Disability Related Variables Associated with Loneliness Among People with Disabilities
Journal of Rehabilitation, July-Sept, 2001 by Sandra L. Hopps, Michel Pepin, Isabelle Arseneau, Melanie Frechette, Genevieve Begin
Loneliness is defined as a subjective experience and is not synonymous with social isolation, which represents a lack of involvement in a social network. According to Peplau and Perlman (1982), cognitions act as a factor mediating feelings of loneliness. These representatives of the cognitive approach hold that loneliness is the result of a perceived discrepancy between the quality and the quantity of current interpersonal relationships and those that the individual wishes to have.
For Peplau and Perlman, people may experience different types of loneliness. One categorization of loneliness is that proposed by Weiss (1973), who distinguished two types of loneliness: social loneliness and emotional loneliness. Social loneliness results from the absence of involvement in a social network, and may only be resolved by access to a satisfying social network. Emotional loneliness is the result of the absence of an important attachment or the loss of such a relationship. Young (1982) defined other ways to categorize loneliness: chronic loneliness, situational loneliness and transitory loneliness. These differentiations demonstrate the multidimensional aspect of loneliness, and indicate that loneliness is not a single entity.
The definitions mentioned above demonstrate different theoretical approaches to loneliness. Those proposed by Weiss, as well as by Peplau and Perlman, fall respectively into the interactionist and cognitive approaches. These theories are the basis of the UCLA Loneliness Scale, the instrument most frequently used in the study of loneliness (DeGrace, Joshi & Pelletier, 1993). Furthermore, these definitions fall within the approach to psychology adopted by the current study.
Loneliness is an important problem. At the beginning of the 1980s, Rubenstein and Shaver (1982) reported that each month, 35 million Americans feel lonely or excluded… This finding was concurs with findings from another survey in which 11% to 26% of the people in the United States complained of loneliness (Peplau, Russell, & Heim, 1979). Socio-demographic predictions regarding loneliness, based on prevalence rates, indicated that in year 2000, each month, 29 to 70 million Americans will feel lonely (Ernst & Cacioppo, 1999). However, investigators seem unable to identify those who are susceptible to feeling lonely. Attempts to verify the relationship between loneliness and socio-demographic characteristics, including age, sex and level of education have not been successful, though certain researchers have demonstrated a weak negative relationship between loneliness and age (Mullins, Hall, & Gutkowski, 1996). However, a recent longitudinal study reveals that certain important moments in human development, notably the transition from high school to university, may provoke feelings of loneliness (Marangoni & Ickes, 1989).
Borys and Perlman (1985) completed a meta-analysis of studies comparing loneliness among men and women. They found that men are lonelier when the UCLA Loneliness Scale (a measure that does not involve the word “lonely”) is used. However, for self-rating data, the opposite was true. Furthermore, Mullins et al. (1996) found studies indicating that people with low levels of education obtain significantly higher results on an instrument measuring affective loneliness, but they also found some studies that show no relationship.
In contrast to the inconclusive studies concerning the relationship between loneliness and socio-demographic characteristics, studies are more likely to agree that a high level of loneliness negatively affects mental and physical health. Depression, anxiety and low self-esteem appear to be related to loneliness (DiTomasso & Spinner, 1997; Frieze, Bar-Tal & Carroll, 1979; Vitkus & Horowitz, 1987). Suicide, suicide fantasies, as well as alcohol and drug abuse are also positively associated with loneliness (McWhirter, 1990). Furthermore, loneliness is also related to poor social skills (Morier, Boisvert, Loranger & Arcand, 1996). Finally, physical health is negatively related to loneliness. Loneliness is a causal and exacerbating factor for physical health problems and poor immune system functioning, not to mention health problems resulting from previously mentioned substance abuse (Hojat & Vogel, 1987). In a study of heavy users of an emergency department, lonely people were more likely to make repeat visits than the general population (Andren & Rosenquist, 1985).
Despite all the knowledge acquired concerning the relationship between loneliness and mental/physical health among diverse populations, few empirical studies examine loneliness among people with physical disabilities, and even fewer are likely to include those who are living within the community. As time (extra time required to complete activities and for adapted transportation), negative attitudes of others (belief that the person is less interesting), and physical barriers (lack of access ramp and transportation) constitute important obstacles to the social integration of people with visible physical disabilities (Furrie, 1990), they are faced with social realities that differ from those who do not have disabilities. This also implies that interventions that target reducing loneliness and increasing social participation among this population should be adapted to their social reality and the obstacles involved. Verifying the existence of a relationship between loneliness and variables associated with physical disability could provide useful information concerning potential intervention objectives and strategies. Furthermore, considering that lonely people are generally less socially integrated than those who are not (DiTommaso & Spinner, 1997), and are unlikely to consult mental health caregivers (Evans & Dingus, 1987), it is important to detect people at risk for loneliness and then provide them with appropriate interventions, especially in light of the costs of loneliness on mental and physical health care systems.