Who self-identifies as disabled? An examination of impairment and contextual predictors


Bogart, K.R., Rottenstein, A., Lund, E. M., & Bouchard, L. (2017). Who self-identifies as disabled? An examination of impairment and contextual predictors. Rehabilitation Psychology. Advance online publication. http://dx.doi.org/10.1037/r93896335


Approximately 15% of the world population may be classified as a person with a disability.  In the context of international health organizations’ goals to establish common language for describing health and health-related states, this study investigates impairment-related and contextual factors that predict disability self-identification. In reference to Social Identity Theory, the authors note that minority group members manage stigma by passing as majority group members or identifying with their minority group.  Review findings show that identification as disabled may promote positive outcomes such as self-efficacy, advocacy, etc.   Impairment factors of duration, time of onset (congenital or acquired), noticeability, severity, number of impairments, and pain have been found to differentially affect likeliness to identify as disabled, as have environmental factors of stigma and social support and far lesser researched personal factors such as gender, race/ethnicity, income, age, and psychological distress. The authors point out that, despite previous related studies, there has been little systematic research on what factors are most crucial to disability identification. Based on hierarchical multiple linear regression, the study finds that impairment factors (severity), personal factors (older age and lower income), and environmental factors (increased awareness of stigma) are most predictive of disability identity. Strengths and weaknesses of the study are explored, and the authors remind us that, overall, disability self-identification continues to be rare given the prevalence of health conditions.

I PICKED THIS ARTICLE BECAUSE, following 2001, the International Classification of Impairments, Disabilities, and Handicaps (based on a medical model of disability) transitioned to the International Classification of Functioning, Disability, and Health (based on a biopsychosocial model). Beyond the organization’s interest in a common language for describing health and health-related states, the authors offer biopsychosocial-minded providers insight into what factors, amongst people with whom they work, may predict disability self-identification. Moreover, the interest of setting goals to support positive disability identity, to work toward ameliorating stigma, and to reduce severity is fostered, and action toward finding commonalities among, and improvements to, impairment, personal, and environmental factors is encouraged.

This month’s rehabilitation science spotlight was chosen by Caitlin Reese, Ph.D., Staff Neuropsychologist, Baylor Institute for Rehabilitation.