History of Intellectual Disability - Essay Example

Running Head: History f Intellectual Disability History of Intellectual Disability of the of the History of Intellectual Disability With increasing age come increases in one's risk for illness and disability. The incidence and prevalence f a number f possibly life-changing, disability-provoking medical conditions increase with age (e.g., Verbrugge & Jette, 1994). In recent years, proponents f the "successful aging" approach, in both the scientific and the popular literatures, have suggested that behavioural factors can influence the risk f a number f medical conditions and subsequent disabilities (witness the number f books with this title, i.e., Baltes & Baltes, 1990; Friedrich, 2001; Rowe & Kahn, 1998). In this article, we extend this line f thinking as we examine the relative roles f three primarily psychological factors that may affect such behaviour-fatalism, self-confidence, and intellectual resources-in the development f illness and subsequent disability in middle-aged and older adults. Illness and pathology are not the same as disability. Verbrugge and Jette (1994) define disability as "a gap between personal capability and environmental demand" (p. 1). In contrast, they define pathology as "biochemical and physiological abnormalities" (p. 3). Illness or pathology alone is not necessarily sufficient to yield disability (e.g., Glass, 1998; Institute f Medicine, 1991; Nagi, 1965; Verbrugge & Jette, 1994). Instead, researchers describe the disablement process as a phenomenon that can be described by several steps or concepts (Lawrence & Jette, 1996; Verbrugge & Jette, 1994). Verbrugge and Jette's (1994) model includes the following: (a) pathology, (b) impairments (i.e., dysfunctions and structural abnormalities in body systems), (c) functional limitations (i.e., restrictions in fundamental physical actions and basic psychological processes), and (d) disability (i.e., difficulty performing activities in a domain f life typical for one's reference group). The process by which a person becomes disabled (or "handicapped," depending on the model) can be characterized as a set f interactions between dysfunction at any f these levels f phenomena and psychological and environmental factors. For example, the degree to which older individuals with osteoarthritis f the hands are disabled (i.e., have difficulty in normal activities and roles) will depend on a number f factors: the nature and efficacy f medical interventions, the availability f environmental supports, changes in activities and lifestyle, environmental demands, and psychological resources. In this article, we examine the roles f several psychological characteristics that may serve as protective (or, conversely, risk) factors in the disablement process. Verbrugge and Jette (1994) have suggested that, given some pathology (i.e., disease, injury, or developmental condition), pre-existing psychological characteristics may affect the likelihood f impairment or functional limitations. Evidence also suggests that psychological characteristics can affect the likelihood f pathology itself. There are a number f mechanisms by which psychological resources might affect the disablement process. One useful perspective, derived from the Verbrugge and Jette (1994) model, was suggested by Femia, Zarit, and Johansson (1997). They suggested that psychological, or "internal," resources "can strongly influence the relationship between personal capability and environmental demand by either increasing personal capability, reducing the environmental demand, or both" (p. P13). There are a number f ways in which psychological resources might help increase personal capability. They may serve as motivational factors for engaging in health- or rehabilitation-related behaviours, or they may enable people to engage in more adaptive coping strategies. They may also be used to decrease environmental demands if they serve to motivate or enable people to use or devise appropriate environmental supports or interventions. Having control over one's environment, or believing that one has such control, is related to a wide range f health and disability outcome variables in older adults, including disability, overall physical health, and even mortality (e.g., Creamer, Lethbridge-Cejku, & Hochberg, 2000; Kempen, Sanderman, Miedema, Meyboom-de Jong, & Ormel, 