Acceptance of Disability among Chinese Individuals with Spinal Cord Injuries: The Effects of Social Support and Depression

Jie Jiao, Mark M. Heyne, Chow S. Lam

Department of Psychology, Illinois Institute of Technology, Chicago, USA.

DOI: 10.4236/psych.2012.329117                

Abstract

This study explored the roles of perceived social support and depression in acceptance of disability among Chinese individuals with spinal cord injuries (SCI). Design: An exploratory and cross-sectional study was conducted in an outpatient rehabilitation center in Guangzhou, China. One hundred Chinese individuals with SCI completed the Multidimensional Scale of Perceived Social Support, Center for Epidemiological Studies Short Depression Scale, and Acceptance of Disability Scale. Results: In general, there was low acceptance of disability and a high prevalence of depression among Chinese individuals with SCI. Higher acceptance of disability was associated with less depressive symptoms and higher level of perceived social support. Furthermore, depression was shown to mediate the relationship between perceived social support and acceptance of disability. Conclusion: Depression is an essential factor in the process of acceptance of disability. Cross-cultural studies are needed to facilitate a better understanding of the adjustment process following disabilities and apply culturally sensitive interventions to promote acceptance of disability.

Keywords

Acceptance of Disability; Depression; Social Support; Spinal Cord Injuries; Chinese

