European Journal of Special Education Research
ISSN: 2501 - 2428
ISSN-L: 2501 - 2428
Available on-line at: www.oapub.org/edu
Volume 2 │ Issue 3 │ 2017
doi: 10.5281/zenodo.244433
PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES:
A SYSTEMATIC REVIEW OF THE LITERATURE
Proios Ioannis, Proios Miltiadisi, Fotiadou Eleni
Department of Physical Education and Sport Science,
Aristotle University of Thessaloniki, Greece
Abstract:
The purpose of the present systematic review was to gather information on the interest
of researchers on psychological issues of people with physical disabilities throughout a
time period of twenty years (1995-2015). Previous similar reviews were not determined
by the literature. For the implementation of their view electronic bases and hand search
were used following specific criteria. Search revealed approximately 70.000 studies but
only 58 in total covered the set criteria. The findings of the review revealed a limited
research interest on psychological issues relevant to people with physical disabilities,
with the interest increasing for the period 2006-2010. It was also found that descriptive,
cross-sectional and qualitative research designs were preferred with data mainly
gathered via questionnaires. Samples were derived from general and sport population
(male and female). Finally, psychological issues mainly studies were parts of the self
and emotions and less parts of personality and motivation.
Keywords: systematic review, psychological issues, physical disabilities, 1995-2015
1. Introduction
Physical disability is a negative situation that affects the psychological status of
disabled people. A number of authors consider physical disability as a major limitation
to psychosocial interactions of a person with his or her environment (Hutzler & Bar-Eli,
1993). In people with physical disabilities, one may observe typical psychological
phenomena resulting from the interplay between their individual personality structures
and the unique environmental and social problems confronting them (Hutzler & Bari
Correspondence: email mproios@phed.auth.gr
Copyright © The Author(s). All Rights Reserved.
© 2015 – 2017 Open Access Publishing Group
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Proios Ioannis, Proios Miltiadis, Fotiadou Eleni
PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
Eli, 1993). It seems that physical disability has an important effect on the psychological
situation of disabled people a fact that makes the role of psychology rather important.
Olkin (2003) claims that psychology generally views disability as being the domain of
rehabilitation psychology rather than part of mainstream psychology training. The use
of the psychological factor has mainly been found in interventions (psychological)
regarding the transition of disabled people towards a new way of life where he/she may
found assistance in solving possible issues deriving from this new way of life. People
experiencing disability for the first time face stress, have to deal with life changes,
differentiation of values and a series of issues relating to their experiences through their
life.
The relation between disability and psychology is an issue that has attracted the
interest of researchers. Sherrill and Tripp (2015) at a traditional review of literature in
the area of physical activity and sports have presented the psychological characteristics
of individuals with disabilities. These are: self (self-concept, self-efficacy, self-esteem,
self-confidence, self-image, self-identity), motivation (goal orientation) and emotions
(stress, anxiety, happiness, dejection).
Regarding reviews, these in general constitute a research method with review
studies holding an exceptional position among the most researched studies (Grant &
Booth, 2009). According to Medical Subject Headings (MeSH) a literature review
describes the published material that offers an examination of recent and present
literature.
Regarding systematic review, it is supported that it is a research method that
aims to review research literature through the use of systematic and rigorous methods
Gough, Oliver, & Thomas,
. The systematic review refers to a literature review
associated with a clearly formulated research question that uses systematic explicit
methods to identify, select, and critically appraise relevant research from previously
published studies related to the question at hand (The Cohrane Collaboration, 2005).
Boland, Cherry, and Dickson (2008), claim that systematic reviews can be considered as
the
gold standard
for reviewing the extended literature on a specific topic as it
synthesizes the findings of previous research investigating the same or similar
questions.
Apart from the systematic, there is also the traditional literature review.
According to Aveyard and Sharp (2011), Gough et al. (2012), and Petticrew and Roberts
(2006), we may say that a traditional review is more prone to bias than a systematic
review, including selection bias when only studies which are published are selected and
language bias when studies are selected based on their language of publication, such is
English.
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
Regarding disability and psychology, review studies deal mainly with the total
disability range (e.g., Jensen, Moore, Bockow, Ehde, & Engel, 2011). Review studies that
deal with specific disabilities such are the physical ones, literature shows that the
interest of scholars is focused only on special populations as for example on disabled
people who participate in physical activities and sports (e.g., Block, Griebenauw, &
Brodeur, 2004; Sherrill & Tripp, 2015), or on non-participants at sport activities(e.g.,
Kawanishi & Greguol, 2013).
The non-exclusion of a population by a review in relation to the population’s
activities offers a clearer view on the cognitive object of study. The importance of the
present study is firstly the fact that it deals with their view of articles on disability, the
largest minority group in the world (Shapiro, 1993). Secondly, it covers the gap in
literature of systematic reviews of cognitive psychology in disability in general
population and strengthens the area of athletic population, i.e. the work of Hutzler and
Bar-Eli (1993) who examined the psychological benefits of sports on disabled people.
This will offer additional information to scholars in the area of psychology in people
with physical disabilities as is for example research tendencies on the creation of a clear
view on psychological issues that have been studied in the area of disability in all
populations.
2. Method
The present research design was based on the information drawn from relevant studies
with systematic reviews (Grant & Booth, 2009; Petticrew & Roberts, 2006; Saebu, 2010),
studies on the issue of physical disability (Freitas, Dias, & Fonseca, 2013; Saebu, 2010)
and studies on psychological issues within the area of disability (Hutzler & Bar-Eli,
1993; Sherrill, 2015; Weiss, 2004).