2000; Kempen, van Heuvelen, van Sonderen, van den Brink, Kooijman, & Ormel, 1999; Marshall, 1991; Penninx et al., 1997, 2000; Rodin, Timko, & Harris, 1985). In general, psychological characteristics that reflect lower degrees f actual or perceived control are associated with higher degrees f illness, disability, and mortality. There are a host f control-related psychological concepts-fatalism, self-confidence, locus f control, self-direction, learned helplessness, and self-efficacy, to name a few. Many f these have overlapping, if not virtually synonymous, definitions. They do, however, reveal a fundamental distinction. There is an important difference between recognizing the role f external factors, such as chance and luck, in one's life and one's perceived ability to handle the challenges f life (cf. Lachman, 1986; Rodin et al., 1985). In this article, we focus on this distinction as we examine the roles f fatalism and self-confidence, two constructs previously investigated in this research project (Kohn & Schooler, 1983), as they apply to the disablement process. Fatalism is the belief that the events f one's life are largely beyond one's control (Kohn & Schooler, 1983). Some authors refer to its reverse, that is, the belief that one can largely control one's life events, as mastery (e.g., Kempen, van Sonderen, & Ormel, 1999; Pearlin & Schooler, 1978; Penninx et al., 1997). Several authors have suggested that older individuals demonstrate lower mastery or greater fatalism (e.g., Grob, Krings, & Bangerter, 2001; Lachman, 1986; Schieman & Turner, 1998); others have demonstrated that decreased fatalism (or increased mastery) is associated with lower degrees f disablement (Femia et al., 1997; Kempen, van Sonderen, & Ormel, 1999; Simonsick, Guralnik, & Fried, 1999). Self-confidence is the belief that one can handle whatever events life brings one's way. It shares some f the characteristics f self-efficacy and is a component f self-esteem (Kohn & Schooler, 1983). It has also occasionally been referred to as "mastery" (e.g., Marshall, 1991). A number f studies have demonstrated that higher levels f self-confidence-related constructs, particularly self-efficacy, are associated with lower levels f disablement (Kempen et al., 2000; Mendes de Leon, Seeman, Baker, Richardson, & Tinetti, 1996; Rejeski, Miller, Foy, Messier, & Rapp, 2001). One might also expect cognitive or intellectual resources to provide individuals with the means f either compensating for or buffering the effects f pathology due to illness, injury, or chronic conditions. Older people frequently compensate for age-related cognitive declines (e.g., Backman & Dixon, 1992; Baltes, 1993; Compton, Bachman, Brand, & Avet, 2000; Li, Lindenberger, Freund, & Baltes, 2001; Salthouse, 1990; Salthouse & Maurer, 1996). Effective compensation for potentially disabling conditions can resemble practical problem solving (see Diehl, Willis, & Schaie, 1995). Therefore, cognitive resources seem likely to provide the individual with skills needed to engage in or invent interventions, to create appropriate environmental accommodations, or to devise other possible compensations. Research on the relation between cognitive resources and disability frequently reveals negative relationships. Generally, impairment on tests like the Mini-Mental State Exam (MMSE; Folstein, Folstein, & McHugh, 1975) is associated with increased levels f disability in community-dwelling adults (Gill, Williams, Richardson, & Tinetti, 1996; Moritz, Kasl, & Berkman, 1995; see also the review by Tombaugh & McIntyre, 1992). Other investigators have reported negative relationships between assessments f cognitive functioning and disability, without necessarily discussing dementia (Allaire & Marsiske, 2002; Diehl et al., 1995; Kempen, Steverink, Ormel, & Deeg, 1996; Poon, Messner, Martin, Noble, & Johnson, 1992). There is some evidence that cognitive resources are more strongly associated with maintaining functioning in instrumental-type activities than in physical activities. Tombaugh and McIntyre (1992) pointed out that in the Epidemiological Catchment Area Piedmont Health Survey, MMSE scores were correlated with instrumental activities f daily living (IADL) but not with physical activities f daily living (PADL). Similarly, Poon et al. (1992) found that centenarians' performance on fluid intelligence measures was related to their