Predictors of COVID-19 precautionary behaviors to protect people with disabilities

Disability is conceptualized using one of two major frameworks: the medical and the social model of disability. The medical model of disability describes disability as an individual issue in which the appropriate intervention is to remove the disability. The social model of disability describes disability as a social construction in which the appropriate intervention is societal change to increase accessibility. This study drew on models of disability to understand predictors of engagement in COVID-precautionary behavior prior to the vaccine to protect people with disabilities (PWD) from contracting COVID-19. Participants (n = 720) with and without disabilities (n = 77 and n = 633, respectively) completed an online questionnaire measuring disability beliefs, attitudes toward PWD, concerns about PWD contracting COVID-19, and engagement in behavior protecting PWD from contracting COVID-19. Medical model beliefs were negatively associated with behavior. In addition, negative attitudes toward PWD and low concern about PWD contracting COVID-19 fully accounted for the relationship. Social model beliefs were positively associated with behavior. In addition, positive attitudes toward PWD and greater concern about PWD contracting COVID-19 partially explained the relationship. These findings suggest that framing disability as a social construction rather than a medical issue could promote greater public health behavior to protect PWD from contracting COVID.     

The Pain of Endo Existence: Toward a Feminist Disability Studies Reading of Endometriosis

Disability scholars have critiqued medical models that pathologize disability as an individual flaw that needs treatment, rehabilitation, and cure, favoring instead a social‐constructionist approach that likens disability to other identity categories such as gender, race, class, and sexuality. However, the emphasis on social constructionism has left chronic illness and pain largely untheorized. This article argues that feminist disability studies (FDS) must attend to the common, chronic gynecological condition endometriosis (endo) when theorizing pain. Endo is particularly important for FDS analysis because the highly feminized and sexualized nature of endo pain is a major source of disability. Because medical treatments of endo enhance fertility rather than provide pain relief, those with endo must not only have access to medical services to manage their pain, but also demand better medical management of their pain as well as disability accommodations for their pain. Thus, I propose a pain‐centric model of disability that politicizes pain through social‐constructionist and medical models of disability by attending to the lived experiences of pain.     

Could you hold the door for me? Including disability in diversity

This article is intended to help those unfamiliar with disability studies by providing a context for disability on which psychologists can build. The 1st part presents data on disability training in graduate clinical programs and on training accessibility for graduate students with disabilities. The 2nd part is an introduction to disability studies and includes 3 core concepts of disability issues in psychology: (a) the framing of disability from 3 models (the moral, medical, and social models); (b) the ways in which disability is like and unlike other minority groups; and (c) the language that is used to describe disability. These 2 parts taken together constitute a brief introduction to disability issues within psychology.     

Towards a social model approach to counselling disabled clients

The social model of disability has emerged over the past 30 years in Britain to challenge the dominant individual, particularly medical and tragedy, models. This social model is borne from the experiences of disabled people and essentially defines disability as the discrimination faced by people with impairments. This paper explores the possible conflicts between some counselling approaches that can individualise and personalise problems and disability as a political issue. Drawing on research with counsellors and disabled clients, we illustrate the social construction of disability as an individualised problem within the counselling process. Considering the implications for counselling practice, we argue for an approach to counselling which recognises the social model of disability as the basis for social change.     

Correlates and Prognosis in Relation to Participation in Social Activities Among Older People Living in a Community in Osaka, Japan

To examine the factors associated with social participation and to determine whether social participation is predictive of mortality, a cohort of 1405 randomly selected older people aged 65 years and over, living in Settsu, Osaka Prefecture, was followed up for 66 months. By multivariate analysis using logistic regression, female sex, older age, disability, medical treatment, no use of health checks, no daily preventive health practices, and no life worth living (no Ikigai) were independent risk factors for no participation in social activities. From the analysis using the Kaplan–Meier method, the cumulative survival rates were higher among those who took part in social activities than among those who did not in both age groups, 65–74 years and 75 years and older, for men and women. Application of the Cox proportional hazards model resulted in adjusted hazard ratio of no participation in social activities for mortality of 1.53 (95% confidence interval: 1.11–2.11), controlling for other potential factors. These results suggest that participation in social activities is closely associated with health and psychosocial conditions and may be an independent risk factor for mortality among community-residing older people.     

