Adjustment To Disability

Front 1

Adjustment to disability:

Back 1

(a)acceptance of disability, esp. as it relates to the ability to retain the value of existing abilities and transcending physical losses
(b) a final stage in the process of psychosocial adaptation to disability that reflects a congruence between the subjective world of the person and the external environment
(c)the ability to manage successfully one's environment and efficiently use problem solving skills

Front 2

Adaptation to disability:

Back 2

-the dynamic process leading the person with a disability to progress from a state of negative wellbeing to that of positive well-being, or from the period immediately following disablement to a more distant time period
-process through which the individual gradually approaches an optimal state of person-environment congruence

Front 3

Psychosocial reactions to chronic illness/disability:

Back 3

-are partially overlapping vs. occurring in a predictable sequence of events
-include 8 reactions in groups of three:
1. Early Reactions: shock, anxiety, denial
2. Intermediate Reactions: depression, internalized anger, externalized hostility
3. Later Reactions: acknowledgment/acceptance, adjustment

Front 4

Shock

Back 4

-one of the first reactions to chronic illness/disability onset
-the result of an overwhelming experience characterized by psychic numbness, cognitive disorganization, and diminished speech and mobility activities
-typically encountered by ind. who have experienced spinal cord injury, tbi, or limb amputations but can be experienced by anyone who experiences onset of a chronic illness/disability

Front 5

Anxiety

Back 5

-an early reaction to chronic illness/disability onset following shock
-resembles panic-like reaction upon initial sensing of the enormity of a traumatic event
-is typified by heightened and uncontrolled feelings of fear, confused thinking, cognitive flooding, a variety of physiological manifestations,, and disorganized overactivity

Front 6

Denial

Back 6

-an early reaction to onset of chronic illness/disability
-an attempt at defense mobilization against the painful realization of the future implications of the illness/disability
-may include unrealistic expectancy of condition improvement or full recovery
-the ind. may present as aloof and indifferent to the condition and its impact on their daily lives and may employ selective attention to surroundings, acknowledging only those facts that support their distorted view allowing them to avoid the reality of their condition

Front 7

Depression

Back 7

-an intermediate response to chronic illness/disability
-is a response to the loss of a body part or function, anticipated deterioration in one's health, or impending death
-clinical manifestations often include: feelings of helplessness, hopelessness, and despair, perceptions of self-depreciation, poor self-regard, attempts at social withdrawal, and psychomotor retardation

Front 8

Internalized anger

Back 8

-an intermediate reaction to chronic illness/disability
-is regarded as a reflection of self-blame
-is manifested via feelings of self-resentment and guilt
-the ind. attributes the onset of the disabling condition and lack of medical progress to one's own behavior and to past faulty health practices
-manifests with depression-like reactions but also with increased bitterness, possible self-injurious acts, and incidents of suicidal ideation

Front 9

Externalized hostility

Back 9

-an intermediate reaction to chronic illness/disability
-is manifested as a form of retaliation against the imposed condition and is directed at other people or aspects of the environment believed to be linked to the conditions onset of lack of improvement
-manifested as acts of aggressiveness, blaming others for encountered mishaps, exhibiting demanding and critical attitudes, and engaging in passive-aggressive activities directed at undermining treatment and rehabilitation practices.

Front 10

Acknowledgement/acceptance

Back 10

-a later reaction to chronic illness/disability
-indicates the person has reconciled with or accepted existence of the condition and has reached a state of cognitive reorganization toward self and the external world
-manifests as the ind. accepting themselves as a person with a disability, reaching a new and positive sense of self-concept, and seeking new life values, meanings, and future goals

Front 11

Adjustment

Back 11

-final stage of psychosocial adaptation to chronic illness/disability
-reflects an affective internalization of the permanency of the condition as well as a socio-behavioral reintegration into a changed life situation
-manifests as the ind. actively pursuing and implementing renewed social and vocational goals, successfully negotiating obstacles encountered during the course of pursing these goals, and reestablishing a positive self-worth

Front 12

General measures of psychosocial adaptation to chronic illness include:

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-General Health Questionnaire (GHQ)
-the Millon Behavioral Health Inventory (MBHI)
-the Psychosocial Adjustment to Illness Scale (PAIS)
-the Sickness Impact Profile (SIP)

Front 13

Unidimensional measures of adaptation to disability include:

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-Acceptance of Disability (AD) Scale
-Acceptance of Loss (AL) Scale
-Bell Disability Scale of Adjustment (BDSA)

Front 14

Multidimensional measures of adaptation to disability include:

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-Q-sort (Heinemann & Shontz)
-the Reactions to Impairment and Disability Inventory (RIDI)

Front 15

Measures of adaptation to specific illnesses/disabilities include:

Back 15

-cancer=Mental Adjustment to Cancer Scale
-diabetes=Diabetic Adjustment Scale
-hearing impairment=Communication Profile for the Hearing Impaired, Meadow-Kendall Social-Emotional Assessment Inventory for Deaf and Hearing-Impaired Students
-rheumatoid arthritis=Arthritis Impact Measurement Scales
-seizure disorders=Washington Psychosocial Seizure Inventory, Adolescent Psychosocial Seizure Inventory
-spinal cord injury=Psychosocial Questionnaire for Spinal Cord Injured Persons
-TBI=Glasgow Assessment Schedule, Portland Adaptability Inventory