3. Introduction to Psychological Issues of Physically Disabled Persons
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Transcript of 3. Introduction to Psychological Issues of Physically Disabled Persons
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REHAN ALI MALIKGOLD MEDALIST BS(HONS.)O&P
GENERALSECRETARY POSP
CPO. ALAC AFIRM RWP.
Introduction To Psychological issues of
Physically Disabled persons
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Definitions According To World Health Organization
Impairment
Permanent or Transitory psychological, physiological or
anatomical loss or abnormality
E.g. a missing or defective part, tissue organ or mechanism of the
body such as amputated limb, paralysis after polio, Myocardial
Infarction, cerebrovascular thrombosis, Restricted Pulmonary
capacity, Diabetes, Myopia, Disfigurement, Mental Retardation,
Hypertension, perceptual disturbance and sensory deprivation
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Functional Limitation
Impairment may cause functional limitations which are partial or
total inability to perform those activities necessary for motor,
sensory or mental functions within the range and manner of
which the human being is normally capable.
Walking, lifting loads, seeing, speaking, hearing, reading, writing,counting, taking an interest in and making contact with
surroundings
Functional limitation may last for a short time, long time, be
permanent or reversible
Should be quantified whenever possible
Could be progressive or Regressive
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Disability
Impairment or functional limitation is causative factor
Defined as an existing difficulty in performing one or more
activities which in accordance with the subjects age, sex and
normative social role are generally accepted as essential
Depending on the duration of functional l imitation:
Disability could be:
Short Term Long Term
Permanent
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Case
5o years old male who has had hypertension for several years suffers astroke resulting in right sided hemiparalysis & dysphasia
Impairment:
Hypertension along with disturbance of brain function Functional Limitation:
Decreased ability to talk
Decreased ability to walk & use right hand
Disability:
Inability to work
Partial inability to look after himself
Reduced ability to interact with surroundings
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Some Psychological Stresses Originating From Physical
Disability
I ndividual Consequences:
Decreased Independence
Compromised Mobility
Hampered Leisure Activities
Problems related to Social integration
Decreased economic Viability
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Family Consequences
Needs for Constant Care
Constant Liability on Family Members
Disturbed Social and Interpersonal Relationships
Economic Burden
Marital Disharmony and interpersonal conflicts
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Societal Consequences
Demands for Care
Fulfillment of special needs
Loss of Productivity leading to inability to fulfill social demands
Disturbed social integration
Stigmatization
Constant sympathy of society leading to low self esteem
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Major Psychological Problems Originating As A Result
Of Being Handicapped
Stress, Distress and Depressive Disorder
Post Traumatic Stress Disorder
Anxiety Disorder
Mixed Anxiety and Depressive Disorder
Adjustment Disorder
Acute Psychotic Episode (New onset or Relapse)
Acute Manic Episode (New onset or Relapse)
Agitated Depression
Personality Changes
Substance Misuse ( Alcohol, Cannabis, Opioids,Benzodiazepines)
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Depressive Disorder
Important to differentiate depressive symptoms which
can also be categorized as sadness which requires no
specific treatment
Depressive disorder or agitated depression on other
hand would require specific medical treatment
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When to diagnose
Depressive disorder should be diagnosed only:
When persons symptoms are severe enough to fulfill the
criteria
When persons symptoms are severe enough to disablethe individual functionally
Full blown symptoms of depressive disorder wouldrequire both pharmacological and psychological help
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Signs and symptoms of Depressive Illness
Depressed mood Feelings of sadness
Anguish & feelings of agony
Mournful, irritable & anxious
Reduced energy, easy fatigability, decreased activity, markedtiredness on slightest of effort
Reduced concentration & attention on a task
Reduced confidence & low self esteem
Feelings of guilt & worthlessness
Bleak & pessimistic view of the future Act of self harm & attempted suicide
Disturbed sleep, diminished libido, reduced appetite
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Physical symptoms in Depression
Many patients with Depression present to doctor with
physical symptoms such as:
Headache Chest Pain
Loss of Appetite
Burning sensations Pins and needles sensations
Gas, Gola etc
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Pharmacological Treatment
Choice of antidepressants would depend upon:
Anticipated side Effects
Safety
Tolerability
Presence of Comorbid physical illnesses
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Anxiety Disorders
Anxiety Disorders include:
GAD
Panic Disorders
social and Specific Phobias
PTSD
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Signs and Symptoms
Prominent somatic symptoms:
Increased Heart Rate
High Blood Pressure
Palpitations
Muscle tremor
Perspiration
Abdominal discomfort
Hyperventilation Restlessness
Fidgety feeling
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Post Traumatic Stress Disorder
Condition which can occur soon after disability
When people face an overwhelming event in life
Event thats perceived as dangerous & beyond normalcoping capabilities
When ability to respond to such event gets hampered
PTSD is not a single symptom but cluster of symptoms
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Symptoms of PTSD
Re-experiencing the event e.g. Nightmares
Routine avoidance of reminders of event
General lack of responsiveness
Diminished interest and engagement
Increased sleep disturbance and poor concentration
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Management of PTSD
Psychological F irst Aid
Psychoeducate patient and family
Help the patient understand his condition
Repeated reassurances that their reactions are b/c of stressdue to traumatic event
support from family, friends, relatives
Let the individual know that he is not alone and is notresponsible for the event
Deep Breathing and Muscle Relaxation Exercises
May require pharmacological Rx for management of anxiety
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interpersonal relationships with handicapped
people
H istor ical perspective:
Historically disabled have been confronted with physical and
mental impediments of their Disabilities
Confronted also by accompanying social stigma and Negative
social attitudes
A persistent negative attitude and social rejection of people with
disabilities is quite evident throughout history and cross culturally
Ancient Roman and Greek cultures viewed disabled as burden on
the society and as less than Human
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Interpersonal Difficulties in disabled
Early Research examined interactional Difficulties b/w people
with and without disabilities
A feeling of Discomfort and unease identified as interaction strain
Later on researchers noticed novelty of interactional situation and
self consciousness over appropriate behavior during these
interactions may also contribute to the problem
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People without disabilities vs. disabled
According to Fichten, Robillard, Judd and Amsel(1989):
People without disabilities perceive the Disabled to be different
across several social dimensions for e.g.
To be more socially Anxious
Uneasy about keeping social liaisons
To be socially more vulnerable to be picked up by others or being
criticized
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Impact of the negative attitudes on disabled
A significant impact on both social & vocational lives
of Disabled
Befriended
Social isolation Social stigmata
Social distance causing Low self esteem
Self image problems
Conscious of oneself all the time
Feeling of being lonely or left out
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How to improve attitudes regarding
interpersonal relationships of Disabled
Increased social contacts with the Disabled
Greater awareness campaigns for the Disabled
Improving societal attitudes about various Disabilities
True understanding about underlying cause
Be more empathic towards the disabled
Addressing the negative perceptions about the Disabled
Fostering the development of more friendly and optimistic
attitude towards the disabled Role of counselors and Educators regarding awareness generation
about various Disabilities
H t i i l l ti hi i
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How to improve social relationships in
physically challenged children
1). Building of self concept & self esteem 2). Confidence Building
3). Fostering involvement in games & creative acts
4). Channelizing energies & reducing frustrations byinvolving in certain activities
5). Acceptance of ones disability rather than feeling
ashamed of it
6). Social involvement and Deinstitutionalization
7). Community based rehabilitation
8). Vocational Training ( Knitting, Sewing, Tailoring, cooking)
9). Encouraging to participate into self Help Groups
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Th n s