2.1 Search Strategy
2.1.1 Selection of Search Means
Petticrew and Roberts (2006) claim that the number of data bases or other sources
required for search vary and is defined based on the time and available sources. SuarezAlmazor, Belseck, Homik, Dorgan, and Ramos-Remus (2000) supported that for a full
search at least two or more data bases are required, as well as hand searching in
selective journals. The use of hand searching in journals is often considered as necessary
since electronic searches depend on how well studies are adjusted to the data bases in
order to avoid mistakes in search. Hand searching offers researchers confidence for the
received information from the specific journals (Petticrew & Roberts, 2006).
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
Thus, in the present study the strategy used the following two main sources to
locate published studies psychological issues in the individuals with physical
disabilities: (a) electronic searches of computerized databases, including Scholar
Google, PsychoINFO, and PubMed. The selection of these data bases is generally
acknowledged and provides a complete overview of studies and articles that covering
disability to psychology. This way of search is in accordance to previously similar
literature reviews (e.g., Hutzler & Bar-Eli, 1993; van der Ploeg, van der Beek, van der
Woude, & van Mechelen, 2004). The key words used in the present study were
physical disabilities “ND psychology or psychological issues , b hand searching
of journals, including Adapted Physical Activity Quarterly, European Journal of Adapted
Physical Activity, International Journal of Disability, Development and Education, Archives of
Physical Medicine and Rehabilitation, Disability and Rehabilitation, Disability Studies
Quarterly, European Journal of Counselling Psychology, Journal of Developmental and Physical
Disabilities, Journal of Rehabilitation Research & Development, Psychological Reports.
It is understood that the present study focused only on research published in
journals, since they represent
are cord of an area’s scholarships and provide a
foundation to understand research trends
Silverman & Skonie,
, p.
.
Nevertheless, we should recognize that there are other sources (e.g., dissertations,
books, conferences) that may contribute to the study of physical disability and
psychology. We should though note that for example, dissertations are not easily
accessible and a rigorous review process is not always required for books (Gilbert &
Trudel, 2004). Finally based on the previous recommendations on conducting
systematic reviews (see, Knipschild, 1995), in the present study we did not include
studies that had been published as abstracts or conference proceedings.
2.1.2 Study Selection
The following criteria were set to select studies. More specifically articles should: (1) be
written in English, (2) be published in peer-reviewed journals, (3) be published within
the time period between 1995 and 2015, (4) include individuals of all ages with physical
disability or spinal cord injury without pain. (In the present study physical disabled
was defined as someone with a mobility or sensory impairment). Impairment is a
characteristic, feature or attribute within an individual which is long-term and may or
may not be the result of disease or injury and may (Morris, 2004, p. 19). (5) to include at
least one measure on psychological issue.
In the present study, quality of life was considered as a psychological issue.
Quality of life in psychology has been adopted as an outcome measure (Holmes, Bix,
Meritz, Turner, & Hutelmyer, 1997). According to World Health Organization’s Quality
of Life WHOQOL , quality of life is defined as the perception of people’s position in
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
life within culture and value system where they live in and in relation to their goals and
expectations. An element of the quality of life is life satisfaction, which is considered as
one of the primary indicators of quality of life, well-being (Diener, Oishi, & Lucas,
2009).
2.1.3 Data Collection
The copies of articles were gathered and assessed based on the criteria set. The analysis
of articles was done via the descriptive and semi-quantitative review protocol as
described by Sallis, Prochaska, and Taylor (2000). Initially the articles were coded by a
number, but as independent sample populations (k) used as unit analysis. Additionally,
the sample was distinguished by: year of publication, journal, research design (e.g.,
descriptive, longitudinal, quantitative), data collection (e.g., interview, questionnaires),
general and sport population, male and female, ages groups based on the mean age and
measures.
2.1.4 Data Extraction
Considering these lection criteria for the studies, data extraction based on the titles
located 70.467 studies (51.085 from data bases search and approximately 19.380 about
by hand searching in journals). Most of the articles were (70.381) were eliminated based
on title or abstract being irrelevant to the search, following an assessment by two
reviewers. 87full text articles were assessed by one special reviewer. Following the
above mentioned assessment, 29 articles were excluded leaving 58 articles for final
analysis.
3. Results
Results are presented based on: (a) the years of review and journals that published the
studies, (b) research designs, (c) the way data was gathered, (d) the characteristics of
samples (population type, mean age, and gender), and (e) the psychological issues dealt
by the studies.
3.1. Publication Year and Journals
Table 1 presents the results of the review of studies based on year of publication.
Results were grouped in 4 groups but and the journals in which the studies were
published. A closer look at the table shows that the research interest of the scholars on
psychology related issues of people with physical disabilities is high for the time period
2006-2010 at 34.5% for the twenty -year period examined in the present study. The Table
also shows that even though a large number of journals have published the studies
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
located, the main volume of studies were published by the Adapted Physical Activity
Quarterly at 37.9%, the European Journal of Adapted Physical Activity (8.6%), the
Archives of Physical Medicine and Rehabilitation (6.9%), the International Journal of
Disability and the Development and Education (6.9%).
3.2. Research Design
The results of the review (Table 2) regarding research design, initially revealed that
descriptive design (72.4%) was used more than the experimental one (20.7%). At this
point the limited number of studies that used experimental and control groups should
be noted.
