The effects of physical disability upon body-image : an analysis together with some implications for rehabilitation : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University
The physical aspects of self-concept which comprise the body-image and are essential for personal identification, are of particular importance in health restoration and maintenance. A study of 285 physically disabled adults variously suffering from spinal cord injury, multiple sclerosis and rheumatoid arthritis, and a control group of 100 able-bodied adults, investigated the effects of physical disability upon body-image. All subjects completed three 52-item Body Cathexis scales and three 16-item bi-polar adjectival Semantic Differential forms, while the disabled completed an additional 11-item Activities of Daily Living form, in an attempt to identify and measure the form and content of three body-image components paralleling the three aspects of self identified by phenomenological theory, and four modes of adjustment in the body-image of the disabled. The influence of years of disablement and degree of incapacity upon body-image disturbance and the internal structure of the Body Cathexis and Semantic Differential scales were also investigated. Simple correlational analysis failed to isolate any parallel relationships between body-image and self-concept for either disabled or able-bodied individuals, although discriminant function analysis revealed that both concepts for the disabled differed significantly from those of normals. These findings indicated that the difference was one of content and not of formal relationships pertaining between the concepts. As a result, a tripartite theory of body-perception was proposed. The question of whether type of disability contributed significantly to variance was answered positively. The physically disabled tended to be separated out according to the nature of their disability which appeared to influence both body-image and self-concept. Four discrete modes of adjustment were identified by pattern analysis. Differences due to age and sex, disability type and years of disablement made no significant contribution to the type of adjustment adopted. Finally, the number of years of impairment and degree of functional incapacity had no influence upon body-image disturbance. Considering past research, the findings indicated there to be basic differences in body-image content between the physically-disabled and physically normal populations, but not in the formal structure. Further research is needed to investigate these differences, to isolate further modes of adjustment which might be manifest amongst those excluded from the 4 identified in this investigation and to verify and elaborate upon the usage of the tripartite theory of body-perception. Factor analysis provided confirmation for both the Body-Cathexis and Semantic Differential scales as being complex measures of the self, and enabled shortened revised scales to be introduced for both the able-bodied and disabled subjects. However, further research is required utilising such scales in studies of body-image in order to ascertain their reliability and validity in aiding the development of intervention strategies tailored to the needs of the disabled person, especially in light of the fact that body-image is increasingly being the single most important concept in the consideration of the physically disabled. The results of this research suggest that body-image is a function of numerous variables, of which physical disability is only one.