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventive Medicine, 10, 77-84.
[2]	Attawong, T., & Kovindha, A. (2005). The influencing factors of acceptance of disability in spinal cord injured patients. Nepal Journal of Neuroscience, 2, 67-70.
[3]	Baron, R. M, & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psy- chology, 51, 1173-1182. doi:10.1037/0022-3514.51.6.1173
[4]	Beedie, A., & Kennedy, P. (2002). Quality of social support predicts hopelessness and depression post spinal cord injury. Journal of Clinical Psychology in Medical Settings, 9, 227-234. doi:10.1023/A:1016003428370
[5]	Belgrave, F. Z. (1991). Psychosocial predictors of adjustment to disability in African Americans. Journal of Rehabilitation, 57, 37-40.
[6]	Chan, R. C. K., Lee, P. W. H, & Lieh-Mark, F. (2000). The pattern of coping in persons with spinal cord injuries. Disability and Rehabil- itation, 22, 501-507. doi:10.1023/A:1016003428370
[7]	Cheung, C. K., & Bagley, C. (1998). Validating an American scale in Hong Kong: The Center for Epidemiological Studies Depression Scale (CES-D). The Journal of Psychology, 132, 169-186. doi:10.1080/00223989809599157
[8]	Chou, K. L. (2000). Assessing Chinese adolescents’ social support: The multidimensional scale of perceived social support. Personality and Individual Differences, 28, 299-307. doi:10.1016/S0191-8869(99)00098-7
[9]	Chronister, J. A., Johnson, E. K., & Berven, N. (2006). Measuring social support in rehabilitation. Disability and Rehabilitation, 28, 75- 84. doi:10.1016/S0191-8869(99)00098-7
[10]	Dahlem, N. W., Zimet, G. D., & Walker, R. (1991). The multimensional scale of perceived social support: A conformation study. Journal of Clinical Psychology, 47, 756-761. doi:10.1002/1097-4679(199111)47:6<756::AID-JCLP2270470605>3.0.CO;2-L
[11]	Draguns, J. G. (1996). Abnormal behaviour in Chinese societies: Clinical, epidemiological, and comparative studies. In M. H. Bond (Ed.), Handbook of Chinese psychology (pp. 412-428). Hong Kong: Oxford University Press.
[12]	Elliott, T. R. (1999). Social problem-solving abilities and adjustment to recent-onset spinal cord injury. Rehabilitation Psychology, 44, 315- 332. doi:10.1037/0090-5550.44.4.315
[13]	Elliott, T. R., Kurylo, M., & Rivera, P. (2002). Positive growth follow- ing acquired physical disability. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 687-699). New York: Oxford University Press.
[14]	Elliott, T. R., Uswatte, G., Lewis, L., & Palmatier, A. (2000). Goal in- stability and adjustment to physical disability. Journal of Counseling Psychology, 47, 251-265. doi:10.1037/0022-0167.47.2.251
[15]	Green, B., Pratt, C., & Grigsby, T. (1984). Self-concept among persons with long-term spinal cord injury. Archives of Physical Medicine and Rehabilitation, 65, 751-754.
[16]	Hampton, N. Z. (2001). Disability status, perceived health, social support, self-efficacy, and quality of life among people with spinal cord injury in the People’s Republic of China. International Journal of Rehabilitation Research, 24, 69-71. doi:10.1097/00004356-200103000-00010
[17]	Hampton, N. Z. (2004). Subjective well-being among people with spinal cord injuries: The role of self-efficacy, perceived social support, and perceived health. Rehabilitation Counseling Bulletin, 48, 31-37. doi:10.1177/00343552040480010401
[18]	Hampton, N. Z., & Qin-Hilliard, D. B. (2004). Dimensions of quality of life for Chinese Adults with spinal cord injury: A qualitative study. Disability and Rehabilitation, 26, 203-212. doi:10.1080/09638280310001639704
[19]	Hwu, H. G., Chang, I. H., Yeh, E. K., Chang, C. J., & Yeh, L. L. (1996). Major depressive disorder in Taiwan defined by the Chinese Diagnostic Interview Schedule. Journal of Nervous and Mental Disease, 184, 497-502. doi:10.1080/09638280310001639704
[20]	Joiner, J. G., Lovett, P. S., & Goodwin, L. K. (1989). Positive assertion and acceptance among persons with disabilities. Journal of Rehabilitation, 2, 22-29.
[21]	Keaney, K. C. M. H., & Glueckauf, R. L. (1993). Disability and value change: An overview and reanalysis of acceptance of loss theory. Rehabilitation Psychology, 38, 199-210. doi:10.1037/h0080297
[22]	Kemp, B. J, & Krause, J. S. (1999). Depression and life satisfaction among people ageing with post-polio and spinal cord injury. Disability and Rehabilitation, 21, 241-249. doi:10.1080/096382899297666
[23]	Kendall, E., & Buys, N. (1998). An integrated model of psychosocial adjustment following acquired disability. Journal of Rehabilitation, 64, 16-20.
[24]	Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., Wittchen, H., Kendler, K. S. (1994). Lifetime and 12- month prevalence of DSM-III-R psychiatric disorders in the United States. Archives of General Psychiatry, 51, 8-19. doi:10.1001/archpsyc.1994.03950010008002
[25]	Krause, J. S., Brotherton, S. S., Morrisette, D. C., Newman, S. D., & Karakostas, T. E. (2007). Does pain interference mediate the rela- tionship of independence in ambulation with depressive symptoms after spinal cord injury? Rehabilitation Psychology, 52, 162-169. doi:10.1037/0090-5550.52.2.162
[26]	Linkowski, D. (1971). A scale to measure acceptance of disability. Re- habilitation Counseling Bulletin, 14, 236-244.
[27]	Lorig K. R., Sobel, D. S., Ritter P. L., Laurent, D., & Hobbs, M. (2001). Effects of a self- management program for patients with chronic disease. Effective Clinical Practice, 4, 256-262.
[28]	Martz, E., Livneh, H., Preibe, M., Wuermser, L. A., & Ottomanelli, L. (2005). Predictors of psychosocial adaptation among people with spinal cord injury or disorder. Archives of Physical Medicine and Rehabilitation, 86, 1182-1192. doi:10.1016/j.apmr.2004.11.036
[29]	Melamed, S., Groswasser, Z., & Stern, M. J. (1992). Acceptance of disability, work involvement and subjective rehabilitation status of traumatic brain-injured (TBI) patients. Brain Injury, 6, 233-243. doi:10.3109/02699059209029665
[30]	Morris, M. W., & Peng, K. (1994). Culture and cause: American and Chinese attributions for social and physical events. Journal of Personality and Social Psychology, 67, 949-971. doi:10.1037/0022-3514.67.6.949
[31]	Parker, G., Chan, B., Tully, L., & Eisenbruch, M. (2005). Depression in the Chinese: The impact of acculturation. Psychological Medicine, 35, 1475-1483. doi:10.1017/S0033291705005623
[32]	Perry, K. N., Nicholas, M. K., & Middleton, J. (2009). Spinal cord injury-related pain in rehabilitation: A cross-sectional study of relationship with cognition, mood and physical function. European Journal of Pain, 13, 511-517. doi:10.1016/j.ejpain.2008.06.003
[33]	Post, M. W. M., Ros, W. J. G, & Schrijvers, A. J. P. (1999). Impact of social support of health status and life satisfaction in people with spinal cord injury. Psychology and Health, 14, 679-695. doi:10.1080/08870449908410757
[34]	Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401. doi:10.1177/014662167700100306
[35]	Richards, J. S., Kewman, D. G., & Pierce, C. A. (2000). Spinal cord injury. In F. G. Frank & T. R. Elliott (Eds.), Handbook of Rehabilitation Psychology (pp. 11-27). Washington, DC: American Psychological Association. doi:10.1037/10361-001
[36]	Sherman, J. E., DeVinney, D. J., & Sperling, K. B. (2004). Social support and adjustment after spinal cord injury: Influence of past peermentoring experiences and current live-in partner. Rehabilitation Psychology, 49, 140-149. doi:10.1037/0090-5550.49.2.140
[37]	Short, K. H., & Johnston, C. (1997). Stress, maternal distress, and children’s adjustment following immigration: The buffering role of so- cial support. Journal of Consulting and Clinical Psychology, 65, 494-503. doi:10.1037/0022-006X.65.3.494
[38]	Snead, S. L., & Davis, J. R. (2002). Attitudes of individuals with acquired brain injury towards disability. Brain Injury, 16, 947-953. doi:10.1080/02699050210147211
[39]	Triandis, H. C., Bontempo, R., Betancourt, H., Bond, M., Leung, K., Brenes, A., Georgas, J., Hui, C. H., Martin, G., Setiadi, B., Sinha, J., Verma, J., Spangenberg, J., Touzard, H. & Montmollin, G. (1986). The measurement of the etic aspects of individualism and collectivism across cultures. Australian Journal of Psychology, 38, 257-267. doi:10.1080/00049538608259013
[40]	Wright, B. A. (1983). Physical disability: A psychosocial approach (2nd ed.). New York: Harper & Row. doi:10.1037/10589-000
[41]	Wu, W. D., & Lu, T. H. (1999). The Chinese translated version of acceptance of disability scale. Taipei: National Taiwan Normal University.
[42]	Yang, K. S. (1981). Social orientation and individual modernity among Chinese students in Taiwan. Journal of Social Psychology, 113, 159- 170. doi:10.1080/00224545.1981.9924368
[43]	Yen, S., Robins, C. J., & Lin, N. (2000). A cross-cultural comparison of depressive symptom manifestation: China and the United States. Journal of Consulting and Clinical Psychology, 68, 993-999. doi:10.1037/0022-006X.68.6.993
[44]	Zhang, J., & Norvilitis J. M. (2002). Measuring Chinese psychological well-being with western developed instruments. Journal of Personality Assessment, 79, 492-511. doi:10.1207/S15327752JPA7903_06
[45]	Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30-41. doi:10.1207/s15327752jpa5201_2