IADL levels but not to their PADL levels; they suggested that "fluid intelligence contributes to the amelioration f the effects f aging in the management f everyday needs" (p. 41). References Allaire, J. C., & Marsiske, M. (2002). Well- and ill-defined measures f everyday cognition: Relationship to older adults' intellectual ability and functional status. Psychology and Aging, 17, 101-115. Backman, L., & Dixon, R. A. (1992). Psychological compensation: A theoretical framework. Psychological Bulletin, 112, 259-283. Baltes, P. B. (1993). The aging mind: Potential and limits. The Gerontologist, 33, 580-594. Baltes, P. B., & Baltes, M. M. (Eds.). (1990). Successful aging: Perspectives from the behavioral sciences. Cambridge, England: Cambridge University Press. Compton, D. M., Bachman, L. D., Brand, D., & Avet, T. L. (2000). Age-associated changes in cognitive function in highly educated adults: Emerging myths and realities. International Journal f Geriatric Psychiatry, 1, 75-85. Creamer, P., Lethbridge-Cejku, M., & Hochberg, M. C. (2000). Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology, 39, 490-496. Diehl, M., Willis, S. L., & Schaie, K. W. (1995). Everyday problem solving in older adults: Observational assessment and cognitive correlates. Psychology and Aging, 10, 478-491. Femia, E. E., Zarit, S. H., & Johansson, B. (1997). Predicting change in activities f daily living: A longitudinal study f the oldest old in Sweden. Journal f Gerontology: Psychological Sciences, 52B, P294-P302. Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State: A practical method for grading the cognitive state f patients for the clinician. Journal f Psychiatric Research, 12, 189-198. Friedrich, D. D. (2001). Successful aging. Springfield, IL: Charles C Thomas. Gill, T. M., Williams, C. S., Richardson, E. M., & Tinetti, M. E. (1996). Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons. Journal f Gerontology: Medical Sciences, 51A, M283-M288. Glass, T. A. (1998). Conjugating the "tenses" f function: Discordance among hypothetical, experimental, and enacted function in older adults. The Gerontologist, 38, 101-112. Grob, A., Krings, F., & Bangerter, A. (2001). Life markers in biographical narratives f people from three cohorts: A life span perspective in its historical context. Human Development, 44, 171-190. Institute f Medicine. (1991). Disability in America: Toward a national agenda for prevention. Washington, DC: National Academy Press. Kempen, G. I., Sanderman, R., Miedema, I., Meyboom-de Jong, B., & Ormel, J. (2000). Functional decline after congestive heart failure and acute myocardial infarction and the impact f psychological attributes: A prospective study. Quality f Life Research, 9, 439-450. Kempen, G. I., Steverink, N., Ormel, J., & Deeg, D. J. (1996). The assessment f ADL among frail elderly in an interview study: Self-report versus performance-based tests and determinants f discrepancies. Journal f Gerontology: Psychological Sciences, 51B, P254-P260. Kempen, G. I., van Heuvelen, M. J., van Sonderen, E., van den Brink, R. H., Kooijman, A. C., & Ormel, J. (1999). The relationship f functional limitations to disability and the moderating effects f psychological attributes in community-dwelling older persons. Social Science & Medicine, 48, 1161-1172. Kempen, G. I., van Sonderen, E., & Ormel, J. (1999). The impact f psychological attributes on changes in disability among low-functioning older persons. Journal f Gerontology: Psychological Sciences, 54B, P23-P29. Lachman, M. E. (1986). Locus f control in aging research: A case for multidimensional and domain-specific assessment. Psychology and Aging, 1, 34-40. Lawrence, R. H., & Jette, A. M. (1996). Disentangling the disablement process. Journal f Gerontology: Social Sciences, 51B, S173-S182. Li, K. Z., Lindenberger, U., Freund, A. M., & Baltes, P. B. (2001). Walking while memorizing: Age-related differences in compensatory behavior. Psychological Science, 12, 230-237. Marshall, G. N. (1991). A multidimensional analysis f internal health locus f control beliefs: Separating the wheat from the chaff Journal f Personality and Social Psychology, 61, 483-491. Mendes de Leon, F., Seeman, T. E., Baker, D. I., Richardson, E. D., & Tinetti, M. E. (1996). Self-efficacy, physical decline, and change in functioning in community-living elders: A prospective study. Journal f Gerontology: Social