The purpose of this study is to better understand the relationships among vision impairment severity, functional disability, coping tendencies, and mental health among middle-aged and older adults who are confronted with chronic vision impairment. Age-related vision loss is the second most prevalent disability among older adults (NCHS, 1993). Its major impact on functional ability and interaction with others has been shown to put individuals at risk for depression and poorer perceived life quality (Horowitz & Reinhardt, 2000). While preliminary evidence shows that coping is a key factor in adaptation to vision loss, this work has contributed more to the understanding of coping patterns that are maladaptive than to learning what may be adaptive. However, optimal interventions depend as much on knowing what is adaptive as on understanding the factors that increase risk for poor mental health. Furthermore, prior research has not included a developmental perspective, and has been limited to the study of older adults. The present study seeks to fill this gap by comparing middle-aged and older adults, and by utilizing a theoretical framework that incorporates a developmental component, and specifies modes of coping that mitigate depression and enable a person to stay resilient in the face of major decline: the model of assimilative and accommodative coping (Brandtstädter, 1999). The insights gained from this study will guide subsequent research that will serve to identify those who are at risk for mental health problems, and to optimize interventions that help individuals adapt to vision impairment as well as to other disabilities.
Participants were 55 middle-aged (40-64) and 52 older adults (65+) experiencing a recent vision impairment. Data were collected through telephone interviews. Multivariate analyses were conducted to explore the interrelationships between vision impairment severity, functional disability, assimilative and accommodative modes of coping, and mental health outcomes among middle-aged and older adults, and to examine if these relationships vary by age. The effect of functional disability on mental health depending on age was also investigated.
Data collection and analyses have been completed. Study findings support the importance of accommodative and assimilative modes of coping for mental health outcome among middle-aged and older adults with a chronic impairment. The two coping modes accounted for a significant proportion of the variance in mental health outcome, even after controlling for sociodemographics and impairment status. Furthermore, the negative direction of the individual effects indicates that the more participants used either of the coping modes, the less mental health problems they reported. The effect of accommodative coping on mental health outcome did not seem to vary depending on age, as had been predicted. However, the role of accommodative coping varied depending on a person's level of disability. Thus, findings demonstrated a critical role of accommodative coping for adaptation, with beneficial effects on mental health that were more pronounced in the case of high disability. Findings also showed that mental health problems were most likely under the condition of younger age and high levels of disability, which suggests that having to deal with disability may pose more of a mental health risk in middle than in late adulthood.
Boerner, K. (2002). Vision Loss, Coping Tendencies, and Mental Health. Final Report to the National Institute of Mental Health. New York: Arlene R. Gordon Research Institute of Lighthouse International.
Boerner, K. (2004). Adaptation to disability among middle-aged and older adults: The role of assimilative and accommodative coping. Journal of Gerontology: Psychological Sciences, 59(1), P35-P42.
Boerner, K., & Jopp, D. (2007). Improvement/Maintenance and Reorientation as Central Features of Coping with Major Life Change and Loss: Contributions of Three Life-Span Theories. Human Development, 50(4), 171-195.
Boerner, K. (November, 2003). Disability and depression in mid- versus late adulthood: The benefits of assimilative and accommodative coping.Poster to be presented at the annual scientific meeting of The Gerontological Society of America, San Diego, CA.
Investigators: Kathrin Boerner, PhD, Principal Investigator
Christopher Meehan, MA, Research Assistant
Funded by: NIMH
Project Period: 11/1/01 - 10/31/02