Table 1: Publication Year, and Journals
Characteristics
Reference of Studies
Samples
k(%)
Publication Year
1995 – 2000
5,6,8,9,28,30,33,35,41,45,51,
12(20.7)
52
2001 – 2005
2,15,17,19,34,37,38,39,44,49,
13(22.4)
50,53,58
2006 – 2010
3,10,11,12,13,16,18,21,22,27
20(34.5)
29,31,32,36,40,42,47,48,55,57
2011 – 2015
1,4,7,14,20,23,24,25,26,43,46,
13(22.4)
54,56
Note: The years were delineated into 4-year periods for comparison across equal periods of time
Journals
Adapted Physical Activity Quarterly
5,6,7,9,10,13,15,30,31,32,33,34,
22(37.9)
35,41,42,43,44,47,48,49,53,54
European Journal of Adapted Physical Activity
4,12,23,46,55
5(8.6)
Archives of Physical Medicine and Rehabilitation
1,3,26,28
4(6.9)
Disability and Rehabilitation
22
1(1.7)
Health & Social Work
2
1(1.7)
International Journal of Disability, Development and
8,14,37,45,56
5(8.6)
Women & Health
11
1(1.7)
Journal of Sport Behavior
16
1(1.7)
Rehabilitation Psychology
17,57
2(3.4)
Women’s Health Issues
18,19
2(3.4)
Journal of Exercise Rehabilitation
20
1(1.7)
Kaohsiung Journal of Medicine Science
21
1(1.7)
Physical Education and Sport
24
1(1.7)
Journal of Developmental and Physical Disabilities
25,29,36
3(5.2)
Education
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
Perceptual and Motor Skills
27,50
2(3.4)
Journal of Rehabilitation
38
1(1.7)
Social Science & Medicine
39
1(1.7)
Violence Against Women
40
1(1.7)
Journal of Adolescent Health
51
1(1.7)
International Journal of Psychology
52
1(1.7)
The Sport Psychologist
58
1(1.7)
Note: k = number of sample populations: 1=(Amtmann, Bamer, Cook, Askew, Noonam, & Brockway,
2012), 2=(Antle, 2004), 3=(Arbour-Nicitopoulos, Ginis, & Latimenr, 2009), 4=(Bastos, Crredeira, Probst, &
Fonseca, 2012), 5=(Blinde & McClung, 1997), 6=(Campbell & Jones, 1997), 7=(de Bressy de Guast, Golby,
VanWersch, & d’“rripe-Longueville, 2013), 8=(Davis, Langone, & Malone, 1996), 9=(Dunn, 2000),
10=(Dunn & Dunn, 2006), 11=(Duvdevany, 2010), 12=(Ferreira & Fox, 2008), 13=(Giacobbi, Stancil, Hardin,
& Bryant, 2008), 14=(Gilbert, Murphy, Krueger, Ludwing, & Efron, 2013), 15=(Goodwin, 2001), 16=(Groff
& Zabriskie, 2006), 17=(Hughes, Robinson-Whelen, Taylor, Swedlund, & Nosek, 2004), 18=(Hughes,
Robinson-Whelen, Taylor, & Hall, 2006), 19=(Hughes, Taylor, Robinson-Whelen, & Nosek, 2005),
20=(Jeong & Park, 2013), 21=(Ju, Lee, Wang, Chu, & Lin, 2006), 22=(Ju, Lee, Lee, Wang, Teng, & Lo, 2009),
23=(Kampfe, Honer, &Willimczik, 2014), 24=(Kasum, Lazarevic, Jakovljevic, & Bacanac, 2011), 25=(Kim,
Hong, & Kim, 2015), 26=(Klyse, Bombardier, et al. Kalpakjian, 2015), 27=(Kokaridas, Perkos, Harbalis, &
Koltsidas, 2009), 28=(Manns & Chad, 1999), 29=(Marinic & Brkljacie, 2008), 30=(Martin, 1999), 31=(Martin,
2006), 32=(Martin, 2008), 33=(Martin, Adams-Mushett, & Smith, 1995), 34=(Martin & Smith, 2002),
35=(Martin, Eklund, & Mushett, 1997), 36=(Miyahara & Piek, 2006), 37=(Mrug & Wallander, 2002),
38=(Nosek & Hughes, 2001), 39=(Nosek, Hughes, Swedlund, Taylor, & Swank, 2003), 40=(Nosek, Hughes,
Taylor, & Taylor, 2006), 41=(Perreault & Marisi, 1997), 42=(Perreault & Vallerand, 2007), 43=(Perrier,
Smith, Strachan, & Latimer-Cheung, 2014), 44=(Rose & Larkin, 2002), 45=(Sands & Wettenhall, 2000),
46=(Scarpa, 2011), 47=(Shapiro & Martin, 2010), 48=(Sit, Lau, & Vertinsky, 2009), 49=(Skordilis, Koutsouki,
Asonitou, Evans, Jensen, & Wall, 2001), 50=(Skordilis, Gavriilidis, Charitou, & Asonitou, 2003),
51=(Stevens, Steele, Jutai, Kalnins, Bortolussi, & Biggar, 1996), 52=(Tam & Watkins, 1995), 53=(Tasiemski,
Kennedy, Gardner, & Blaikley, 2004), 54=(Tasiemski & Brewer, 2011), 55=(Van de Vliet, Van Biesen, &
Vanlandewijck, 2008), 56=(Wanneberg, 2014), 57=(Wilson, Washington, Engel, Ciol & Jensen, 2006),
58=(Martin, 2002).