Sciences, 51B, S183-S190. Miller, M. E., Rejeski, J. W., Reboussin, B. A., Ten Have, T. R., & Ettinger, W. H. (2000). Physical activity, functional limitations, and disability in older adults. Journal f the American Geriatrics Society, 48, 1264-1272. Moritz, D. J., Kasl, S. V., & Berkman, L. F. (1995). Cognitive functioning and the incidence f limitations in activities f daily living in an elderly community sample. American Journal f Epidemiology, 141, 41-49. Nagi, S. Z. (1965). Some conceptual issues in disability and rehabilitation. In M. B.Sussman (Ed.), Sociology and rehabilitation (pp. 100-113). Washington, DC: American Sociological Association. Pearlin, L. I., & Schooler, C. (1978). The structure f coping. Journal f Health and Social Behavior, 19, 2-21. Penninx, B. W., Guralnik, J. M., Bandeen-Roche, K., Kasper, J. D., Simonsick, E. M., Ferrucci, L., & Fried, L. P. (2000). The protective effect f emotional vitality on adverse health outcomes in disabled older women. Journal f the American Geriatrics Society, 48, 1359-1366. Penninx, B. W., Messier, S. P., Rejeski, W. J., Williamson, J. D., DiBari, M., Cavazzini, et al. (2001). Physical exercise and the prevention f disability in activities f daily living in older persons with osteoarthritis. Archives f Internal Medicine, 161, 2309-2316. Penninx, B. W., van Tilburg, T., Kriegsman, D. M. W., Deeg, D. J. H., Boeke, A. J. P., & van Eijk, J. T. M. (1997). Effects f social support and personal coping resources on mortality in older age: The Longitudinal Aging Study Amsterdam. American Journal f Epidemiology, 146, 510-519. Poon, L. W., Messner, S., Martin, P. C., Noble, C. A., & Johnson, M. A. (1992). The influences f cognitive resources on adaptation and old age. International Journal f Aging and Human Development, 34, 31-46. Rejeski, W. J., Miller, M. E., Foy, C., Messier, S., & Rapp, S. (2001). Self-efficacy and the progression f functional limitations and self-reported disability in older adults with knee pain. Journal f Gerontology: Social Sciences, 56B, S261-S265. Rodin, J., Timko, C., & Harris, S. (1985). The construct f control: Biological and psychosocial correlates. Annual Review f Gerontology & Geriatrics, 5, 3-55. Rowe, J. W., & Kahn, R. L. (1998). Successful aging. New York: Pantheon Books. Salthouse, T. A. (1990). Cognitive competence and expertise in aging. In J. E.Birren & K. W.Schaie (Eds.), Handbook f the psychology f aging (3rd ed., pp. 310-319). San Diego, CA: Academic Press. Salthouse, T. A., & Maurer, T. J. (1996). Aging, job performance, and career development. In J. E.Birren & K. W.Schaie (Eds.), Handbook f the psychology f aging (4th ed., pp. 353-364). San Diego, CA: Academic Press. Schieman, S., & Turner, H. A. (1998). Age, disability, and the sense f mastery. Journal f Health and Social Behavior, 39, 169-186. Schooler, C. (1994). A working conceptualization f social structure: Mertonian roots and psychological and sociocultural relationships. Social Psychology Quarterly, 57, 262-273. Schooler, C., & Mulatu, M. S. (2001). The reciprocal effects f leisure time activities and intellectual functioning in older people: A longitudinal analysis. Psychology and Aging, 16, 466-482. Schooler, C., Mulatu, M. S., & Oates, G. (1999). The continuing effects f substantively complex work on the intellectual functioning f older workers. Psychology and Aging, 14, 483-506. Seeman, T. E., McEwen, B. S., Rowe, J. W., & Singer, B. H. (2001). Allostatic load as a marker f cumulative biological risk: MacArthur Studies f Successful Aging. Proceedings f the National Academy f Sciences, 98, 4770-4775. Simonsick, E. M., Guralnik, J. M., & Fried, L. P. (1999). Who walks Factors associated with walking behavior in disabled older women with and without self-reported walking difficulty. Journal f the American Geriatrics Society, 47, 672-680. Tombaugh, T. N., & McIntyre, N. J. (1992). The Mini-Mental State Examination: A comprehensive review. Journal f the American Geriatrics Society, 40, 922-935. Verbrugge, L. M., & Jette, A. M. (1994). The disablement process. Social Science and Medicine, 38, 1-14. Willis, S. L., Dolan, M. M., & Bertrand, R. M. (1999). Problem solving on health-related tasks f daily living. In D. C.Park, R. W.Morrell, & K.Shifren (Eds.), Processing f medical information in aging patients: Cognitive and human factors perspectives (pp. 199-219). Mahwah, NJ: Erlbaum. Read More