Anxiety at 13 and its effect on pain,pain-related anxiety,and pain-related disability at 17: An ALSPAC cohort longitudinal analysis

The aim of the present study was to investigate the influence of anxiety at 13 years of age on the presence of chronic pain, pain-related anxiety, and pain-related disability at 17 years of age in a large longitudinal cohort. We hypothesized that mother-reported anxiety at 13 would be associated with the presence of chronic pain at 17 and an increase in pain-related anxiety using all available data from the longitudinal cohort. Further, we hypothesized that anxiety at 13 would predict pain-related disability in adolescents who reported chronic pain at 17 years of age. Participants were recruited from the Avon Longitudinal Study of Parents and Children based in the UK who attended a university research clinic at 17. Child anxiety (reported by the mother) was extracted at child age 13, and self-report of the presence of chronic pain, pain-related anxiety, and pain-related disability at 17. Analyses revealed that child anxiety at 13 was not significantly associated with the presence of chronic pain at 17 (n = 842). However, anxiety at 13 was significantly associated with pain-related anxiety at 17 (n = 1831). For the subsample of adolescents who reported chronic pain, anxiety at 13 was associated with pain-related disability at 17 (n = 393). Further analyses revealed that pain-related anxiety at 17 mediated the association between anxiety at 13 and pain-related disability at 17, suggesting that pain-related anxiety should be a target for treatment in adolescents with chronic pain, to reduce the impact of pain in later adolescence. General anxiety at 13 was unrelated to the presence of chronic pain at 17, but should be considered a risk factor for later pain-related anxiety and disability in a subset of adolescents who develop chronic pain.     

Representing disability in charity promotions

Social psychological research in relation to charity advertising in the area of disability has attempted to distinguish between ‘positive’ and ‘negative’ images and the way in which these are related to their fundraising potential. In the light of the critique of charity advertising offered by a number of disability theorists, it is suggested that this perspective would be enhanced by consideration of the attitudes of disabled people to charity advertisements. A study is reported that compares the attitudes of disabled and non‐disabled people to two charity advertisements. Differences between these two groups are reported and in the light of the nature of these it is suggested that what are considered to constitute ‘positive images’ is unlikely to be consensual. Copyright © 1999 John Wiley & Sons, Ltd.     

Reducing bias in psychometric assessment of culturally and linguistically diverse students from refugee backgrounds in Australian schools: A process approach

The present article examines a process developed within Brisbane Catholic Education to reduce bias in assessment of students from refugee backgrounds when there is a concern about a possible intellectual disability. Several factors impacting upon assessment are described including previous trauma, language, lack of previous schooling and acculturation difficulties. A proactive process (Support Process for the Assistance and Assessment of Students from Refugee Backgrounds) is described involving broad‐based, longitudinal collection of data by the school psychologist as part of a support team. Factors to consider in conducting standardised psychometric assessments are discussed. Strengths and limitations of this process as well as the need for future research into its effectiveness are summarised.     

Beyond the 'Awkward Embrace': DisabilityRights, Dialogue and 'Law, Loveand Language' Revisited

Despite the perceived 'human rights revolution' within Church teaching since Vatican II, a measure of dissonance survives between secular rights theory and practice on the one hand and, on the other, ethical thinking informed by the natural law tradition. This article examines some recent developments in that secular theory and practice for signs of possible rapprochement. In particular, it considers the way in which the emergence of 'disability' as a rights issue, for example in the recently ratified United Nations Convention on the Rights of Persons with Disabilities, has contributed to the transformation of equality and human rights law and so has helped shape a broader transformation of rights theory and practice. Central to that transformation has been the ambition of establishing human rights as the basis of a progressive political programme, as witnessed for example by the work of Sandra Fredman and by the Hamlyn Lectures of Conor Gearty, whose Catholic provenance makes his approach especially salient. The article concludes by considering Herbert McCabe's interpretation of Aquinas' ethics, especially in his Law, Love and Language , and proposes some potentially fruitful points of contact between McCabe's approach and the identified developments in secular rights theory.     