Table 2: Research designs
Characteristics
Reference of studies
Samples
k(%)
Research design
Descriptive
1,2,4,6,9,10,11,12,13,20,21,22,23,24,25,27,28,
42(72.4)
30,31,32,33,34,35,37,39,40,41,42,43,44,47,48,
49,50,51,52,53,54,55,56,57,58
Experimental
3,5,7,8,11,14,1516,17*,18*,19,29*,45,46
12(20.7)
Cross-sectional
2,3,4,5,6,9,10,11,12,13,14,16,17,18,19,20,21,22,
50(86.2)
23,24,26,27,28,29,30,31,32,33,34,35,37,40,41,
42,43,44,45,46,47,48,49,50,51,5253,54,55,56,57,58
Longitudinal
1,25,26
Quantitative
1,2,3,4,5,6,8,9,10,11,12,13,14,16,17,18,19,20,21,22,
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52(89.6)
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
23,24,25,26,27,28,29,30,31,32,33,34,35,37,39,40,41,
42,44,45,46,47,48,49,50,51,52,53,54,55,57,58
Qualitative
36,38,43,56
4(6.9)
Mix Methods
7,13
2(3.4)
Note: * Studies using experimental and control group
Results also showed that cross-sectional (86.2%) studies are preferred more than
longitudinal ones (5.2%). A similar picture was presented between quantitative and
qualitative studies with the quantitative studies (89.6%) mostly preferred by researchers
in comparison to qualitative ones (6.9%).
3.3 Data Collection
As can be seen in Table 3 the majority of studies used questionnaires to gather data,
while a small number used the method of interview. Regarding the questionnaire
mostly used were the Athletic Identity Measurement Scale (AIMS; Brewer & Cornelius,
2001), which was used at 8 studies for the evaluation of athletic identity, the Task and
Ego Orientation in Sport Questionnaire (TEOSQ; Duda, 1989) and the Sport Orientation
Questionnaire (Gill & Deeter, 1988) both used at 4 studies each to investigate goal
orientation in sports and sport orientation accordingly, the Perceived Stress Scale (PSS;
Cohen, Kamarck, & Mermelstein, 1983), and Physical Self-Perception Profile (PSPPp;
Fonseca, Fox, & Almeida, 1995) used at 3 studies each regarding the estimation of
perceived stress and physical self-concept accordingly, while the rest of the
questionnaires were used by a smaller number of studies.
Table 3: Data Collection
Characteristics
Reference of Studies
Total
Data Collection
Interviews
5,13,14,15,19,26,39,43,51,56
Observation
8
Questionnaires
1,2,3,4,6,7,9,10,11,12,13,16,17,18,
10
1
48
20,21,22,23,24,25,26,27,28,29,30,
31,32,33,34,35,37,40,41,42,44,45
46,47,48,49,50,51,52,53,54,55,57,58
CDSΕS
1
1
PSS
1,18,40
3
PHQ 9-item
1
1
PROMIS
1
1
Self-perception
2
1
Self-efficacy
3,51
2
TOPS
4
1
CTAI-2
6
1
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PPI
7
1
TEOSQ
9,23,49,50
4
PMCSQ
9,10
2
ALT-PE
10
1
TSCS
11
1
QOL.Q
11
1
PSPPp
12
1
RSES
12,30,48
3
PASIPD
13
1
AIMS
16,27,30,33,35,53,54,55
8
CES-D
18,40
2
GSES
18
1
CSAI 2
20,41
2
COMQOL-S
21,22
2
Cattell 16PF
24
1
PHQ-9
26
1
(PGD
26
1
SOQ
27,33,49,50
4
QOLP-PSD
28
1
RWI
29
1
SPAS
30
1
SFQS
31,34
2
PSE
32
1
TSE
32
1
TCSE
32
1
RSE
32,55
2
PANA
32
1
PAQ
37
1
SMS
42
1
ACSI-28
42
1
SPPC
44
1
PSPP
45,55
2
SPAQ
45
1
PSDQ
46,47
2
TSCS-2
48
1
ASSEI
52
1
HADS
53,54
2
CHQ–CF87
57
1
MSPSS
57
1
HPSE
58
1
SRPSE
58
1
SRTSE
58
1
Questionnaire for social validation
12,26
2
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3.4 Sample Characteristics
From the analysis of the literature as shown in Table 4, studies addressed to two
population types (general and sport) with a small superiority of general population.
Ages used were: under 16 years old, 30-40 years old and the combination of all ages
with a unified percentage around 22% for each group. Regarding gender, the
combination of both sexes (50.0%) was the dominant one.
Table 4: Sample Characteristics
Characteristics
Reference
Samples
k(%)
Population Type
General
1,2,3,5,8,9,10,11,14,15,17,18,19,21,22,25,26
32(55.2)
28,29,36,37,38,39,40,41,43,44,48,51,52,56,57
Sport
4,6,7,12,13,16,20,23,24,27,30,31,32,33,34,35,
26(44.8)
42,45,46,47,49,50,53,54,55,58
Mean Age
Under 16
2,8,9,10,15,22,31,34,37,44,51,57
16-20
12,21,26,30,33,47
12(20.7)
21-25
45,46
2(3.4)
26-30
23,41,42,
3(5.2)
30-40
4,6,7,13,14,24,27,32,48,52,54,56,58
Over 41
3,18,25,53
Combined
1,5,11,16,28,29,36,38,39,40,43,49,55
Not identified
17,19,20,35,50
5(8.6)
Males only
7,27,41,50,58
5(8.6)
Females only
11,17,18,19,38,39,40,45
Combined
1,2,4,5,6,8,9,10,12,13,14,15,16,29,30,32,33
6(10.3)
13(22.4)
4(6.9)
13(22.4)
Gender
8(13.8)
29(50.0)
34,42,43,44,46,47,48,49,51,54,55,56
Not identified
3,20,21,22,23,24,25,26,28,31,35,36,37,52,53,57
16(27.6)
3.5 Measurements of psychological issues
Table 5 presents measurements of psychological issues in there viewed studies.
