Date of Award

1989

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology

First Advisor

Donald A. Williamson

Abstract

Individuals with diabetes face complex health management tasks over a long period and must cope with serious long-term medical complications including retinopathy and resulting blindness and disability. Although it may be expected that psychological problems may accompany loss of vision in adulthood, little research attention has been given to psychological coping and adjustment in this group. Using a stress and coping model, this investigation focused on identifying and measuring stressor, cognitive, and coping variables in order to determine their associations with psychological and functional adjustment in individuals with adult-onset loss of vision. Forty diabetic subjects with vision loss requiring rehabilitation training were individually assessed, using standardized measures in a structured interview format. Another group of 40 demographically similar subjects, with comparable vision loss due to causes other than diabetes, served as a comparison group. Results showed that, as a whole, the subjects exhibited psychological symptoms of mild severity. Individuals with vision loss due to diabetes showed significantly more disability in performance of daily activities than did the comparison group, although the two groups did not differ in severity of their vision loss. Diabetics also expressed a lower overall sense of positive well-being than did nondiabetics. There were no group differences in general psychological symptomatology or depressive symptoms. Similarly, the two groups did not differ in their reported use of eight categories of strategies to cope with blindness. Subjects were more likely to report using positive reappraisal, self-control, and distancing as coping strategies, and less likely to report confrontive coping, escape-avoidance, or accepting responsibility for the blindness. Canonical correlation analyses in the sample as a whole revealed that the presence of diabetes, vision loss of more recent onset, coping by escape-avoidance, accepting responsibility for the vision loss, and an absence of planful problem-solving are most highly associated with disability in daily activities, a diminished sense of well-being, and symptoms of depression. Methodological issues and implications for rehabilitation efforts were discussed.

Pages

130

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