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.

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

“…2 The third coping factor, ®ghting spirit, did not signi®cantly contribute to psychological outcome, although high levels of internal control have been linked to less psychological distress 2,20 and better well being among persons with SCL. 13 A partial explanation for the lack of e ect regarding Fighting spirit might be related to the extreme positive skewness of the scoring distribution (Table 2). This in turn might re¯ect the fact that ®ghting spirit represents a highly valued attitude of independence in western cultures.…”

“…This is consistent with the ®ndings that persons with SCL who report high levels of social support also report little depression. 12,13 In general, sociodemographic and disability-related variables were weak predictors of psychological outcome with one exception: educational level predicted intrusion, where the higher the educational level the lower the intrusion. Education has previously been found to predict emotional well being in SCL.…”

“…However, a shortcoming of the design was that sociodemographic and disabilityrelated variables shown to impact emotional wellbeing in other studies were not controlled. Because social support has repeatedly proven to be a correlate of psychological distress in SCL 12,13 it seemed necessary to include this variable among the background variables.…”

Long-term body-weight-supported treadmill training and subsequent follow-up in persons with chronic SCI: effects on functional walking ability and measures of subjective well-being

“…16 The CES-D has demonstrated a high degree of reliability and validity 15 and has been shown to be sensitive to change in studies of people with SCI. 16,17 Life satisfaction The 5-item Satisfaction With Life Scale (SWLS 18 ) was used to measure 'overall goodness' of the participants' lives. Respondents indicated the extent to which they agreed with each item (eg 'I am satisfied with my life') using a scale ranging from 1 (strongly disagree) to 7 (strongly agree).…”

Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning

“…Weinberger et al, 1990;Smith et al, 1991;Schwarzer, 1994). Social support has been hypothesized to benefit well-being directly äs well äs indirectly by acting äs a mediator or a buffer in coping with stress or illness (Lazarus and Folkman, 1984;Cohen and Wills, 1985;Schulz and Decker, 1985). In studying social support, a general distinction must be made between structural and functional characteristics (Cohen and Wills, 1985).…”