Theses Doctoral

Psychological Adjustment to Disability: Heterogeneous Trajectories of Resilience and Depression Following Physical Impairment or Amputation

McGiffin, Jed N.

Adjustment to disability is a foundational concept within rehabilitation psychology and constitutes an important public health problem given the adverse outcomes associated with maladjustment. While the disability literature has highlighted depressive elevations in response to functional impairment, resilience and alternative patterns of psychological adjustment have received substantially less empirical inquiry. This dissertation is comprised of three papers, the first two of which are longitudinal studies utilizing distinct samples of individuals with acquired disabilities: a population-sample of physically impaired older adults, and a convenience sample of individuals with newly acquired amputations. The third paper summarizes current data science and statistical findings regarding disability adjustment for patients and their providers. The two longitudinal studies share a common statistical methodology, latent growth mixture modeling (LGMM), allowing for the identification of distinct subgroups (classes) of individuals who share similar symptom profiles over time. LGMM is well-poised to resolve fundamental questions about whether psychological functioning after disability is best described by a population-level archetypal response (i.e., distress and depression that remits over time), or alternatively, whether the data suggest a variety of definable subgroups with distinct psychological trajectories. Results of empirical papers 1 and 2 provide strong empirical evidence that the process of disability adjustment is heterogeneous, with multiple pathways of symptom development and remission. The third paper demonstrates how findings from current rehabilitation science can be utilized to inform psychoeducational materials for practitioners and their patients with recent limb loss. This chapter addresses gaps in dissemination of knowledge by describing various patterns of psychological outcomes encountered by individuals following amputation surgery, as supported by Study 2 and the broader resilience literature.


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More About This Work

Academic Units
Thesis Advisors
Bonanno, George A.
Ph.D., Columbia University
Published Here
October 20, 2020