Susan Miller Smedema

The Relationship of Coping, Self-Worth, and Subjective Well-Being: A Structural Equation Model

The purpose of this study was to determine the relationship between various coping-related variables and the evaluation of self-worth and subjective well-being among persons with spinal cord injury. Positive coping variables included hope, proactive coping style, and sense of humor, whereas negative coping variables included perceptions of stress, dysfunctional attitudes, and catastrophizing. Evaluations of self-worth were determined by measures of self-esteem and acceptance of disability. Quality of life and life satisfaction were indicators of subjective well-being. The results of the study indicate that negative coping has a negative association with both positive self-worth and subjective well-being. Feelings of positive self-worth were found to be positively associated with subjective well-being. In addition, positive coping appears to influence subjective well-being positively by first increasing feelings of positive self-worth. The findings indicate that coping strategies play an important role in the psychosocial adjustment of individuals with disabilities, and subsequently, in their quality of life. The implications for counseling individuals with disabilities are discussed.

The relationship among frequency and type of internet use, perceived social support, and sense of well-being in individuals with visual impairments.

Purpose. To determine the relationship among amount and type of internet use and perceived social support and subjective well-being in persons with visual impairments. Method. One hundred seventy-five participants were recruited through a letter sent out over 46 national and state listservs for persons with visual impairments and blindness. The mean age of participants was 46.7 years (SD = 13.3), and 50.9% were women. The participants completed a survey containing a demographic questionnaire, an internet use questionnaire, the personal resources questionnaire – 2000 (PRQ-2000), and the sense of well-being inventory (SWBI). Results. Frequency and type of internet use was not significantly related to perceived social support in persons with visual impairments. There was a marginally significant positive association between internet use and overall sense of well-being. Specifically, online chat had a positive association with social support and well-being. Disability-related information seeking and participation in online support groups were negatively associated with well-being. Conclusions. Despite the mixed results of this study, the internet has potential practical implications for increasing the independence and social connectedness in persons with visual impairments.

Substance abuse and psychosocial adaptation to physical disability: analysis of the literature and future directions

Abstract Purpose. To analyse the current state of the literature with respect to substance abuse and psychosocial adjustment in persons with disabilities. Method. The two primary databases containing the literature related to rehabilitation and disability issues (PsychINFO and MedLine) were searched to identify articles addressing the psychosocial impact of substance abuse in persons with disabilities. Eleven empirical articles specifically measuring the strength of the relationship between substance use and psychosocial outcomes in persons with disabilities were selected for analysis. Results. Of the studies identified, five were related to spinal cord injury, three were related to traumatic brain injury, one was related to chronic back pain, one was related to HIV/AIDS, and one was related to persons with any type of disability. Each of the studies used different methodologies, measured substance abuse in different ways, and examined different psychosocial outcome variables. Examination of trends suggested that pre-injury substance abuse appears to be unrelated to acceptance of disability in persons with spinal cord injury and negatively associated with satisfaction in persons with traumatic brain injury. Recent substance abuse tends to have a detrimental effect on psychosocial outcomes across all disability groups. Conclusions. Future research, combined with appropriate pre-service and continuing education related to substance abuse and disability for rehabilitation practitioners, has the potential to lead to improved psychosocial outcomes in persons with disabilities.

Willingness of Graduate Students in Rehabilitation Counseling to Discuss Sexuality with Clients.

The purpose of this study was to obtain a greater understanding of the willingness of graduate students in rehabilitation counseling to discuss sexuality with clients.This was done by testing a model of factors predicted to influence the willingness of rehabilitation counseling master’s students to discuss sexuality with clients, using path analysis.The results of this study suggest that sexuality knowledge, sexuality education, attitudes toward the sexuality of people with disabilities, and comfort with sexuality affect the willingness of rehabilitation counselors to discuss sexuality with clients, with sexuality knowledge and comfort with sexuality having direct effects on willingness. Understanding the relationships between these variables may facilitate the design of interventions that promote the willingness of rehabilitation counselors to discuss sexuality with clients.

The impact of humorous media on attitudes toward persons with disabilities.

Purpose: To examine the relationship between disability-related humor and attitudes toward persons with disabilities in business students (i.e. “future employers”). Method: Students watched one of two films designed to reduce negative attitudes toward persons with disabilities (one humorous in tone and the other serious in tone) or no film at all, and completed a measure of attitudes toward persons with disabilities. Results: Results indicated that, after controlling for previous contact with persons with disabilities, age, and gender, students who watched the humorous film reported significantly more positive attitudes toward persons with disabilities. Conclusions: Disability humor may be an effective means of positively influencing attitudes toward persons with disabilities in future employers. Implications for Rehabilitation The acceptance and integration of persons with disabilities into society continues to be limited by negative attitudes. Previous research has shown that employers with positive attitudes toward persons with disabilities may be more likely to hire a person with a disability than employers with negative attitudes. In this study, students who watched a humorous film reported significantly more positive attitudes toward persons with disabilities than students who watched a serious film or no film at all. Consequently, it may be beneficial to embed disability humor into job-placement strategies in order to improve attitudes and positively influence hiring decisions.

