Erin Martz

Coping with chronic illness and disability

Coping with chronic illness and disability : , Coping with chronic illness and disability : , کتابخانه دیجیتال جندی شاپور اهواز

DEATH ANXIETY AS A PREDICTOR OF POSTTRAUMATIC STRESS LEVELS AMONG INDIVIDUALS WITH SPINAL CORD INJURIES

Because the onset of a spinal cord injury may involve a brush with death and because serious injury and disability can act as a reminder of death, death anxiety was examined as a predictor of posttraumatic stress levels among individuals with disabilities. This cross-sectional study used multiple regression and multivariate multiple regression to examine whether death denial and death awareness predicted posttraumatic stress disorder (PTSD) among veterans and civilians with spinal cord injuries (N = 313). The results indicated that death anxiety (after controlling for demographic and disability-related variables) predicted a significant amount of the total levels of posttraumatic stress reactions among individuals with spinal cord injuries. Further, death awareness, pain level, and spiritual/religious coping significantly predicted the posttraumatic stress clusters of reexperiencing, avoidance, and hyperarousal. Death denial significantly predicted only hyperarousal. Because death anxiety predicts various aspects of PTSD reactions, one possible therapeutic implication is that addressing death-related topics may help to reduce PTSD reactions. Further research is needed to better ascertain the possible causality among these variables.

Do Posttraumatic Reactions Predict Future Time Perspective Among People With Insulin-Dependent Diabetes Mellitus?

One of the major tasks of developing an Individual Plan of Employment (IPE) during the rehabilitation counseling process is setting a vocational goal. For more than half a century, researchers (Frank, 1939; Lewin, 1943; Nuttin, 1985; Teahan, 1958) have stated that goalsetting implies a future time orientation, which can be defined as an interest or engagement in one’s personal future. Some clients undergoing rehabilitation have difficulty thinking about their long-term vocational futures, which may be the result of a variety of factors, including an altered capacity of having a future time perspective following trauma (American Psychiatric Association [APA], 2000; Terr, 1983). Several rehabilitation counseling/ psychology textbooks have noted that some clients lack a future orientation, to the detriment of their vocational future (Anthony, Cohen, & Farkas, 2001; Fischler & Booth, 1999). In view of the potential rehabilitation implications of a truncated future orientation, this study sought to examine the effect of posttraumatic reactions on future time perspectives of individuals with insulin-dependent diabetes mellitus (IDDM).

Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature

Purpose This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability. Methods Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment. Conclusion The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers.

Psychosocial Adaptation to Chronic Illness and Disability: A Preliminary Study of its Factorial Structure

This study examined the factorial structure of psychosocial adaptation to chronic illness and disability in a sample of 313 individuals who sustained spinal cord injury (SCI). Three models were examined. The first model tested the hypothesis that psychosocial adaptation is composed of a single, global factor, in which positive (adaptive) and negative (nonadaptive) reactions define two opposing poles of the same dimension. The second model tested the validity of two distinguishable factors, representing adaptive and nonadaptive dimensions. The third model examined the relationship between the 2-factor model and a third dimension, that of denial. The data from the instruments measuring psychosocial adaptation to trauma and disability (the Reactions to Impairment and Disability Inventory and the Purdue Posttraumatic Stress Disorder-Revised) were submitted to a series of confirmatory factor analyses, and the results from the goodness of fit tests and fit indices provided strong support to the validity of the latter two models. The findings indicated that the structure of adaptation to SCI can be best conceptualized as representing two, moderately linked but clearly distinguishable, factors and that the construct of denial of disability further elucidates our understanding of the structure of adaptation to loss of body integrity.

Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Philosophical Aspects and Historical Roots

Purpose The purpose of this article is to review the conceptual and clinical similarities that exist between the principles of positive psychology and those underlying rehabilitation counseling and psychology, occupational rehabilitation, and those espoused by the field of psychosocial adaptation to chronic illness and disability (CID). Methods Three themes were selected for review. These included the historical contributions of early scholars in the area of psychosocial adaptation to CID that later were indirectly infused into mainstream positive psychology; state and trait constructs that constitute much of the infrastructure of positive psychology and psychosocial adaptation to CID; and, finally, the philosophical congruencies between positive psychology and psychosocial adaptation to CID. Conclusion The existing literature indicates that there is a substantial philosophical and conceptual overlap between the fields of positive psychology and psychosocial adaptation to CID. Since theoreticians and researchers, from both fields, often use differing terminology and definitions to describe similar concepts, as well as seek similar research goals, it would behoove both fields to seek a closer partnership in order to establish a meaningful dialogue that focuses on human strengths and virtues in the lives of people with CID.

PSYCHOSOCIAL ADAPTATION TO SPINAL CORD INJURY: A DIMENSIONAL PERSPECTIVE'

From 313 individuals who sustained spinal cord injuries self-reported responses were examined on their psychosocial adaptation to disability and perceived quality of life. A multidimensional scaling analysis yielded a 2-dimensional structure of adaptation. The first dimension indicated adaptive versus nonadaptive reactions. The second dimension was suggestive of denial versus realization of the affect related to the medical impairment.

Disability Prototypes in the United States and the Russian Federation:An International Comparison

The purpose of this cross-cultural research is to examine prototypical perspectives about disability groups in the United States and Russia by extending the research on disability prototypes that was conducted by McCaughey and Strohmer. Open-ended questions permitted participants to describe what they thought were prototypical characteristics of people in three disability groups (AIDS, hearing impairment, and spinal cord injury). A series of chi-square analyses indicate that there are significant differences across superordinate categories between the two countries, in addition to significant differences within two superordinate categories when examining the two samples across three disability categories.Tentative conclusions of the findings, possible implications for rehabilitation counselors, and directions for further research are briefly discussed.

Posttraumatic Growth Moderates the Effect of Posttraumatic Stress on Quality of Life in U.S. Military Veterans with Life-Threatening Illness or Injury

• Facilitating PTG among U.S. Veterans who experienced life-threatening illness or injury can help to bolster quality of life of those individuals. This is of particular importance in those Veterans who, additionally, have experienced PTSD during their service.

A Pilot Randomized Clinical Trial Comparing Three Brief Group Interventions for Individuals With Tinnitus

Background Tinnitus (ie, ear or head noises not caused by external sounds) is common among the general population and is the most prevalent service-connected disability in the United States’ Department of Veterans Affairs system. While numerous clinical interventions have been created to systematically address the range of issues caused by tinnitus, only a few tinnitus interventions have focused on both teaching and assessing coping strategies. The present pilot study involved a randomized clinical trial comparing 3 brief group interventions to a usual-care (UC) group (ie, a wait-list control group): the first intervention based on acceptance and commitment therapy (ACT), a second based on cognitive-behavioral therapy (CBT), and a third based on coping effectiveness training (CET). Each intervention group also received tinnitus-related audiological education. Participants Forty individuals met the eligibility requirements and were randomized into 1 of the 4 groups (ACT, CBT, CET, or UC). An intent-to-treat analysis was used in this study. Measures The Brief COPE scale was used to assess coping. Coping was assessed at 3 time points (pre-intervention, post-intervention, and at 4-week follow-up). The outcomes were 3 coping factors (engagement coping, disengagement coping, and social support coping). Results When examining differences among the groups on mean coping scores over time, significant group differences were found on social support coping, with the CET group scores significantly higher than the UC group. Discussion While all 3 brief interventions teach stress-reduction techniques, ACT and CBT focus primarily on managing one’s unwanted thoughts and emotions. CET teaches participants both a range of coping strategies (eg, stress-management approaches) to more effectively manage stressors that cannot be changed, as well as coping strategies (eg, such as problem-solving) that can be used to eliminate stressors that can be changed. CET also teaches communication skills for telling others about one’s tinnitus-related issues. CET instructs individuals on how to select coping strategies that are appropriate for different kinds of stressors and how to seek social support, which is a skill not explicitly taught by ACT or CBT. Results of this study were derived from a small sample size, and thus, future research should focus on replicating the results among a larger sample. In addition, future research could focus on adapting the CET intervention to a different delivery format.