Specifically, issues relating to self, such are self-worth, self-concept, self-esteem, selfefficacy, self-talk, to motivation such are sport and goal orientation, motivation climate,
to emotions such are grief, anxiety, stress, depression, emotional control, quality of life,
happiness, sport friendship quality, personality and general issues such are identity,
athletic identity and behavioral issues.
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Table 5: Summary Table of Studies referring to psychological issues
Study
Sample
Measure/s
Amtmann, Bamer, Cook,
726 adults aged 18 years and older
Depression,
Askew,
Noonam,
&
Anxiety
Brockway (2012)
Antle (2004)
85 young people 8-23 years
Global self-worth
Arbour-Nicitopoulos,
44 adults mean age 49.70years
Self-efficacy
Bastos, Crredeira, Probst,
70 males and 3 female athletes mean age 33.3
Goal setting
& Fonseca (2012)
years
Emotional control
Ginis, & Latimenr (2009)
Automaticity
Relaxation
Activation
Self-talk
Imagery
Attentional control
Blinde & McClung (1997)
Eleven women (ages 19 to 54 years) and 12 men
Self-perception
(ages 20 to 36 years)
Campbell & Jones (1997)
103 people (87 male and 16 female) wheelchair
Competitive Trait
sport participants, ages ranged from 19 to 46
Anxiety
years old
De
Bressy
de
Guast,
38-year-old male
Golby, Van Wersch, &
Psychological
performance
d’“rripe-Longueville
(2013)
Davis,
Langone,
&
Three preschool children with disabilities and six
Prosocial behaviours
Malone (1996)
children without disabilities
Dunn (2000)
65 children (23 boys and 42 girls) with movement
Goal orientation in
difficulties (Mage = 11.01 years) and 111 children
Physical Education
(45 boys and 66 girls) without movement
Perceptions of
difficulties (Mage = 10.77 years)
motivational climate in
Physical Education
Dunn & Dunn (2006)
Duvdevany (2010)
Ferreira & Fox (2008)
65 children (23 boys and 42 girls) with movement
Motivational climate
difficulties (Mage = 11.01 years) and 111 children
Adaptive and
(45 boys and 66 girls) without movement
maladaptive
difficulties (Mage = 10.77 years)
participation behaviors
100 women with physical disabilities, and 100
Self-concept
women without PD, age 21-45 years
Quality of life
137 basketball players (64 wheelchair basketball
Physical Self-perception
players [5 females and 59 males], and 69 male
Profile Self-esteem
athletes without disability), mean age 20.91 years
Giacobbi, Stancil, Hardin,
12 male and 14 female adults playing wheelchair
& Bryant (2008)
basketball, ages 18–54 years
Gilbert,
Krueger,
Murphy,
Ludwing,
&
Quality of life
Sample (N = 196), 64 men, 122 women, and 10
Αffective states
(5%) who did not indicate gender. Mean age
(depression, anxiety,
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
Efron (2013)
35.12 years
positive emotion, life
satisfaction)
Self-evaluation (selfesteem)
Goodwin (2001)
Twelve students (9 boys and 3 girls) between the
Self-esteem
ages of 7 and 13 years, with physical disabilities
Groff & Zabriskie (2006)
22 males and 11 females athletes with physical
Athletic identity
disabilities, age 11-44 years
Hughes,
Robinson-
Whelen,
Taylor,
Women with physical disabilities (N=102, 51 per
Self-esteem
group).
Self-efficacy
Swedlund, & Nosek(2004)
Hughes,
Robinson-
Whelen, Taylor, & Hall
Depression
63 women (25 workshop;38 wait-listed control),
Stress
mean age 51.22 years
Psychological health
(2006)
Generalized Self-Efficacy
Hughes,
Taylor,
415 women with physical disabilities
Stress
Jeong & Park (2013)
Sixty-six wheel-chair tennis players
Competition anxiety
Ju, Lee, Wang, Chu, & Lin
63 adolescents from 22 schools aged 10-18 years
Quality of life
1012 adolescents mean age 15.4 years
Quality of life
229 elite German athletes with and without a
Achievement motivation
disability, aged mean 27.27 and 23.97 years
(task and ego
respectively
orientation)
Robinson-Whelen,
&
Nosek (2005)
(2006)
Ju, Lee, Lee, Wang, Teng,
& Lo (2009)
Kampfe,
Honer,
&
Willimczik (2014)
Kasum,
Lazarevic,
25
wheelchair
basketball
players
and
32
Personality
Jakovljevic, & Bacanac,
wheelchair non-athletes, mean age 33.5 years
(2011)
35.2 years respectively
Kim, Hong, & Kim (2015)
6010 adults aged 65 and older with physical
Quality of life (life
disabilities
satisfaction)
206 adults, mean age 15.4 years
Grief
Klyse, Bombardier, et al.
