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Abstract
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Functional limitations - defined as restrictions in carrying out activities of daily living (ADLs), instrumental activities (IADLs), or more complex work and social activities (Stuck et al., 1999) - affect a considerable portion of the U.S. population. Although prevalence rates vary depending upon the definition of functional limitation applied, the U.S. Census estimates that 56.7 million people - or nearly one-fifth of the population - experience some degree of functional limitation, and 38.3 million people (12.6 percent of the population) experience severe limitations (Brault, 2012).
Estimates of functional limitation in the population raise concern because it is associated with a host of secondary physical and mental health complaints, the most prevalent of which is depressive symptoms (Hughes et al., 2001; Nosek and Hughes, 2003). Indeed, a greater degree of functional limitation is associated with higher levels of depressive symptoms both cross-sectionally and over time (Breslin et al., 2006; Turner and Noh, 1988; Yang, 2006). This pattern of findings is found across both self-report and clinical measures of functional limitation and depressive symptoms (Bruce, 2001), and has spurred interest in the question of what social or psychological risk factors link variation in functional limitation severity with psychological distress.
Most social science-oriented studies of the functional limitation severity--depressive symptoms association have drawn from a stress and coping framework (Lazarus and Folkman, 1984; Pearlin, 1989; Pearlin et al., 1981) to investigate stressors such as major life events and chronic strains and psychosocial coping resources such as mastery, self-esteem and perceived social support as explanations (Bruce, 2001; Turner and Noh, 1988; Yang, 2006). In this work - and perhaps because a substantial portion of the effect of functional limitation severity on depressive symptoms is not explained by these factors (Yang, 2006) - it is often acknowledged that adaptation to stressful circumstances can be more difficult for people with functional limitations because of the unique social and personal challenges they experience (e.g., Turner and Noh, 1988). However, the form and meaning of these challenges are not clearly articulated in this literature....
Language: en |