Adolescents' psychosocial adaptation to visual impairment : the roles of perceived social support, perceived societal attitudes, and coping

Abstract

Adolescents with visual impairment are a minority, and a disadvantaged group. Their psychosocial adaptation to their impairment is important to their quality of life and for them to become independent adults. However, little is known about how visually impaired adolescents adapt to their impairment. Prior research suggests that both social contextual variables (e.g., social support, societal attitudes) and personal attributes (e.g., coping) can impact individuals’ psychosocial adaptation to chronic illness and disability. The present research addressed four main issues: 1) the change of adolescents’ psychosocial adaptation to visual impairment, 2) the influences of perceived social support and perceived societal attitudes on adolescents’ coping and psychosocial adaptation to visual impairment, 3) the roles of coping strategies in adolescents’ psychosocial adaptation to visual impairment, and 4) the mediating function of coping in the relationships between the two contextual variables and psychosocial adaptation to visual impairment. The research adopted a quantitatively-driven mixed method design, and involved three studies: a Pilot Study, a Main Study, and a Follow-up Study. The Pilot Study validated a series of inventories testing the four research variables through two rounds of questionnaire testing and two group interviews with students with visual impairment and their teachers. Participants were 176 students from three schools for the visually impaired in China, in the first round of testing, and 185 in the second round. The Main Study was a one-year, longitudinal quantitative study that examined the relationships among the major research variables. At the beginning of an academic year, 334 students from four schools for the visually impaired in mainland China responded to a questionnaire consisting of some demographic questions and the validated inventories. Twelve months later, 170 of the 334 students responded to the same questionnaire, again. To help interpret the results from the Main Study, a Follow-up Study was conducted by interviewing 16 students who had participated in both waves of data collections for the Main Study. Results of the Main Study generally supported the research hypotheses. Over the one-year interval, adolescents with visual impairment tended to score significantly higher on anxiety, depression, and self-esteem, while remaining unchanged in the other three indicators of psychosocial adaptation to visual impairment (social integration, attitudes toward visual impairment, and acceptance of visual impairment). In addition, results showed that: 1) both perceived social support and perceived societal attitudes toward visual impairment significantly predicted adolescents’ coping and psychosocial adaptation to visual impairment, 2) adolescents with visual impairment using self-directed coping strategies more frequently showed better psychosocial adaptation to visual impairment, whereas those using relinquished-control coping strategies more frequently showed worse psychosocial adaptation to visual impairment, and 3) coping strategies mediated the relationships between the two contextual variables and psychosocial adaptation to visual impairment. The present research has made important contributions to the field by advancing knowledge on the influences of perceived social support, perceived societal attitudes, and coping on psychosocial adaptation to chronic illness and disability. This research also promotes the study of the population with visual impairment, and has practical implications for promoting the psychological well-being of adolescents with visual impairment, and for providing educational and counseling services to them. (515 words)