The primary goal of this research is to better understand the implications and consequences of a chronic disability in middle adulthood. Vision impairment is the second most prevalent disability among middleaged and older adults (NCHS, 1993), affecting 7.2 million Americans between the ages of 45 and 64 (The Lighthouse, Inc., 1995). Although little is known about how middle-aged adults deal with such a disability, recent evidence from a prior study conducted by the principal investigator (NIMH 1 R03 MH65382, K. Boerner, PI) shows that the risk for subsequent mental health problems such as clinically relevant levels of depression tends to be higher for middle-aged compared to older adults (Boerner, 2004). Also, the disability is likely to interfere with the pursuit of goals common during this point of adult life, which can result in a significant interruption of daily routines and emotional distress (Wheeler & Munz, 1990).
Research addressing the process of adaptation over the life span has shown that, in the case of loss and decline, adaptive coping approaches involve the ability to adjust one's goals and preferences to what is feasible instead of trying to pursue blocked goals (e.g., Brandtstädter, 1999). Prior work by the PI demonstrated that such coping tendencies were particularly beneficial for the mental health of middleaged adults who reported high levels of vision-related disability (Boerner, 2004). There is also preliminary evidence from a study of vision loss among older adults suggesting that a person's concrete day-to-day coping with goal interference should be assessed in addition to dispositional coping tendencies (Horowitz et al, 2005). Thus, the proposed research seeks to characterize the situation of a thus far understudied group, middle-aged adults with visual impairment, by assessing their important life goals, the extent to which their disability interferes with these goals, and how they cope with this goal interference.
The insights gained from this research will have several important implications: 1) findings can serve to identify those who are at risk for poor adaptation (e.g., developing clinical depression); 2) coping processes identified as beneficial can be incorporated into preventative and therapeutic mental health interventions as well as into rehabilitative treatment programs; and 3) given that intervention goals which encompass important life goals are more likely to result in successful rehabilitation outcomes (Sivaraman Nair, 2003), it is important to understand how life goals can be affected by midlife disability.
200 middle-aged adults (age 40-64) will be recruited from a community-based vision rehabilitation agency. Structural Equation Modeling (SEM) will be employed to test the direct and indirect effects of impairment status, goal interference, and coping on mental health outcomes.
Data collection is in progress.
Project Team: Kathrin Boerner, Ph.D., Principal Investigator
Paula Orozco, B.A, Research Assistant
Luba Popivker, B.A., Research Assistant
Amy Horowitz, PhD, Consultant
Mark Brennan, PhD, Statistical Consultant
Funded by: NIMH
Project Period: 1/1/07 - 12/31/08