Physical illness and symptoms of depression among elderly outpatients.

Elderly outpatients were assessed to clarify relations between symptoms of depression and physical illness, disability, pain, and selected psychosocial variables. Three types of assessments were made: (a) medical evaluations by physicians, (b) self-reported symptoms of depression and physical health, and (c) demographic and psychosocial data relating to participants' life circumstances. Both objective (physician-rated illness symptoms) and subjective (self-reported health, activity restriction, and use of pain medications) indicators of health accounted for independent variance in symptoms of depression. After controlling for these factors, additional variance was explained by health-related concerns (e.g., health care expenses, service needs), social support, and "other worries" (e.g., feeling useless, becoming a burden to others).     

Mothers and Models of Disability

Based on a qualitative anthropological study of American mothers of infants and young children newly diagnosed with disability, this essay examines how mothers understand their children and define disability in relation to publicly available discourses of disability and identity. In seeking to improve their children's opportunities in mainstream society, mothers appear to comply with the medical model. But over time and in the process of providing meaning to their experience, mothers retool models, drawing both on the social and minority group models' rejection of a problem-based definition of disability as inherently caused by impairment and on their own intimate engagement with impairment as an embodied experience.     

Adjustment to multiple sclerosis: application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n = 96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS.     

Medical Education and Disability Studies

The biomedicalist conceptualization of disablement as a personal medical tragedy has been criticized by disability studies scholars for discounting the difference between disability and impairment and the ways disability is produced by socio-environmental factors. This paper discusses prospects for partnerships between disability studies teaching/research and medical education; addresses some of the themes around the necessity of critical disability studies training for medical students; and examines a selection of issues and themes that have arisen from disability education courses within medical schools globally. The paper concludes that providing there is a commitment from senior management, universities are well positioned to apply both vertical and horizontal approaches to teaching disability studies to medical students.     

Attitudes of Health Care Trainees About Genetics and Disability: Issues of Access, Health Care Communication, and Decision Making

Prior studies suggest that knowledge and attitudes of health care professionals influence patient communication and medical decision making. To study this dynamic in the context of genetic disability, we developed a survey on health professionals' attitudes regarding disability and genetic screening and pilot-tested it on a sample of medical students, residents, and genetic counseling students (N = 85). Despite minimal experience with disability or genetics, most respondents reported feeling comfortable dealing with genetics (59%) and disability (75%). The majority felt that disability caused significant suffering for both the person (51%) and family (64%), and that research should be directed toward preventing genetic disability (62%). Similar to prior literature, perceived Quality of Life was most often based on degrees of physical and cognitive functioning, pain, and social support. However, differences were found between genetic counseling trainees and other medical trainees in their relative emphasis of social versus medical issues in questions of disability and genetic testing, and these response patterns were associated with differences in the groups' priorities for offering information about social resources. Respondents agreed that access to genetic testing and information is personal and that testing should be available upon request for oneself (68%) and to a lesser degree for one's fetus (55%) or child (41%). However, the same individuals frequently stated that society should regulate access to such technologies. Although most felt that the patient and professional should jointly make such decisions on a case-by-case basis, it was also seen as appropriate for the health care professional to occasionally decline genetic testing. It seems apparent that training and experience influence knowledge and attitudes. Therefore, it is critical to document knowledge and attitudes of various health care providers and trainees, including differences between various specialties, to improve educational interventions geared to this area.     

Social support,social integration,and health-related quality of life over time: Results from the Fitness and Arthritis in Seniors Trial (FAST)

The present study tested whether baseline perceived social support and social integration predicted baseline and follow-up measures of health-related quality of life for 364 older adults with osteoarthritis. The findings are secondary analyses of a randomized controlled trial of an exercise intervention. Multiple regression analyses indicate that perceived social support was related to baseline measures of functioning in psychological (depressive symptoms, social functioning, and life satisfaction) and physical domains (self-rated disability, observed physical function, and perceived health), after accounting for demographic and clinical status factors. At 18-month follow-up (additionally controlling for exercise intervention and baseline outcomes), social support significantly predicted changes in psychosocial functioning, but was unrelated to changes in self-reported and observed physical health. The findings indicate that social support is an important predictor of long-term psychosocial outcomes, but is less important than baseline clinical status for physical health endpoints in this cohort of older adults. In contrast, social integration was not a consistent predictor of outcomes.     

