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Overview

Research with older adults confronted with health-related stressors, such as stroke, has shown that overprotection, a form of negative support, not only leads to depression but also hinders successful rehabilitation outcomes leading to unnecessary disability. The impact of overprotection on adjustment to age-related vision loss, however, stands mostly unexplored. Moreover, very little is known about factors predicting perceived overprotection in this population. This is unfortunate because vision loss is often associated with falls and injuries, and therefore overprotection from significant others might be especially likely in visually impaired elders because of the safety issues involved. Secondary analyses were conducted for two purposes. The first was to investigate the impact of perceived overprotection and other social support variables, namely instrumental, affective, and negative support, on the adjustment to agerelated vision loss and the other purpose was to identify longitudinal predictors of perceived overprotection.

Method

Study participants were 400 (58% female) elders with a recent vision loss, who were first time applicants to a vision rehabilitation service agency. Participants constituted a subsample of individuals involved in a large-scale longitudinal study on the interrelationships among depression, vision loss, and rehabilitation use (Dr. Amy Horowitz, PI; Dr. Joann P. Reinhardt, Co-PI). Perceived overprotection by family and friends/neighbors was measured using the 9-item short version of Overprotection Scale for Adults (OPSA; Thompson & Sobolew-Shubin, 1993a). In addition, the frequency of other types of support (instrumental, affective, and negative) received over the past month from family, friends, and neighbors was assessed employing items specifically designed for this study. The items were based on Morgan's and Rook's work. Optimal adjustment was operationalized as having high environmental mastery (an indicator of psychological well-being) and high scores on a vision-specific adaptation measure (AVL; Horowitz & Reinhardt, 1998). For 297 of these participants, data from a 6-month follow-up interview were available, including data on the use of vision rehabilitation services.

Findings

The Impact of Perceived Overprotection on Adjustment to Age-Related Vision Loss - The primary goal of these cross-sectional analyses was to investigate the impact of perceived overprotection, a negative social network variable, and other social support variables, namely instrumental, affective, and negative support, on the adjustment to age-related vision loss. Optimal adjustment was operationalized as having high environmental mastery (an indicator of psychological well-being) and high scores on a vision-specific adaptation measure. Path analysis results demonstrated that functional disability, stemming from vision loss and other comorbid health conditions, significantly, positively impacted social support variables (overprotection, affective support, and instrumental support) and significantly, negatively impacted the two indicators of adjustment. In addition, higher levels of overprotection led to decreased mastery and lower scores on the vision-specific adaptation measure. Both higher levels of instrumental support and higher levels of negative support predicted higher overprotection. All social support variables taken together mediated the impact of functional disability on the outcome variables, but individually they did not. Moreover, higher mastery was predicted by lower levels of both negative support and overprotection, but was unaffected by instrumental and affective support. In contrast, higher scores on the vision specific adaptation measure were predicted by lower levels of overprotection and affective support and by higher levels of instrumental support.

Predictors of Perceived Overprotection: A Longitudinal Analysis - The primary goal of this study was to investigate baseline predictors of perceived overprotection at a 6-month follow up in a sample of older adults (N=297) with visual impairment. Predictors included demographic variables (age, gender, race, and education), functional disability, self-rated health, and social support variables (instrumental, affective, and negative support) assessed at baseline. In addition, the use of vision rehabilitation services, specifically the number of programs in which the participants were engaged between baseline and 6-months later was also examined as a predictor of long-term perceived overprotection. Results from a hierarchical regression analysis demonstrated that higher levels of baseline functional disability, lower self-rated health, and higher levels of instrumental support as well as the greater number of service programs the participants were engaged in predicted higher levels of perceived overprotection at the 6- month follow-up.

Publications

Cimarolli, V. R. (2002). The impact of perceived overprotection on adjustment to age-related vision loss (Doctoral dissertation, Fordham University, 2002). Dissertation Abstracts International, 62, (12-B), 5994.

Cimarolli, V. R., Reinhardt, J. P., & Horowitz, A. (2006). Perceived overprotection: Support gone bad? Journal of Gerontology: Social Sciences, 61: S18-S23.

Presentations

Cimarolli, V., Reinhardt, J. P., & Horowitz, A. (2001, November). The impact of perceived overprotection on adjustment to age-related vision loss. Paper presented at the 54th Annual Meeting of The Gerontological Society of America, Chicago, IL.

Cimarolli, V. R., Reinhardt, J. P., & Horowitz, A. (2002, November). Predictors of perceived overprotection: A longitudinal analysis. Paper presented at the annual meeting of The Gerontological Society of America, Boston, MA.

Investigators: Amy Horowitz, DSW/PhD, Principal Investigator
Joann P. Reinhardt, PhD, Co-Investigator
Mark Brennan, PhD, Data Analyst
Verena Cimarolli, MA, Research Coordinator (to 7/2001)
Thalia MacMillan, MSW, Research Coordinator (from 7/2001)

Funded by: National Eye Institute

Project Period: October 1999 - September 2004

 

 

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