INTRODUCTION: RETHINKING PHILOSOPHICAL PRESUMPTIONS IN LIGHT OF COGNITIVE DISABILITY

Abstract: This Introduction to the collection of essays surveys the philosophical literature to date with respect to five central questions: justice, care, agency, metaphilosophical issues regarding the language and representation of cognitive disability, and personhood. These themes are discussed in relation to three specific conditions: intellectual and developmental disabilities, Alzheimer's disease, and autism, though the issues raised are relevant to a broad range of cognitive disabilities. The Introduction offers a brief historical overview of the treatment cognitive disability has received from philosophers, and explains the specific challenges that cognitive disability poses to philosophy. In briefly summarizing the essays in the collection, it highlights the distinctive contributions the collection makes to ethics, political philosophy, bioethics, and the philosophy of disability. We hope that the richness of the topics explored by these essays will be a spur to further investigation.     

THE PERSONAL IS PHILOSOPHICAL IS POLITICAL: A PHILOSOPHER AND MOTHER OF A COGNITIVELY DISABLED PERSON SENDS NOTES FROM THE BATTLEFIELD

Abstract: Having encountered landmines in offering a critique of philosophy based on my experience as the mother of a cognitively disabled daughter, I ask, "Should I continue?" I defend the idea that pursuing this project is of a piece with the invisible care labor that is done by people with disabilities and their families. The value of attempting to influence philosophical conceptions of cognitive disability by virtue of this experience is justified by an inextricable relationship between the personal, the political, and the philosophical. If one grants that the "special relationship" between mother and child requires moral recognition, then I need first to make vivid the case that this relationship in the case of a child who lacks some "normal capacities" is indistinguishable from any mother-child relationship. If this is so, then I believe I can make a case that has as its conclusion that the moral personhood of even the severely cognitively disabled must be granted. Moreover, such recognition, I argue, necessitates the recognition of others who bear no special relationships to the child.     

SPECIESISM AND MORAL STATUS

Abstract: Many people believe that all human life is of equal value. Most of them also believe that all human beings have a moral status superior to that of nonhuman animals. But how are these beliefs to be defended? The mere difference of species cannot in itself determine moral status. The most obvious candidate for regarding human beings as having a higher moral status than animals is the superior cognitive capacity of humans. People with profound mental retardation pose a problem for this set of beliefs, because their cognitive capacities are not superior to those of many animals. I argue that we should drop the belief in the equal value of human life, replacing it with a graduated view that applies to animals as well as to humans.     

EQUALITY, FREEDOM, AND/OR JUSTICE FOR ALL: A RESPONSE TO MARTHA NUSSBAUM

Abstract: This essay is a reply to Martha Nussbaum's "Capabilities and Disabilities." It endorses Nussbaum's critique of the social-contract tradition and proposes that it might be productively contrasted with Michael Walzer's critique of John Rawls in Spheres of Justice . It notes that Nussbaum's emphasis on surrogacy and guardianship with regard to people with severe and profound cognitive disabilities poses a challenge to disability studies, insofar as the field tends to emphasize the self-representation of people with disabilities and to concentrate primarily on the aesthetic and political representation of physical disability. The essay concludes with an account of a recent exchange with Peter Singer on the question of our social expectations of people with Down syndrome.     

COGNITIVE DISABILITY AND COGNITIVE ENHANCEMENT

Abstract: This essay explores problems of consistency among commonsense beliefs about the comparative moral status of animals, fetuses, and human beings congenitally endowed with cognitive capacities and potential no higher than those of higher animals. The possibility of genetic cognitive enhancement exacerbates some of these problems, but also offers new resources for understanding the basis of our moral status as inviolable.     

Constructions and Reconstructions: Latino Parents' Values for Children

There is a fair amount of support for the premise that parents construct their child-related values from the ethnic cultural models that are available to them. There are also indications that personal experiences play a role in the construction of values. However, this latter influence has not been well-researched. We reconstructed the child-related values of a sample of Mexican American and Puerto Rican parents of young children with disability to describe parent-held values and to examine the extent to which having a child with a disability impacted on these values. Analysis of parental ratings and of their narratives indicated substantial consistency across gender, civil status, and country of origin. Disability appeared to have a small and diffused impact on the values. Ratings differed significantly on the basis of the language of interview, and the definitions that parents offered also showed an effect of interaction with the Anglo American culture. However, an in-depth examination of these differences indicated that they were mostly restricted to labeling. The basic values of parents remained fairly consistent. This finding has substantial implications for research and practice. Equivalence of meaning should not be assumed across populations.