Expectations and attributions in social anxiety disorder: diagnostic distinctions and relationship to general anxiety and depression

Contemporary cognitive models suggest that social anxiety disorder arises from a number of cognitive factors, including tendencies to form pessimistic (rather than optimistic) attributions and expectations for socially-related events. These models also assume that the strengths of such attributions and expectations are more closely linked with social anxiety than with general anxiety or depression. To test these assumptions, a battery of self-report measures was completed by participants with a primary diagnosis of generalized social anxiety disorder (n = 75), panic disorder with agoraphobia (n = 44), or post-traumatic stress disorder (n = 59). To examine differences on these cognitive variables, group comparisons were performed controlling for general anxiety, depression and medication status. Social anxiety disorder, compared with panic disorder with agoraphobia and post-traumatic stress disorder, was characterized by lower expectations for positive social events and higher expectations for negative social events. There was no difference among the groups on expectations for non-social positive or negative events. Stable and global attributions for social negative events were more closely associated with social anxiety disorder than with panic disorder with agoraphobia and post-traumatic stress disorder. Correlational analyses also revealed specific relationships among social-cognitive measures and social anxiety, even after controlling for general anxiety and depression. The results are consistent with cognitive models of social anxiety disorder.     

Social Workers' Intervention Preferences in Cases of Parental Violence Toward Intellectually Disabled Children

Children with intellectual disabilities are at risk of being abused by family members. This study sought to identify factors influencing the intervention decisions of social workers. Fifty-nine social workers employed at welfare services participated in the study. The study used a factorial survey design describing a violent interaction between a child with intellectual disability and a parent. Professional characteristics of the workers as well as personal attitudinal characteristics had no significant effect on the preference of intervention mode. However, levels of child and parental aggression presented in the vignettes did influence the preferred intervention. Child's challenging behavior plays an important and increasing role in preferences for more intrusive and authoritative interventions, even after controlling for parental aggression.     

Expectations and Attributions in Social Anxiety Disorder: Diagnostic Distinctions and Relationship to General Anxiety and Depression

Contemporary cognitive models suggest that social anxiety disorder arises from a number of cognitive factors, including tendencies to form pessimistic (rather than optimistic) attributions and expectations for socially-related events. These models also assume that the strengths of such attributions and expectations are more closely linked with social anxiety than with general anxiety or depression. To test these assumptions, a battery of self-report measures was completed by participants with a primary diagnosis of generalized social anxiety disorder (n?=?75), panic disorder with agoraphobia (n?=?44), or post-traumatic stress disorder (n?=?59). To examine differences on these cognitive variables, group comparisons were performed controlling for general anxiety, depression and medication status. Social anxiety disorder, compared with panic disorder with agoraphobia and post-traumatic stress disorder, was characterized by lower expectations for positive social events and higher expectations for negative social events. There was no difference among the groups on expectations for non-social positive or negative events. Stable and global attributions for social negative events were more closely associated with social anxiety disorder than with panic disorder with agoraphobia and post-traumatic stress disorder. Correlational analyses also revealed specific relationships among social-cognitive measures and social anxiety, even after controlling for general anxiety and depression. The results are consistent with cognitive models of social anxiety disorder.     

Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis

Pain-related avoidance factors and social resources, as assessed by pain coping and social support, are supposed to have lasting effects on functional disability and pain in chronic pain disorders. As a follow-up to a prospective study demonstrating short-term effects after one year (Behaviour Research and Therapy, 36, 179-193, 1998), the role of pain coping and social support at the time of diagnosis was investigated in relationship to the long-term course of functional disability and pain after three and five years in 78 patients with rheumatoid arthritis (RA), taking into account personality characteristics of neuroticism and extraversion, clinical status and use of medication. In line with findings at the one-year follow-up, results showed that more passive pain coping predicted functional disability at the three-year, but not the five-year follow-up. In addition, low levels of social support at the time of diagnosis consistently predicted both functional disability and pain at the three and five-year follow-ups. Results indicate that pain coping and social support, assessed very early in the disease process, can affect long-term functional disability and pain in RA, and suggest that early interventions focusing on pain-related avoidance factors and social resources for patients at risk may beneficially influence long-term outcomes in RA.     

