Psychosocial Predictors of Adjustment to Disability in African Americans
Belgrave, Faye Z., The Journal of Rehabilitation
The purpose of this study was to identify psychosocial variables predictive of adjustment to disability in African Americans. Psychosocial variables were social support, self-esteem, health locus of control, and perception of disability severity. Demographic variables were also included as predictor variables. Data were obtained from 170 African Americans who were disabled. The results of a stepwise multiple regression procedure indicated that three of the psychosocial variables, perception of disability severity, social support, and self-esteem, were significant contributors and accounted for 50% of the variance in explaining adjustment to disability in this sample. None of the demographic variables were significant predictors.
One in seven (14%) working age African Americans is Odisabled (Bowe, 1983). African Americans(1) who are disabled have more unfavorable employment, educational, economic, and rehabilitation outcomes than White Americans. For example, a smaller percentage are employed (16% of African Americans compared to 26% of White Americans). Educational level and household income are also lower for disabled African Americans than Whites (Bowe, 1983). Furthermore, access to and utilization of rehabilitation services are not as available for African Americans as White Americans (Atkins & Wright, 1980; Baldwin & Smith, 1984). Yet, many African Americans with disabilities are adjusted to their disabilities and cope well in the home, at work, and in the community. What personal resources do these individuals have that differentiates them from those who are not as well adjusted? The purpose of this study was to examine the psychosocial resources that predict adjustment to disability in African Americans who are disabled.
Four psychosocial variables were investigated. They were (a) social support; (b) self-esteem; (c) health locus of control; and (d) the perception of disability severity. The study investigated and analyzed these psychosocial variables in combination with select demographic variables that were also expected to be contributors to adjustment to disability. These demographic variables were gender, chronological age, educational level, income, and age at onset of disability.
In this study, adjustment to disability is conceptualized as acceptance of disability. Acceptance of disability is based on Dembo, Leviton and Wright's (1956) and Wright's (1960) theory of acceptance of loss. According to this theory, the process of acceptance of loss is a series of value changes. Acceptance of disability is favorable to the extent that a person: a) is able to see values other than those that are in direct conflict with the disability; b) is able to de-emphasize aspects of physical ability and appearance that contradict his/her disabled situation; c) does not spread his/her handicap beyond his/her actual physical impairment to other aspects of the functioning self; and d) does not compare him/herself to others in terms of areas of limitations but emphasizes his/her own assets and abilities.
The facilitative role of social support on mental and physical outcomes of African Americans with disabilities has been demonstrated in a number of studies (Belgrave & Gilbert, 1989; Belgrave & Moorman-Lewis, 1986; Miller, 1986). In a study of chronically ill African American patients, Belgrave and Moorman-Lewis (1986) found that social support was significantly related to the perception of disease severity. In a study of 100 African American disabled persons, Miller (1986) found that family support was significantly related to adjustment to disability. Social support was hypothesized to be a significant predictor of adjustment to disability in the present study.
The results of a number of studies have documented a positive relationship between self-esteem and adjustment to disability (Heinemann, and Shontz, 1982; Linkowski, and Dunn, 1974; Wissel, 1981). In a review of studies on self-concept and acceptance of disability, Linkowski (1988) found that a positive relationship existed between self-concept and adjustment to disability
regardless of age, disability, or other characteristics of the samples. …