Kalpakjian (2015)
Kokaridas,
Harbalis,
Depression
Perkos,
&
Koltsidas
50 wheelchair basketball players (all men) aged
Sport orientation
21-47 years
Athletic identity
38 persons, whose time since injury ranged from
Quality of life
(2009)
Manns & Chad (1999)
longer than 2 to less than 30 years
Marinic & Brkljacie (2008)
397 persons with physical disabilities and 913
Happiness
persons from the general population
Martin (1999)
57 adolescent swimmers (27 females and 30
Anxiety
males) with disabilities, ages 16-19 years
Athletic identity
Self-esteem
Martin (2002)
Fifty-one male adult (M= 35.4 yrs; SD = 10.9 yrs;
Self-efficacy
Range = 18 - 61 yrs) wheelchair long distance
racers
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Martin (2006)
112 athletes with disabilities ages 12-18 years
Sport friendship quality
Martin (2008)
79 adults (66 men and 13 women) wheelchair
Self-efficacy
basketball players
Martin, Adams-Mushett,
57 youth swimmers (27 females and 30 males)
Athletic identity
& Smith (1995)
with disabilities, ages 16-19 years
Sport orientation
Martin & Smith(2002)
150 youths (85 male and 65 female) athletes, ages
Sport friendship quality
9-18 years
Martin,
Eklund,
&
Seventy-eight swimmers with disabilities
Athletic identity
Miyahara & Piek (2006)
1984 persons with physical disabilities
Self-esteem
Mrug & Wallander (2002)
184 young people with a physical disability,
Personality
Mushett (1997)
mean age 15.03 years
Nosek & Hughes (2001)
Women with disabilities
Self-esteem
Nosek,
881 women with physical disabilities, ages 18-65
Sense of self in terms of
years
self-esteem,
Self-efficacy
Hughes,
Swedlund,
Taylor,
&
Swank (2003)
Self-cognition
(perceptions of how
others see them)
Nosek, Hughes, Taylor, &
415 women with physical disabilities, with a
Depression
Taylor (2006)
mean age of 46.0 years
Stress
Perreault & Marisi (1997)
Thirty-seven elite male wheelchair basketball
Anxiety
players ranging in age from 25 to 40 years old
Perreault
&
72 (41 men and 31 women) wheelchair basketball
Sport motivation
(2007)
players, with a mean age of 30.1 years
Athletic coping skills
Perrier, Smith, Strachan,
Seven women and four men, with an average age
Athletic identity
& Latimer-Cheung (2014)
of 40.1
Rose & Larkin (2002)
380 children, ranging in age from 8-12 years
Self-perception profile
Sands
six female wheelchair basketball players and 20
Physical Self-perception
female able-bodied basketball players, ages
profile
ranged from 18 to 33years for the wheelchair
Social Physique Anxiety
&
Vallerand
Wettenhall
(2000)
participants and 18 to 28 years for the ablebodied
Scarpa (2011)
Shapiro & Martin (2010)
1149 individuals with and without disability
Physical self-concept
aged between 13 and 28 (578 boys and 571 girls)
Self-esteem
36 youth (ages 12–17 years) and older adolescent
Physical self-concept
(18–21 years) athletes with physical disabilities
(female = 9, males = 27; M age = 16)
Sit,
Lau,
&Vertinsky
(2009)
Skordilis,
Koutsouki,
Asonitou, Evans, Jensen,
66 persons (33 men and 33 women) with physical
Physical Self-concept
disabilities, and a mean age of 30.1 years
Self-esteem
34 male and 14 female marathoners and 166 male
Sport orientation
and 29 female basketball players
Goal orientation
35 professional, 36 amateur, and 35 wheelchair
Sport orientation
basketball athletes
Goal orientation
& Wall (2001)
Skordilis,
Charitou,
Gavriilidis,
&
Asonitou
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
(2003)
Stevens,
Steele,
Jutai,
Kalnins,
Bortolussi,
101 students (male and female), ages 11-16 years
Self-esteem
146 non-disabled and 135 subjects with physical
Self-esteem
&
Biggar (1996)
Tam & Watkins (1995)
disabilities
Tasiemski,
Gardner,
Kennedy,
&
678 people, ages 20-77 years
Blaikley
Athletic identity,
Anxiety,
(2004)
Depression
Tasiemski
&
Brewer
(2011)
1034 persons (173 women and 861 men),ages 19-
Athletic identity,
68 years
Life satisfaction
Anxiety,
Depression
Van de Vliet, Van Biesen,
18 Paralympic athletes, ages 17-48 years, and 37
Athletic identity
& Vanlandewijck (2008)
non-Paralympic Elite athletes ages 13-25 years
Self-esteem
Physical Self-perceptions
Wanneberg (2014)
15persons (12women and3men),ages 15-65years
Identity
Wilson,
37persons, ages8-20years
Psychological
Engel,
Washington,
Ciol,
&
Jensen
adjustment
(2006)
4. Discussion
The present study aimed to offer a systematic review of psychological issues presented
in people with physical disabilities. The study also aimed to reveal research trends and
issues presenting the most interest in populations with physical disabilities.
