Serious psychological distress among adults with and without disabilities.
OBJECTIVE
Our objective was to examine the extent to which serious psychological distress (SPD) is associated with behavioral and social correlates among US adults with self-reported disabilities.


METHODS
Self-reported data on disability, SPD, and behavioral and social correlates were collected from 202,383 participants (aged > or = 18 years) of the 2007 Behavioral Risk Factor Surveillance System. Adults with self-reported disabilities were identified using two standardized questions--one relating to activity limitation, the other to special equipment.


RESULTS
The age-adjusted prevalence of SPD among adults with disabilities was nearly seven times higher than among adults without disabilities (14.1 % vs. 1.8 %, respectively). Adults with disabilities who have both activity limitations and who use assistive technology, and those with activity limitations only consistently experienced a higher prevalence of SPD than those who used assistive technology only (age-adjusted prevalence: 21.0 % and 12.7 % vs. 4.9 %). After adjusting for age, sex, race/ethnicity, educational attainment, marital status, and employment status, in the past 30 days SPD was more common among Hispanic persons, and was significantly associated with younger age, lower educational attainment, marital history, and employment status. Adults with SPD and disabilities experienced increased levels of risk behaviors, life dissatisfaction, and inadequate social support. Most importantly, just over half of adults with disabilities and SPD (51.6 % [95 % CI = 48.6-54.6]) were receiving medical care for a mental health condition compared to 20.6 % (95 % CI = 19.9-21.3) without SPD.


CONCLUSIONS
Given that SPD is strongly associated with both the behavioral and psychosocial determinants of health, this work underscores the need for evidence-based interventions that may reduce its prevalence among people living with disabilities.
Okoro
Catherine A
CA
National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, 4770 Buford Highway NE, Atlanta, GA 30341, USA. Cokoro@cdc.gov
Strine
Tara W
TW
Balluz
Lina S
LS
Crews
John E
JE
Dhingra
Satvinder
S
Berry
Joyce T
JT
Mokdad
Ali H
AH
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D015897:Comorbidity; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D004651:Employment; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012656:Self-Help Devices / Q000523:psychology / Q000706:statistics & numerical data; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult