The relationship between the severity and duration of physical disability and body esteem

The current study investigated the association between the severity and duration of physical disability and body esteem. A total of 748 participants (367 males, 381 females) who had a physical disability and 448 participants (171 males, 277 females) who were able-bodied participated in the study. The results demonstrated that people with more severe physical disability experienced lower levels of body esteem than people with milder physical disabilities and able-bodied people. The duration of physical disability was not related to levels of body esteem. Except for the face, people with physical disabilities devalued all aspects of their body more than able-bodied people. For males with physical disability, the unique predictors of high body esteem were decreased need for assistance, higher self-esteem, lower depression and higher sexual esteem; for females with physical disability, the unique predictors were higher self-esteem and higher sexual esteem. Overall, the study suggested that people with physical disability, particularly those with severe disabilities, may be particularly vulnerable to problems associated with their body esteem.     

Using Cognitive Mapping to Understand Problems Experienced by Family Caregivers of Persons with Severe Physical Disabilities

Individuals who provide ongoing care for family members who have a chronic disease or disability are likely to encounter a wide array of problems that can compromise their own health and their ability to function effectively in a caregiving role. Structured focus group meetings were conducted to elicit a comprehensive list of the problems that caregivers experienced during their first year of providing care to a person with a severe physical disability. A separate group of caregivers (N = 60) individually sorted problems into piles based on their similarity and assigned relative importance to each problem. The aggregated data were analyzed with multidimensional scaling and hierarchical cluster analysis. Results indicated that caregivers cognitively organize problems along three dimensions: I. Centeredness–caregiver versus patient-oriented; II. Relationship Demands–physical versus emotional; and III. Caregiver Burden–time versus emotional. Additionally, 6 clusters of substantively similar problems were identified and prioritized in terms of personal relevance: Basic Needs (lowest); Perceived Constraints; Caregiver Challenges; Patient Resentment; Patient Withdrawal; and Patient Intrapsychic Adjustment (highest). Further examination of the organization of problems identified by caregivers should provide important insights about the experience of caregivers and how more targeted interventions can be developed to address their specific needs.     

Predictors of successful discharge from out-of-home care among children with complex needs

We examined the predictors for successful discharge from out-of-home care of children with complex needs placed in a novel comprehensive service intervention (Manatee Model) and compared their discharge experiences to their out-of-home counterparts from the same county. The study design consisted of a longitudinal two-year comparison of these two groups. A total of 147 cases were included in the analysis, and the propensity scoring technique was used to equate the groups. Among children admitted to the Manatee Model, boys, White children, younger children, those who came from a single-parent family, those who were abused, and those who had a disability (physical or emotional disability or medical condition) were found less likely to successfully exit within the two years when these predictors were examined separately. Multivariate analyses indicated that only age at the time of removal and health status were significantly associated with successful discharge. Implications of the findings are discussed.     

The Role of Military and Veterans Affairs Chaplains in the Treatment of Alcohol Problems

Chaplains can play a unique and valuable role in the treatment of alcohol dependence, a condition that has physical, psychological, and spiritual dimensions. To best fulfill this role, chaplains need to have a broad understanding of the nature of alcohol problems and current strategies for effectively interacting with individuals who have these problems, especially those with severe problems, and with their families. This article is designed to expand the chaplain’s knowledge about alcohol use disorders as well as evidence-based treatments and to offer recommendations on how chaplains can promote recovery of individuals with alcohol-related problems.     

The use of leisure counselling as a therapeutic technique

If leisure is defined as free or unobligated time, then leisure is clearly the category of time expenditure that has the greatest potential for making people healthy and happy but it also has the greatest potential for creating problems. Therefore, educating and counselling people on how to make best use of their free time can have a great impact on the physical and mental health of individuals. The intent of this paper is to explain how leisure counselling can be implemented as a therapeutic technique for the benefit of many different types of people. It is also the intent of this paper to provide those who work as counsellors with information about leisure and leisure counselling so that they can help their clients to improve their lives through leisure. Therefore, this paper examines the contributions that both leisure counselling and leisure education can make in promoting maximal physical and psychological well-being, although the main focus is on leisure counselling. The overall conclusion is that effective leisure counselling services can significantly help to improve the physical and mental well-being of individuals and society in general.     

Stigma of mental and physical illness and the use of mobile technology

Research has shown the stigma attached to mental disabilities, yet little research has directly compared the experiences of people with physical disabilities and those with mental disabilities. Not only are both conditions likely perceived as stigmatizing, but the pervasive use of mobile technology may be one means by which people with disabilities can manage and understand their disability. Four hundred and eighty-seven individuals with physical and/or psychological disabilities completed a survey examining whether they would be willing to use mobile technology to manage their disability and how stigmatizing they perceived their disability to be. Willingness to use mobile technology was related to the age of the sample as well as the type of disability. Individuals with psychological disabilities were more likely to use certain forms of mobile technology relative to those with physical disabilities. Observed differences between physical and psychological disabilities are discussed in terms of the symbolic interaction stigma model.     

AIDS‐Related Stigma in Individuals With Other Stigmatized Identities in the USA: A Review of Layered Stigmas

AIDS‐related stigmas have profound negative impacts on people living with and those affected by HIV/AIDS. While a considerable body of work examines AIDS‐related stigma, it is less clear how AIDS stigmas affect individuals in relation to other stigmatized identities, particularly ethnic minorities. This review examines the literature on AIDS‐related stigma among these groups. The limited available research indicates that AIDS stigmas can seriously interfere with HIV testing, treatment, and care. In addition, prevention studies conducted with incarcerated adolescents, a group characterized by stigmatized identities and high risks for HIV, indicate that interventions for this population do not address stigmatized identities and demonstrate limited effects on risk reduction outcomes. Research is needed to examine stigma in primary prevention of HIV with an at‐risk stigmatized group.     

Alcohol-related knowledge and attitudes in people with a mild learning disability – the effects of a ‘sensible drinking’ group

Alcohol-related knowledge and attitudes in people with a mild learning disability, who were either living, or being prepared to live, in relatively independent conditions in the community, were assessed through a structured interview format. Compared with non-learning-disabled teenagers, adults and a hospitalized patient sample, alcohol-related knowledge in the people with a learning disability was found to be significantly poorer, alcohol was reported as having particularly negative effects and susceptibility to social pressure to drink alcohol was greater. A ‘sensible drinking’ group, taking a social skills and influences approach to alcohol education, was conducted with a subgroup of the individuals with a learning disability. The group format and methods, including in vivo sessions in a public house, are described. Follow-up evaluations suggested some significant positive changes in knowledge, attitudes and sensible drinking skills. It is concluded that this population, which is increasingly living, or being moved into, independent conditions in the community, is at least as vulnerable to social influences on alcohol use and abuse as are young people. As with young people, the usefulness of making available such alcohol-education programmes as described in this study, is discussed.     

The Inclusion House: Where Pastors Learn to Minister to Individuals with Disabilities

The Inclusion House is a unique dorm in Holland, Michigan, where nondisabled students, studying to be leaders in the faith community as future pastors, live side-by-side same-aged individuals with intellectual disabilities. After one year, a qualitative study using semi-structured interviews was conducted with the nondisabled roommates. Findings showed overall positive feelings involving watching roommates with a disability become more independent, learning to balance roles as a friend vs. helper, as well as knowledge gleaned about working with these type of individuals as well as their families for their future occupations. These findings are important for the education of future leaders of the church and the manner by which they can include people with disabilities and their families in faith communities.     

Ethnicity and the stigma of disabilities

Abstract

Recent studies reveal significant differences in the attitudes held by people of various ethnic groups toward people with disabilities. We surveyed university students and community members on a scale of desired social distance from people with disabilities. Study 1 revealed that Asian-American participants were more likely to stigmatize and less likely to differentiate between individuals with physical and mental illness than were their African-American, Latin-American or European-American counterparts. Study 2 compared U.S. born with Asian born Asian-Americans and found that nativity was a useful predictor of attitudes toward people with disabilities. Asian born participants were more likely to stigmatize disabilities overall (except mental illness and old age) than U.S. born participants presumably because of the level of assimilation. These cultural differences may have health care and psychosocial implications for those who are disabled and for health care providers.     

An evaluation of support groups for patients with long-term chronic pain and complex psychosocial difficulties

There is a significant group of chronic pain patients with complex psychosocial needs who are frequent users of hospital outpatient departments and who do not participate in or benefit from traditional pain management treatments and are convinced there is a medical solution to their problems. They are a particularly challenging group of patients to help, often shunned by medical and psychological professionals. A new type of ten-session psycho-social group for these patients that is less demanding than traditional pain management group programmes is investigated. It is designed to foster the development into community-based self-help groups and reduce the need for professional support and unnecessary medical intervention. Accounts of four groups of patients who participated in support groups and successfully established their own groups is presented. To assess changes in motivation, mood and pain disability standardized questionnaire measures were given before and after group attendance. Findings suggest that patients benefited and took increased responsibility for their pain management but did not demonstrate positive changes on measures of mood or level of pain disability. Patients experienced satisfaction with the groups and established their own self-help community groups. The positive experience of participants and staff suggests further work with support groups would be productive for this group of patients.     

Perspectives of people with mental health problems at hot spots: Attitudes and perceptions of safety,crime, and the police

People who live in places with high levels of crime and disorder are more likely to experience mental illness compared with those who do not live in these types of place (Weisburd et al., 2018; Weisburd & White, 2019). The increased police presence on high crime streets may also increase the likelihood that these individuals will encounter law enforcement. There is a strong body of literature focused on the relationship between neighborhoods and the physical and mental health of residents (e.g. Arcaya et al., 2016; Duncan & Kawachi, 2018; Leventhal & Brooks‐Gunn, 2003), but there are very few studies that look at the perceptions of people with mental illness directly, particularly as they relate to the environment of the street on which they live and attitudes toward the police. In turn, existing studies generally look at the most serious mental health problems (e.g. schizophrenia), ignoring more common mental health concerns such as post‐traumatic stress disorder (PTSD) and depression. This paper uses self‐report data from a large in‐person survey of people who live on crime hot spot and non‐hot spot streets in order to assess attitudes among a broader group of persons with mental health problems. Furthermore, we examine the interaction between living in crime hot spots and non‐hot spots and perceptions of these residents. Our findings in this broader sample confirm earlier studies that identify greater fear and less trust of the police among persons with mental illnesses. At the same time, our findings suggest that fear of crime and perceptions of police are moderated by living in a crime hot spot.     

Spiritual Struggles and Health: Assessing the Influence of Socioeconomic Status

Growing evidence suggests that spiritual struggles may play a major role in explaining the relationship between religion and health. Even so, there are significant gaps in the literature. More specifically, researchers do not know enough about how spiritual struggles arise in the first place. This study has two major goals. The first is to see whether socioeconomic status is associated with spiritual struggles. The second is to see whether spiritual struggles are associated with physical health. A conceptual model is tested that contains the following core hypotheses: (1) individuals with lower levels of educational attainment are more likely to encounter chronic economic difficulties; (2) people who experience ongoing financial strain are more likely to live in rundown neighborhoods; (3) people who live in dilapidated neighborhoods will be more angry than their well‐to‐do counterparts; (4) people who are more angry will, in turn, be more likely to experience spiritual struggles; and (5) greater spiritual struggles will be associated with more symptoms of physical illness. Data from a recent nationwide survey (N = 2,146) provide empirical support for each hypothesis.     

Does U.S. federal policy support employment and recovery for people with psychiatric disabilities?

Evidence suggests that a high percentage of people with a psychiatric disability can recover--find meaningful work, develop positive relationships, and participate fully in their communities. Evidence also suggests that work is an essential component of recovery. However, few people with a serious psychiatric disability are actually employed and most of those who are employed work only part-time at barely minimum wages.To assess the impact of federal programs such as Social Security Disability Insurance, vocational rehabilitation, medical insurance, and psychiatric services upon employment, we conducted a qualitative study of 16 employed and 16 unemployed individuals with psychiatric disabilities. All of our participants had disabilities severe enough to qualify them for Social Security Disability benefits.They told us that current federal policies and practices encouraged employment and integration of only a few participants, in a particular stage of their recovery, and placed significant barriers in the employment path of others.     

A Study of Health Perception,Disability Acceptance,and Life Satisfaction Based on Types of Leisure Activity Among Koreans with a Physical Disability

Leisure studies provide evidence that leisure engagement serves as a vehicle for improving life satisfaction among individuals with a physical disability. However, a dearth of research addresses which types of leisure activities are associated with specific psychological benefits. This study sought to capture three aspects of psychological benefits: acceptance of disability, life satisfaction, and health perception, and to explore how leisure activities are related to these psychological benefits. Using data released from the 2011 Panel Survey of Employment for the Disabled in Korea, this study found that individuals with a physical disability who participate in social activity, religious activity, and Internet use reported high health perception, life satisfaction, and disability acceptance. In particular, findings of this study provide evidence that social activity participation plays an important role in increasing health benefits among individuals with a physical disability.     

