Disability, Discrimination, and Mental Health during the COVID-19 Pandemic: A Stress Process Model

Abstract

Drawing on data from a community survey with a sizeable subsample of people with physical, intellectual, and psychological disabilities in the Intermountain West region of the United States ( N = 2,043), this investigation examined the association of social stressors stemming from the COVID-19 pandemic with ableism or disability-related discrimination. We further assessed the significance of these associations for variation by disability status in psychological well-being with a moderated mediation analysis. Study findings provide clear evidence that greater pandemic-related stressor exposure was associated with greater discrimination, which in turn increased the psychologically distressing aspects of the pandemic for people with disabilities relative to people without disabilities. This set of findings challenges us to think about how we engage in research concerning ableism and the proliferation of macro-level stressors such as those associated with the COVID-19 pandemic. The findings also support the application of a minority stress model in addressing mental health contingencies among people with disabilities—in this case, in examining the pandemic’s psychological impact.

Cumulative Pandemic Stressors, Psychosocial Resources, and Psychological Distress: Toward a More Comprehensive Test of a Pandemic Stress Process

“…This finding aligns with prior research that examines the impact of cumulative adversities, such as childhood victimization or lifetime traumas, on mental health ( Breslau et al 1999 ; Cabrera et al 2007 ; Finkelhor et al 2007 ; Sternthal, Slopen, and Williams 2011 ; Turner and Lloyd 1995 ). Our findings also are in line with prior research that observes increases in distress during the pandemic ( Daly and Robinson 2021 ; McGinty et al 2020 ; Tran et al 2022 ; Twenge et al 2021 ) as well as research that documents the consequences of multiple pandemic stressors on mental health ( Brown and Ciciurkaite 2022 ; Ciciurkaite et al 2022 ). These stark increases in distress may indicate that pandemic stressors are more severe than general stressors.…”

“…Although recent research has made significant and timely contributions to our understanding of the mental health consequences of specific pandemic stressors (e.g., bereavement, job conditions, or financial strain) ( Bierman, Upenieks, Glavin, and Schieman 2021 ; Bo et al 2021 ; Brown and Ciciurkaite 2022 ; Craparo et al 2022 ; Donnelly and Farina 2021 ; Fang, Thomsen, and Nayga 2021 ; Grace 2021 ; Grace and VanHeuvelen 2022 ; Han et al 2022 ; Matalon et al 2021 ; Qian and Fan 2022 ; Taquet et al 2021 ; Witteveen and Velthorst 2020 ), little is known about the cumulative toll of experiencing multiple COVID-19 stressors. Over three decades ago, Leonard I. Pearlin (1989 :25) warned that because “stressors typically surface as groups or constellations of stressors,” focusing on particular stressors “may incorrectly assume more similarity in exposure to stressful experience than actually exists.” By this logic, broader assessments of COVID-19 stressors are needed to better estimate the mental health sequelae of pandemic social stress, including the similarly understudied role of coping resources in the moderation of the cumulative stress experience.…”

“…Over three decades ago, Leonard I. Pearlin (1989 :25) warned that because “stressors typically surface as groups or constellations of stressors,” focusing on particular stressors “may incorrectly assume more similarity in exposure to stressful experience than actually exists.” By this logic, broader assessments of COVID-19 stressors are needed to better estimate the mental health sequelae of pandemic social stress, including the similarly understudied role of coping resources in the moderation of the cumulative stress experience. Along these lines, only two studies of adults living in the Intermountain West region of the United States (Colorado, Utah, Idaho, and Wyoming) have shown that higher scores on a 20-item index of “pandemic-related stress exposure” (across the domains of employment, household management, personal relationships, and social life) are associated with higher levels of anxiety and depression ( Brown and Ciciurkaite 2022 ; Ciciurkaite, Marquez-Velarde, and Brown 2022 ).…”

“…Although recent research has made significant and timely contributions to our understanding of the mental health consequences of specific pandemic stressors (e.g., bereavement, job conditions, or financial strain) (Bierman, Upenieks, Glavin, and Schieman 2021;Bo et al 2021;Brown and Ciciurkaite 2022;Craparo et al 2022;Donnelly and Farina 2021;Fang, Thomsen, and Nayga 2021;Grace 2021;Grace and VanHeuvelen 2022;Han et al 2022;Matalon et al 2021;Qian and Fan 2022;Taquet et al 2021;Witteveen and Velthorst 2020), little is known about the cumulative toll of experiencing multiple COVID-19 stressors. Over three decades ago, Leonard I.…”

Disability, COVID-19-related stressors, discrimination, and the amplification of psychological distress.

“…There is now ample evidence that people with disabilities have been more likely than people without disabilities to experience difficulties at work, at home, in personal, family, and social relationships, and related to health and health care access since the start of the pandemic (Bagcchi, 2020; Chen & McNamara, 2020; Ciciurkaite et al, 2022; Landes et al, 2020). In the employment domain, people with disabilities have experienced job loss, reduced employment, lower wages, and an inability to seek new employment opportunities at higher rates than their unimpaired counterparts during this period (Brown & Ciciurkaite, 2022; Maroto et al, 2021). These stressors have been accompanied by disproportionate challenges in household management, such as food insecurity and difficulties paying rent, or mortgage, or monthly utilities (Ciciurkaite et al, 2022; Okoro et al, 2021).…”