Physical Disability and Substance Use Disorders: A Convergence of Adaptation and Recovery

This article explores issues related to substance use disorders in persons with physical disabilities and the commonalities of the parallel research in recovery and adaptation to disability. An approach for converging these areas of research is presented. Parallel research in substance abuse counseling and rehabilitation counseling reveals that quality of life is an indicator of both adaptation to disability and recovery from substance use disorders. Despite this common outcome, the interaction of adapting to a disability and recovery from a substance use disorder has not been adequately addressed in the literature. A more integrative approach to counseling individuals with disabilities may be achieved with a better understanding of the complex relationship between quality of life, adaptation to disability, and substance use disorder. A converged approach to research is discussed in relation to the development of counseling interventions that improve the quality of life of persons with physical disabilities.

Core Self-Evaluations as a Mediator between Functional Disability and Life Satisfaction in College Students with Disabilities Majoring in Science and Technology.

Purpose: To examine the mediational effect of core self-evaluations (CSE) on the relationship between functional disability and life satisfaction. Methods: A quantitative descriptive design using multiple regression analysis. The participants were 97 college students with disabilities receiving services through Hunter College’s Minority-Disability Alliance (MIND Alliance) in science, technology, engineering, and mathematics. Results: CSE was a partial mediator between functional disability and life satisfaction. After controlling for CSE, functional disability was no longer a significant predictor of life satisfaction. Conclusions: CSE partially mediated the impact of functional disability on life satisfaction. Future research should explore the development of interventions to increase CSE to reduce the effect of disability and to improve life satisfaction and employment outcomes for individuals with disabilities.

Core Self-Evaluations as Personal Factors in the World Health Organization's International Classification of Functioning, Disability and Health Model: An Application in Persons with Spinal Cord Injury.

Purpose: To evaluate Chan, Gelman, Ditchman, Kim, and Chiu’s (2009) revised World Health Organization’s International Classification of Functioning, Disability and Health (ICF) model using core self-evaluations (CSE) to account for Personal Factors in persons with spinal cord injury (SCI). Method: One hundred eighty-seven adults with SCI were recruited to take an online survey including measurement scales representing each component of the revised ICF model: Functioning, Activities, Participation, Environmental Factors, Personal Factors, and Quality Of Life. Path analysis was used to evaluate the hypothesized relationships among the ICF components. Results: A respecified path model revealed a strong model-to-data fit, χ2(3, N = 187) = 6.84; p = .08; goodness-of-fit index (GFI) = .99; comparative fit index (CFI) = .99; and root mean square error of approximation (RMSEA) = .08. Taking into account all of the ICF components, CSE had the strongest direct effect on life satisfaction (β = .40, p < .01). Conclusion: This study supports CSE as a significant and direct predictor of life satisfaction in persons with SCI, indicating that CSE may be an important target for intervention in a biopsychosocial approach toward SCI rehabilitation. These findings provide a basis for future research to investigate the role of CSE in quality of life among people with varying health conditions.

Evaluation of a Multiple Mediator Model of the Relationship between Core Self-Evaluations and Job Satisfaction in Employed Individuals with Disabilities.

Purpose: To test a meditation model of the relationship between core self-evaluations (CSE) and job satisfaction in employed individuals with disabilities. Method: A quantitative descriptive design using Hayes’s (2012) PROCESS macro for SPSS and multiple regression analysis. Two-hundred fifty-nine employed persons with disabilities were recruited from Amazon Mechanical Turk to participate in the study. Results: Support from supervisors, work engagement, wage, and job stress were found to partially mediate the relationship between CSE and job satisfaction. The direct effect of CSE on job satisfaction was still significant after controlling for the effects of all mediators. Conclusions: CSE affected job satisfaction in persons with disabilities, both directly and through improved supervisory support, greater engagement in work, increased pay, and decreased job stress. Implications of the results on rehabilitation counseling practice to improve job satisfaction in clients with disabilities are discussed.

A feminist, biopsychosocial subjective well-being framework for women with fibromyalgia.

Objective: To explore the biopsychosocial predictors of subjective well-being (SWB) in women with fibromyalgia syndrome (FMS) through a framework informed by feminist disability theory. Method: Two hundred twenty-nine women with FMS completed an online survey measuring FMS severity, physician–patient working alliance, meaningful role-functioning, illness centrality, and SWB. Structural equation modeling was used to determine the relationships among the constructs and their statistical contributions to SWB. Several open-ended prompts were used to inform the quantitative results. Results: The results indicated a good fit between the data and the respecified model. All variables significantly contributed to the overall model. FMS severity, meaningful role-functioning, and illness centrality accounted for 79% of the variance in SWB, with the indirect effect of physician–patient working alliance. Conclusion: The present study provided strong support for a biopsychosocial framework encompassing the medical environment, FMS severity, illness centrality, and meaningful role-functioning to predict SWB in women with FMS. As a feminist framework, the primary research model needs further refinement but still has significant implications for conceptualization, treatment, and future research.