Psychosocial Correlates of Medical Mistrust Among African American Men

The current study proposed and tested a conceptual model of medical mistrust in a sample of African American men (N = 216) recruited primarily from barbershops in the Midwest and Southeast regions of the United States. Potential psychosocial correlates were grouped into background factors, masculine role identity/socialization factors, recent healthcare experiences, recent socioenvironmental experiences (e.g., discrimination), and healthcare system outcome expectations (e.g., perceived racism in healthcare). Direct and mediated relationships were assessed. Results from the hierarchical regression analyses suggest that perceived racism in healthcare was the most powerful correlate of medical mistrust even after controlling for other factors. Direct effects were found for age, masculine role identity, recent patient–physician interaction quality, and discrimination experiences. Also, perceived racism in healthcare mediated the relationship between discrimination experiences and medical mistrust. These findings suggest that African American men’s mistrust of healthcare organizations is related to personal characteristics, previous negative social/healthcare experiences, and expectations of disparate treatment on the basis of race. These findings also imply that aspects of masculine role identity shape the tone of patient–physician interactions in ways that impede trust building processes.     

The Interactive Effect of Social Comparison and Objective Information on the Decision to See a Doctor

Doctors' schedules are often overcrowded by unnecessary consultations with people complaining of minor or harmless symptoms. Such people typically decide to seek medical attention after hearing the opinions of family and friends. The present study explored some factors that might affect one's readiness to be influenced by nonprofessional opinions. Subjects in a role-playing setting were asked to imagine they were experiencing various symptoms, and then were given social comparison information suggesting they either should or should not see a doctor. As an orthogonal factor, subjects were also given an objective basis, via a simple physical test, for believing the symptoms either did or did not require medical attention. Consistent with Festinger's (1954) propositions, objective information suggesting the need to see a doctor eliminated the influence of social comparison. However, objective information suggesting the symptoms were harmless failed to reduce the impact of social comparison. These results indicate that providing an objective basis for deciding to sec a doctor will not be effective in controlling unnecessary visits, since "don't go" objective information is completely overridden by "go" social comparison information.     

Individual and social correlates of aggressive behavior in Lebanese undergraduates: The role of trait emotional intelligence

This study investigates the relationship between Aggressive Behavior and individual factors, namely trait Emotional Intelligence, personality dimensions, emotion regulation and self-worth, as well as social factors, namely accepting/rejecting parenting styles and exposure to violence. The sample consisted of 252 university students in Lebanon (154 females), from 16 to 30 years old. Results from hierarchical regression analyses (controlling for age and gender and in the presence of social and individual predictors) showed that the Self-control and Emotionality factors of trait Emotional Intelligence were significant negative predictors of Aggressive Behavior while controlling for age and gender and in the presence of social and individual predictors). Exposure to violence and openness to experience also predicted Aggressive Behavior. Implications for future research and limitations of the present study are discussed.     

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.     

The Influence of Group Size and Stigma Severity on Social Acceptance: The Case of People with Intellectual Disability Moving into Neighbourhoods

Dutch adults from a nationwide Internet panel (N = 426) were asked to imagine that their next‐door neighbours would move out and that people with intellectual disability would move in. Severity of disability and group size were varied to manipulate intergroup threat. These two factors independently influenced social acceptance and a variety of emotional and behavioural measures. In particular, it was found that a large group with severe disability aroused the strongest negative response, whereas a small group with mild disability aroused the weakest negative response. Small groups with a severe disability and large groups with a mild disability aroused similar and intermediate negative responses. Results are discussed in terms of theories of intergroup threat and stigmatisation. Practical implications for predicting the success of de‐institutionalisation and social integration of groups with special needs are addressed. Copyright © 2011 John Wiley & Sons, Ltd.