Within the framework of the literature review, the present study located 58
studies dealing with psychological issues of people with physical disabilities. The
largest number (20) of published studies are found between 2006-2010, with other fiveyear periods to present a uniformity regarding the number of publications with
significantly smaller number. Considering the important role of the psychological factor
on disabled people, the total number of studies located in the present study is
considered extremely low, revealing that the interest of researchers on psychology
issues for people with physical disabilities is very limited. This is enhanced by the
previous mentions of other scholars (e.g., Martin, 2002, 2006).
The findings of the present study even though they revealed that a wide range of
journals have selected to publish studies on the psychological issues of people with
physical disabilities, percentage wise the journals that have published a significant
number of such studies is rather limited. This seems to be related to the limited number
of studies located. Nevertheless, we can consider that there are a large number of
journals that are interested in publishing relevant studies.
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Findings regarding research design that were followed by the studies reviewed
for the purposes of the present study initially revealed that descriptive research method
was mainly used at a percentage of 72.4%. This shows that researchers were seeking to
study psychological issues as these were developed in their natural environment at a
specific time and not study how, when and why various psychological phenomena are
developed (Shields & Rangarjan, 2013). In other words, researchers did not show any
interest on the determination of the relation between cause-result for psychological
characteristics of individuals with physical disability (Thomas, Nelson, & Silverman,
2005).
Within the framework of research design, it was observed that researchers
preferred the use of cross-sectional method against longitudinal one. This finding
reveals the interest of researchers on psychological phenomena that appear at a specific
time in individuals with physical disabilities, without though showing the same interest
for the cause of these phenomena and for their formation in various groups such are
sex, age, populations, etc. Heiman (2002) claimed that a cross-sectional study offers the
ability to observe people of various ages and in different time periods.
Finally, the analysis of data on research methods in the present study showed the
preference of researchers in quantitative research (89.6%). The use of quantitative
research assists the understanding of phenomena such is perception of self in
individuals with physical disability through numerical data. The procedure of
measurement followed in quantitative research assists the understanding of the relation
between empirical observation and mathematical expression of quantitative relations
(Given, 2008). Aliaga and Gunderson (2000) describe the quantitative research as
explaining a phenomenon by collecting quantitative (numerical) data that are analyzed
using mathematically based methods such as statistics. The quantitative research is
widely used in sciences such are psychology, health and human development, etc
(Given, 2008).
In order to gather quantitative data the use of questionnaires was preferred.
Researchers used questionnaires to acquire data on psychological issues through asking
the participants to answer questions and not observe their behavior. It is obvious that
results derived from the questionnaires show limitations, since we cannot know if the
answers are compatible with reality. This reveals the need to cross check results with
other methods such are interview and observation. The use of mixed methods such are
questionnaire and interview are used to confirm results despite the differences in data
selection, analysis and interpretation (Harris & Brown, 2010).
Regarding the characteristics of the sample used in there viewed studies,
findings of the present study revealed a small superiority of the general population
against the athletic one. The relevantly high percentage of studies in sports (44.8%)
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
reveals the interest of researchers on the dynamics of psychological issues in disability
sports. Martin (1999), considering the fact that there are many similarities among
athletes with and without disabilities, stressed the importance of understanding factors
such are the psychological ones associated with disability and disability sport. Research
interest for the study of psychological issues was focused mainly in ages under 16
years, from 30 to 40 years, and also a respective interest for the whole age range
simultaneously, with a rate around 22% for each of the three age groups separately. In
general, the sample in the majority of studies included adults. This is possibly due to
the fact that disability is a situation that becomes more intense in this group of people.
Martin (1999) reports that 85% of athletes with a disability had an acquired disability
(e.g., car accident). Another characteristic of the sample was that studies mainly used
mixed samples (male and female) something that shows that in research sex was used
in the same way by the researchers.
Another finding of the present study is the orientation in measures of
psychological issues in individuals with physical disabilities. Block et al. (2004) have
expressed the importance of psychological issues by stating that psychological
problems may be equally significant with those of disability. The psychological issues
examined referred mainly to the components of self and a number of emotions and
secondarily to issues relating to
personality
and
motivation
towards goal
achievement (see Table 6).
Self is determined as the way through which an individual perceives his/her
self
Harter,
; Rosenberg,
. Perception of self typically encompasses the
constructs of self-concept, self-esteem and self-efficacy (Roberts, Treasure, & Conroy,
2007). In the present review, it was found that the above constructs were those used
mainly for the study of self-perception in individuals with physical disabilities.
The interest of researchers on the study of the above mentioned constructs of self
in individuals with physical disabilities seem to be timeless since in a previous review
on athletes with disabilities the findings were similar (Hutzler & BarEli, 1993). This time
less obsession on the study of the self-concept in individuals with physical disabilities is
possibly due to the fact that the concept of self, keeps together the internal cohesion of
the individual, determines the way various experiences are explained and offers a total
of expectations (Burns, 1982).
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
Table 6: Summary table of issues measured
Psychological issue
Issues measured
Number/ (%)
Self-perception
Partial Sum (%)
30 (52.6)
Self-cognition
1 (1.8)
Self-concept
9 (15.8)
Self-esteem
13 (22.8)
Self-efficacy
6 (8.8)
Self-world
1 (1.8)
Self-talk
1 (1.8)
Motivation
12 (21.1)
Goal orientation
5 (8.8)
Sport orientation
4 (7.0)
Motivation climate
3 (5.3)
Emotion
29 (50.1)
Grief
Anxiety
1 (1.8)
8 (14.1)
Stress
3 (5.3)
Depression
6 (10.5)
Quality of life
6 (10.5)
Satisfaction of life
2 (3.5)
Happiness
1 (1.8)
Sport friendship quality
2 (3.5)
Personality
14 (24.6)
General issues
Identity
2 (3.5)
10 (17.7)
Behavior
2 (3.5)
Emotions are psychological concepts and are considered to be a result of a
subjective, conscious experience and are characterized primarily by psychophysiological expressions, biological reactions and mental states. Lazarus (2000) defined
emotions as an organized psycho-physiological reaction to ongoing relationships with the
environment, most often, but not always, interpersonal or social
p.
