectual disability. This is somewhat surprising considering the changes in philosophy and service delivery models across the western world that have resulted in people with an intellectual disability being at the forefront of massive attitudinal shifts within society. In this study, administration of the Lifestress Inventory to 459 people with a mild or moderate intellectual disability revealed that people with a disability reported experiencing an average of 8.57 stressors from a list of 31 stressors. When the stress intensity ratings for the individual stressors were examined it was clear that most stressors bothered the participants ‘a fair bit’. People with an intellectual disability reported a lot of stress from negative interpersonal relationships with peers and others.
It is proposed that many people with intellectual disabilities are facing an extensive range of stressors through current shifts in models of service delivery. They are increasingly being encouraged to adapt to new open employment opportunities and new independent living schemes. Increasingly they are being expected to show independence, initiative and flexibility- to welcome and even demand change. Changes of such magnitude have long been associated with stress. This study describes the development and standardization of a stress scale which can be used by people with mild intellectual disabilities. The items were derived by people with disabilities from events in their lives which stressed them and the scale enables users to quantify the frequency and intensity of daily hassles and major life stressors currently bothering them. With such data may come power and control over the timing and nature of changes in their lives.
Examined the relationship between physical disability and risk for psychological distress and disorder in 731 physically disabled adults (aged 19–91 yrs at initial interview 4 yrs earlier) and 850 nondisabled adults matched in age, sex, and area of residence. Ss completed the Center for Epidemiological Studies Depression Scale, the Diagnostic Interview Schedule, and an anxiety inventory. Disabled Ss were at substantially elevated risk for anxiety, depressive symptoms, and major depressive disorder. These findings can be attributed to chronic stress that tends to characterize the life circumstance and experience of disabled individuals. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The move into community-based supported accommodation for people with an intellectual disability can be exciting and rewarding but also confusing, demanding and perhaps even frightening. Yet, there has been little empirical or descriptive research into the emotional lives of this group. This study follows the concerns and stresses of four people with an intellectual disability for five months as they negotiate the trials and rewards of moving out into a flat in the community, with only drop-in support. The strongest trend emerging from all four participants is that the transition is not perceived by them to be stressful, but rather as a positive event which lowers general stress levels at the time. Unfortunately, the participants in this study found that other issues in their life gradually re-emerged and their perceived stress level soon rose again. Implications are drawn from the data for those involved in supporting people with an intellectual disability to move into supported accommodation.
Replies to an article by R. B. Zajonc (see record) in which Zajonc differed greatly from the present author in his conceptualization of emotion and its relations with cognition, as well as in his evaluation of the evidence. The boundaries of emotion as a phenomenon and whether sensory preferences can be regarded as emotions are discussed, and the evidence Zajonc regards as supporting his claims for the independence of cognition and emotion and the primacy of emotion are analyzed. Finally, the indeterminancy of the issue of cognitive vs emotional primacy is emphasized. (30 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
IN PREVIOUS studies [l] it has been established that a cluster of social events requiring change in ongoing life adjustment is significantly associated with the time of illness onset. Similarly, the relationship of what has been called ‘life stress,’ ‘emotional stress,’ ‘object loss,’ etc. and illness onset has been demonstrated by other investigations [2-131. It has been adduced from these studies that this clustering of social or life events achieves etiologic significance as a necessary but not sufficient cause of illness and accounts in part for the time of onset of disease. Methodologically, the interview or questionnaire technique used in these studies has yielded only the number and types of events making up the cluster. Some estimate of the magnitude of these events is now required to bring greater precision to this area of research and to provide a quantitative basis for new epidemiological studies of diseases. This report defines a method which achieves this requisite. METHOD
This paper presents evidence from three samples, two of college students and one of participants in a community smoking-cessation program, for the reliability and validity of a 14-item instrument, the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The PSS showed adequate reliability and, as predicted, was correlated with life-event scores, depressive and physical symptomatology, utilization of health services, social anxiety, and smoking-reduction maintenance. In all comparisons, the PSS was a better predictor of the outcome in question than were life-event scores. When compared to a depressive symptomatology scale, the PSS was found to measure a different and independently predictive construct. Additional data indicate adequate reliability and validity of a four-item version of the PSS for telephone interviews. The PSS is suggested for examining the role of nonspecific appraised stress in the etiology of disease and behavioral disorders and as an outcome measure of experienced levels of stress.
The standard life events methodology for the prediction of psychological symptoms was compared with one focusing on relatively minor events, namely, the hassles and uplifts of everyday life. Hassles and Uplifts Scales were constructed and administered once a month for 10 consecutive months to a community sample of middle-aged adults. It was found that the Hassles Scale was a better predictor of concurrent and subsequent psychological symptoms than were the life events scores, and that the scale shared most of the variance in symptoms accounted for by life events. When the effects of life events scores were removed, hassles and symptoms remained significantly correlated. Uplifts were positively related to symptoms for women but not for men. Hassles and uplifts were also shown to be related, although only modestly so, to positive and negative affect, thus providing discriminate validation for hassles and uplifts in comparison to measures of emotion. It was concluded that the assessment of daily hassles and uplifts may be a better approach to the prediction of adaptational outcomes than the usual life events approach.
