The Psychological Consequences of Disability over the Life Course: Assessing the Mediating Role of Perceived Interpersonal Discrimination

Abstract

We examine whether perceived interpersonal discrimination mediates the association between disability and psychological well-being (depression, negative and positive affect) and how these processes differ across the life course. Data are from two waves (2004–2006; 2013–2014) of the Midlife in the United States (MIDUS; N = 2,503). Perceived discrimination accounts for 5% to 8% of the association between disability and the three mental health outcomes. Moderated mediation analyses reveal significant age differences; perceived discrimination is a stronger explanatory mechanism among midlife (ages 40–64) relative to older (age 65+) adults. Disability stigma takes a heightened psychological toll at midlife, a life stage when adults are expected to be able-bodied and interact with a diverse social network, which may be a source of interpersonal mistreatment. Among older adults, for whom impairment is expected and common, the psychological impact of disability may operate through other pathways. We discuss implications for research and practice.

Depression and Anxiety Symptoms in UK Thalidomide Survivors: A Brief Survey

“…Although there is substantial evidence that people with disabilities are more likely to report depressive symptoms, the relationship between physical disability and depression is complex. Much of the literature focusses on older adults, and our understanding of this relationship in working-age adults, especially those with early acquired impairments, is still developing [9,12,13]. Kemp and Mosqueda (2004) [22] made the point that whilst rates of depression are higher amongst people with disabilities, impairment alone does not cause depression.…”

“…There are differing views about whether people with early acquired impairments have higher subjective well-being than those disabled later in life [9,[27][28][29][30]. However, there is now growing evidence of the cumulative impact of disability on mental health [10,12,13]. Stress perspectives [31,32] suggest that people with disabilities are likely to experience more negative life events throughout their lives (e.g., discrimination, health problems, and financial pressures).…”

“…In the wider disability literature, the link between disability and depression is well established. There is also substantial evidence about the possible reasons for this association, notably that people with disabilities are likely to experience the negative effects of: lower levels of social integration; activity limitations, barriers to employment; financial difficulties; and both structural and interpersonal discrimination [9][10][11][12]. However, what is less well understood is the cumulative impact of these disadvantages, especially for those with early acquired impairments, and how this impact might change over the life course [13,14].…”

American Older Adults in COVID-19 Times: Vulnerability Types, Aging Attitudes and Emotional Responses

“…Other covariates in the current study including sex (male/female), age (≤ 65/ 65), race (Hispanic/Non-Hispanic white/Non-Hispanic Black/Others), marital status (married/partnered/uncoupled), educational level (less than high school/high school diplomacy/some college or above), household wealth (relatively poor/mid-level/rich), Medicaid eligibility (yes/no), number of di culties in activities of daily life (none/one and more) and selfreported health status (poor/fair/good/very good/excellent). These variables are associated with subjective well-being among older adults in the United States [43,44].…”

The “Own” and the “Wise” Revisited: Physical Disability, Stigma, and Mental Health among Couples

“…These challenges help explain why people with disabilities disproportionately marry or partner with other persons with disabilities (Andrews and Dunn 2019;Nguyen et al 2016). These experiences of prejudice and discrimination also help contextualize the strong and pervasive link between variation in stigma perceptions (henceforth referred to as stigma) and variation in psychological distress observed among people with physical disabilities (Brown 2017;Heräjärvi et al 2020;Namkung and Carr 2020;Quinn and Chaudoir 2009). There is remarkably little research, however, on stigma and relationships among those with physical disabilities who are coupled or their partners.…”