.
Studies reviewed in the present study showed that the psychological concept of
emotion
in people with disabilities has interest scholars. Research on discrete
emotions helps us appreciate the evolutionary-adaptive reasons why humans are
motivated to adopt an apocalyptic orientation to life (Fuller, 2007). A number of
psychologists have confirmed that emotions affect thought, decision making and
actions (Bechara, Damasio, & Damasio, 2000; Fredrickson, 2000; Lerner & Keltner, 2000).
Emotions that mainly concerned researchers were anxiety, depression and the
quality/satisfaction of life. Anxiety is an emotional state that may be of psychogenetic
origin or a consequence of a physical illness. The study of anxiety in individuals with
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
physical disabilities helps the assessment of behavioral disorders caused by anxiety.
The anxiety is considered to reflect uncertainty regarding goal attainment and coping
(Lazarus, 2000) and is typified by feelings of apprehension and tension along with
activation or arousal of the autonomic nervous system (Spielberger, 1966).
Depression is mentioned as an emotional disorder. Frijda (1994) suggested that
depression is an emotion resulting from the perception of the individual on the relation
between actual progress and expectations regarding the rate of progress. Depression is
likely to appear if someone does not believe that has made sufficient progress in
achieving a meaningful goal, or following an actual or perceived failure to achieve a
meaningful goal. A consequence of depression may be the absence of willingness to do
pleasurable things (e.g., communication), less self-perception and low performance in
physical activities (Lane & Terry, 2000). Based on the above it is understood that the
evaluation of depression in people with physical disabilities may be an interesting
element for researchers.
Quality of life can be defined as the subjective evaluation of the satisfaction
derived from the good characteristics of a person’s life Whiteneck, 994). In this case,
quality of life is almost synonymous to the satisfaction for one’s life Siosteen,
Lundqvist, Blomstrand, Sullivan, & Sullivan, 1990). The following factors have been
supported to determine the quality of life social inclusion (e.g., community integration,
residential environment), self-determination (e.g., autonomy, choice), personal
development (e.g., education and rehabilitation), rights (e.g., privacy, citizenship),
interpersonal relations (e.g., friendship, social network), emotional well-being (e.g.,
contentment, self-concept), physical well-being (e.g., health, leisure), and material wellbeing (e.g., employment, transportation) (Brown, Schalock, & Brown, 2009; Schalock,
Brown, Brown, Cummins, Felce, Matikka et al., 2002).
Personality, as psychological term refers to issues relating to the dynamic
organization of physical, spiritual, moral and social individual properties and which are
expressed throughout their social life. Through the present study it was found that
examined researchers dealt with personality issues such are the identity and personality
of individuals in physical activities such are sports. Poppes, van der Putten, and
Vlaskamp (2010) claimed that many disabled individuals present provocative attitudes.
The study of similar elements of personality assists in the better understanding and
prediction of behavior of individuals with physical disabilities through the increase of
their efficiency and problem solving (Bacanac, 2001).
Finally, another psychological issue found to have been researched was goal
motivation. Goal achievement is distinguished by task and ego, each one of which is
linked to a different perception of ability and definition of happiness (Nicholls, 1984,
1989). The present study revealed that studies examining goal achievement of
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PHYSICAL DISABILITIES AND PSYCHOLOGICAL ISSUES: A SYSTEMATIC REVIEW OF THE LITERATURE
individuals with physical disabilities this was examined within the framework of goal
orientation, sport orientation, and motivation climate. This framework helps to research
views that lead disabled individuals to decision making and which behavior they
present towards achievement (Roberts et al. 2007).
4.1 Limitations
Research terms used in the present study did not cover all relevant published studies,
therefore limitations were expected. Regarding the inclusion of criteria leading to the
exclusion of studies, concerns have been raised on possible bias during the review
procedure (Stern & Simons, 1997). An initial limitation may regard the time period set
for the conducting of the present study. The review was limited to studies published
only in the English language. Another limitation may be the criterion set for the use of
studies published in journals with judges, excluding therefore from the procedure
unpublished studies, etc.
5. Conclusions
Despite the above mentioned limitations, findings offer a clear view on the estimation
of psychological issues faced by individuals with physical disabilities. Unfortunately,
the interest of researchers on psychological issues of the examined population was
rather limited with the exception of the time from 2006 to 2010. Even though a large
number of journals was found to have published relevant to what is examined issues,
the most of the studies were covered by one single journal. Research designs for the
study of data used included descriptive, cross-sectional and quantitative. The use of
experimental design with an experimental and a control group was very limited. To
gather data questionnaires were preferred against other methods. Sample used came
equally from general and sport population while ages examined were under 16 years
old, 30-40 years old and some samples that included almost all ages. Regarding gender,
male-female combination was preferred, although in a large number of studies gender
was not determined. Finally, psychological issues examined included mostly parts of
self and emotions, and less issues relating to personality and goal motivation.
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European Journal of Special Education Research - Volume 2 │ Issue 3 │ 2017
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