Academic journal article The European Journal of Counselling Psychology

Adaptation to Physical Disabilities: The Role of Meaning in Life and Depression

Academic journal article The European Journal of Counselling Psychology

Adaptation to Physical Disabilities: The Role of Meaning in Life and Depression

Article excerpt


Currently, people with physical disabilities constitute a very large and simultaneously a heterogeneous group of general population, as the term physical disabilities is broad and covers a wide range of disabilities, including both congenital and acquired disabilities. The onset of an individual's physical disability or chronic illness brings great changes in all aspects of his/her life (Corbin & Strauss, 1987; Morse, 1997). More specifically, an individual with an acquired physical disability experiences the loss of many components of his/her identity: loss of independence, body integrity and mobility, loss of pre-existent roles, regarding his/her job and his/her social relationships (Gordon & Benishek, 1996), resulting in a total functional discount (Charmaz, 1995; Gellman, Sie, & Waters, 1988; Gerhart, Bergstrom, Charlifue, Menter, & Whiteneck, 1993). Therefore, individuals with physical disabilities are often confronted with a new, threatening and stressful reality (Butt & Lanig, 1996; Cohen & Williamson, 1988; Falvo, 1999; Horowitz, 1986), leading possibly to a psychosocial crisis in their lives (Livneh & Antonak, 1997; Moos & Schaefer, 1984), due to the great changes they experience in somatic, psychological, socio-economic, vocational and psychological level.

The individual's adjustment to such a painful situation definitely demands time. It seems that adaptation to physical disability is a complex process depending on many subjective and social parameters, which determine whether or not an individual will accept his/her disability and socially re-integrate, negotiating his/her new identity and roles in personal and social level. Indeed, Livneh and Antonak (1997) define psychosocial adaptation to chronic illness and disability as the final phase of an adaptation process during which the individual achieves a state of reintegration, positive striving to reach life goals, positive self-esteem and demonstrating positive attitudes toward oneself, others and disability.

The onset of a chronic illness or disability typically triggers a chain of psychological reactions, which correspond to eight phases of responses to physical disability (Livneh & Antonak, 2005). Phases 1 to 6 (Shock, Anxiety, Denial, Depression, Internalized anger, Externalized anger) include the initial stages of adaptation (representing negative adaptation to disability), which an individual hopefully goes through, in order to reach phase 7 and/or phase 8 (Acknowledgement, Adjustment), which are considered as the final phases of adaptation and represent positive adaptation to disability.

Researchers have found that persons with acquired physical disabilities, who adjust more successfully to their disabilities are physically and psychologically healthier (Livneh, Lott, & Antonak, 2004; Snead & Davis, 2002). On the contrary, the difficulty of an individual to accept his/her physical disability has been associated with poor physical health (Matthews & Harrington, 2000), and several psychopathological symptoms (Garofalo, 2000; Livneh et al., 2004; Turner, Lloyd, & Taylor, 2006). Additionally, many research data have yielded that people with physical disabilities and chronic illnesses often experience negative emotional situations, especially depression (Livneh & Antonak, 1997; Livneh & Wilson, 2003; McDermott, Moran, Platt, & Dasari, 2007; Mitra, Wilber, Allen, & Walker, 2005; Tsivgoulis et al., 2007; Vahle, Andresen, & Hagglund, 2000).

In fact, the prevalence of depressive disorders in people with physical disabilities, according to bibliography, varies between 6-77% regarding the acquired physical disabilities, such as traumatic brain injury (Alderfer, Arciniegas, & Silver, 2005; Hibbard, Uysal, Kepler, Bogdany, & Silver, 1998; Hughes, Swedlund, Petersen, & Nosek, 2001; Jorge & Starkstein, 2005; Koponen et al., 2002; Kreutzer, Seel, & Gourley, 2001), spinal cord injury (Dryden et al. …

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