The validity of responses by individuals with mental retardation during interviews is threatened by a number of biases. Acquiescence (the disposition to answer 'yes' regardless of the question asked) is a commonly observed response bias committed by respondents to questionnaires and interviews, and this disposition is significantly more pronounced when persons of low status are questioned by high-status interviewers. Research on the acquiescence bias suggests that it can be reduced in mentally retarded respondents by replacing the usual 'yes/no' question format with an 'either/or' format. Enhancing the either/or choices with accompanying picture representations of each choice is beneficial in increasing mentally retarded subjects' responding and in reducing their tendency to choose the latter of two either/or choices. 'Nay-saying' (the disposition to say 'no' regardless of the question asked), while less common than 'yea-saying' (i.e. than acquiescence), has also been noted in response to certain question formats and taboo topics. This review implies that the validity of an interview with respondents of limited intelligence depends greatly on the format of its questions.
The Subjective Stress Scale (SSS) was developed by Bramston and Bostock (1994) to provide a sensitive measure of stress for people with intellectual disabilities. This study examined the underlying structure of the SSS by analysing responses of 221 intellectually disabled people to the questionnaire. Exploratory factor analysis of the interitem correlation matrix yielded at least three solutions that were quite interpretable: a one-factor, a two-factor, and a four-factor solution. Factors in all three solutions bore a strong resemblance to stress dimensions reported for the general population using other stress measures. The results suggest that although the actual stressors vary, persons with mild intellectual disability are affected by the same major stress dimensions as the general population. The results also suggest that the SSS can be used as a much needed measure of subjective stress levels in people with mild intellectual disabilities.
Quality of life (QOL) has become a topic of much debate in the learning difficulties literature. Increasing use is made of questionnaire-driven interview schedules in an effort to find out what clients believe in their own words. However, in this paper, the authors argue that the use made of such questionnaires may actually distort interviewees' 'own words' by severely underestimating the degree to which the questions and answers are changed by the subtle dynamics of the interview. In the first ever close examination of what actually happens in a QOL assessment interview, the qualitative insights of conversation analysis are used to show that the typical administration of a well-known instrument will involve: (1) distortions of the questions brought about by the need to paraphrase complex items, and the inevitable use of pre-questions and response listing; and perhaps more disturbingly, (2) distortions of answers brought about by interviewers' pursuit of legitimate answers and non-take-up of interviewees' matters. The authors believe that these difficulties make it hard for researchers to draw conclusions from simple aggregation of recorded responses to this questionnaire, and, perhaps, to any questionnaire using a fixed-response schedule. On the other hand, the kind of close evidence used here may allow inferences to be drawn about clients' feelings of well being, but even so, these will need to be cast in terms which acknowledge the interactive and constructive nature of feeling-avowals.
The Subjective Stress Scale (SSS; Bramston & Bostock, 1994) was developed to measure stress in people with a mild intellectual disability. In previous research, the SSS was found to measure two broad dimensions of stress (a) a General Worry factor and (b) a factor that tapped concerns about Negative Interpersonal Relations (Bramston & Fogarty, 1995). The present study sought to continue this line of research by introducing a slightly modified form of the SSS, to be known as the Lifestress Inventory (LI) and examining the psychometric properties of the scale when administered to a new sample of 221 people with mild intellectual disabilities. Confirmatory factor analysis indicated that three underlying factors corresponding to General Worry, Negative Interpersonal Relations, and Coping were sufficient to account for the correlations among the items in the LI. Rasch analysis indicated some improvements to the scoring format for the LI and also showed that the most easily experienced stressors were associated with the Negative Interpersonal Relations dimension. The refinements introduced by the LI and the further demonstration that some of the broad stress dimensions identified in the general population can also be found in people with an intellectual disability represent important milestones for researchers interested in exploring reactions to stress among this population.
The assessment of emotional disorders such as anger, depression and stress among people with an intellectual disability has traditionally used one of three methodologies: ratings by a significant other, a clinical interview or self-report. Despite the widespread use of all three methodologies, there is little research into their equivalence. This paper assesses the convergence among these three approaches for 147 people with a mild or moderate intellectual disability across the affective domains of anger, depression and stress. The results showed the overlap among the three methods to be consistently low, although limited convergence was found between self-report and clinical interview. Ratings by work supervisors discriminated least clearly between anger, depression and stress while self-report was the most discriminating between these three overlapping but conceptually distinct states. Suggestions are made for ongoing research into the methodologies of assessing affective states among people with an intellectual disability.
Urinary pH and the psychology of nicotine addiction
- S Schachter
The experience of disability
- J Annison
Managing stress: the stress survival guide for today
- U Markham
Disability: a guide for health professionals
- J Annison