Impaired embodiment and intersubjectivity

This paper considers the importance of the body for self-esteem, communication, and emotional expression and experience, through the reflections of those who live with various neurological impairments of movement and sensation; sensory deafferentation, spinal cord injury and Möbius Syndrome (the congenital absence of facial expression). People with severe sensory loss, who require conscious attention and visual feedback for movement, describe the imperative to use the same strategies to reacquire gesture, to appear normal and have embodied expression. Those paralysed after spinal cord injury struggle to have others see them as people rather than as people in wheelchairs and have been active in the disability movement, distinguishing between their medical impairment and the social induced disability others project onto them. Lastly those with Möbius reveal the importance of the face for emotional expression and communication and indeed for emotional experience itself. All these examples explore the crucial role of the body as agent for social and personal expression and self-esteem.     

DISPOSABLE BODIES,DISABLED MINDS,AND CHRISTIAN HOPE: RESURRECTION IN LIGHT OF TRANSHUMANISM AND INTELLECTUAL DISABILITY

This piece brings into critical conversation Christian resurrection hope, virtual versions of transhumanism, and intellectual disability and demonstrates that Christian resurrection provides a more cogent hope for people with severe intellectual disabilities than transhumanism. I argue that transhumanist virtual futures are theologically problematic, as bodily resurrection is neither required nor desirable. It is particularly problematic for people with severe intellectual disabilities given the way they would be excluded from these futures. Disability theology also raises issues with the traditional notions of “healing” in the resurrection and the implications for the value and identity of persons with intellectual disabilities. Starting with these problems, I explore the nature of Christian hope, noting the inadequacies of a virtual transhumanist future with respect to both resurrection faith and intellectual disability, and address how resurrection hope can account for issues raised in disability theology, and so properly include people with intellectual disabilities.     

Personality prior to disability determines adaptation: agreeable individuals recover lost life satisfaction faster and more completely

Personality traits prior to the onset of illness or disability may influence how well an individual psychologically adjusts after the illness or disability has occurred. Previous research has shown that after the onset of a disability, people initially experience sharp drops in life satisfaction, and the ability to regain lost life satisfaction is at best partial. However, such research has not investigated the role of individual differences in adaptation to disability. We suggest that predisability personality determines the speed and extent of adaptation. We analyzed measures of personality traits in a sample of 11,680 individuals, 307 of whom became disabled over a 4-year period. We show that although becoming disabled has a severe impact on life satisfaction, this effect is significantly moderated by predisability personality. After 4 years of disability, moderately agreeable individuals had levels of life satisfaction 0.32 standard deviations higher than those of moderately disagreeable individuals. Agreeable individuals adapt more quickly and fully to disability; disagreeable individuals may need additional support to adapt.     

Developing and Adapting a Mindfulness-Based Group Intervention for Racially and Economically Marginalized Patients in the Bronx

Mindfulness-based interventions (MBIs; e.g., MBSR, MBCT, ACT) have been widely used and disseminated for treatment of myriad physical and psychological problems. However, most MBIs have primarily been used with middle-or upper-class White populations, with some instances where they have been adapted for use with diverse populations (e.g., Burnett-Zeigler et al., 2016, Roth and Robbins, 2004). However, even when adapted, most MBIs have not explicitly addressed unique factors faced by the target population, such as racial discrimination, unemployment, lack of financial means, and other stressors. We developed and used an iterative approach to refine a MBI group based on MBSR and MBCT, for a racially and ethnically diverse population in the Bronx, considered by the U.S. census to be the most diverse in the country. Based on a trauma-informed care and centering people of color approach, we developed a longer than usual (16 weeks) mindfulness-based group, where core skills were broken down into smaller chunks to facilitate easier incorporation into daily life. We also used a longer duration and 1-hour weekly meeting time keeping in mind needs of the individuals, who often had limited time to participate due to work limitations and other comorbid physical conditions. While acknowledging that the individuals this group was catering to had experienced multiple traumatic events, we sought to also highlight and further develop the resilience and courage people in the Bronx community bring to the table. We review two clinically rich case vignettes, and also discuss recommendations for working with racially and economically marginalized people, and include a call to action for health care providers and organizations to engage in activism.     

Can music bring people together? Effects of shared musical preference on intergroup bias in adolescence

Recent research has successfully applied social identity theory to demonstrate how individuals use music as a basis for intergroup differentiation. The current study investigated how music might also be used to encourage the development of positive intergroup attitudes. Participants (N = 97) were allocated to one of two experimentally created social groups and then led to believe that the groups had similar or different musical preferences. They then evaluated each group and reported their perceptions concerning how they expected their own group to be evaluated by the other group. Participants who believed the groups had similar musical preferences reported more positive intergroup attitudes relative to a control group; they also expected to be evaluated more positively by members of the other group. However, positive intergroup perceptions were also reported by those who believed the two groups had different musical preferences. The implications of these findings for theory and practice are discussed.