Dysmorphia and Disability

ABSTRACT
This paper explores the relationship of identity on disability and employment. Age, race, congenital development and acquisition affect aspects of an individual’s self-image, esteem, efficacy and identity in relationship to their diagnosis and interaction with their social and physical environment. The paper will initially explore the definitions of self image and self-concept and then look at a series of sources that focus on varying studies that determine various characteristics and their effects in the professional world. I will also look at how–although largely prohibited by employment and constitutional discrimination laws prohibit it–workplace and job market politics and culture revolve around first impressions and influence rooted in identity.

Literature Review

1) Identity Formation:
Racial, sexual, spiritual, regional, legal (nationality), vocational and educational aspects of what makes a person and how disability affects that formation.

The study found that youth with disabilities experienced higher rates of suspension than those without. Particularly students with emotional disturbances experienced higher suspension rates across all demographics compared to their non-disabled counterparts. The rates increase too for learning disabilities and other health impairments. The article goes on to discuss how disabled students–particularly African-Americans are suspended at three times the rate of other students. Although the relevance of race to disability may seem a stretch to connect with image counseling, as an African-American consumer I’d like to make the connection between race and dysmorphia topics. I’ve another article that is related and all together I feel it will have cohesion under cognitive disability studies.

Krezmien, M. , Leone, P. , & Achilles, G. (2006). Suspension, race, and disability: Analysis of statewide practices and reporting. Journal of Emotional and Behavioral Disorders, 14(4), 217-226.

“This study looks at the patterns formed by race and disability in the context of educational suspension within the state of Maryland. This study looks at all Maryland public schools, drawing information from state-public records including special education services, suspensions and enrollment from 1995 to 2003. The population breakdown was racially 50.4% white, 37.9% African American, 6.4% Hispanic, 6% Asian American, .4% American Indian; gender was 51.3% boys, 48.7% girls; placement was 88% general education, 12% special education; academically 30% high school, 23.9% middle school, 43% elementary, 2.5% preschool. The categories of disability that were included focused on cognitive, psychiatric and developmental disabilities. The data was analyzed using SPSS calculating the number of suspensions per thousand students and number of students per thousand suspensions. Then calculations were by logistic regression model to examine disproportionate suspensions by race from 1995 to 2003. Then third, using the regression model again, suspension was analyzed by a combination of race and disability.”

Social Media Provides a Digital Mirror for Identity Formation
Allen, Sharee Nicole, “”Adolescents, Social Media, and the Use of Self-Portraiture in Identity Formation”” (2015). LMU/LLS Theses and Dissertations. Paper 150.
http://digitalcommons.lmu.edu/etd/150

“Timing in the therapeutic process is very important when giving a self-portrait
directive: too soon in treatment may cause an insecure adolescent to regress or to
misinterpret a self-image (Muri, 2007). One way to curb this regression is to promote
insight into the so-called social acting. There is a distinct power in projecting one’s
visual self, particularly in a group context. By doing this, individuals encourage their
online audience to know them via the friends they are depicted with, attempting to
generate an impression of them as socially desirable (Zhao et al. 2008)””

“The circulation of Selfies online can be a therapeutic act. There exists a distinct
advantage in projecting one’s visual self. Even when depicting our id in a published
photograph, we recognize what is damaged within us, and open ourselves up for honest
healing. Several participants in this study identify themselves within a group context, an
attempt to label the self by association. This approach may have similar advantages to
group therapy: the formation of and the client’s integration into a group identity based on
a common characteristic.
Posts that contain no image might serve different purposes. In these cases, the
validation of one’s ideas is being sought, and the poster is classified by his or her
thoughts. Participant’s attempts to interact solely via words have been met with some
resistance, reminding us of the power of the visual sphere.”””
Issuew of Dysmorphia of Gender Identity

Arlene Istar Lev LCSW, CASAC (2006) Disordering Gender Identity, Journal of
Psychology & Human Sexuality, 17:3-4, 35-69, DOI: 10.1300/J056v17n03_03″

41:”These diagnoses then influence repressive social policies and judicial decision-making that further institutionalize these bigoted and oppressive polices. Clinically the
question is raised whether the “deviance,” “conflict,” or “disorder” that
women, people of color, and sexual minorities have experienced are, in
fact, symptoms of a “dysfunction in the individual”–as the definition for
mental disorders in the DSM maintains is necessary for a diagnosis to
be made (APA, 2000, p. xxxi, emphasis mine)–or an adaptation to untenable
and abusive social and clinical paradigms.

51:””By stating that some
gendered behavior in children is pathological, the DSM establishes a
“fiction of natural gender” (Spade, 2003, p. 25), an assumption that
there is normal and abnormal ways to express, that creates a policing
and surveillance of correct gender behaviors in all children. Boys are,
however, more frequently referred for assessment of gender disorders
than are girls (Zucker & Bradley, 1995; Cohen-Kettenis et al., 2003)–
and therefore more likely to receive treatment. In all likelihood this is
because they are held to more rigid gender conformity in their dress and
mannerisms and their transgressions cause more social difficulties
(Rottnek, 1999). Although it is their atypical gender identity that has
been identified as the problem, it is possible that their distress is related
to the stigma of being different, indeed being referred to clinics and
professionals to treat these differences, rather than their actual gender
experiences or expressions (Lev, 2004).

54-55: “”This gatekeeping system reinforces the development of a false relationship
between therapist and client and some clinicians are developing
advocacy-based models that allow room for alternative “stories”
about cross-gender experience (see Cole et al., 2000; Bockting &
Coleman, 1992; Lev, 2004; Rachlin, 1997; Raj, 2002). These advocacy
models allow gender specialists to move out of a gatekeeping model of
assessment to a psychotherapeutic relationship that allows for a client’s
unique narrative and gender trajectory. These treatment philosophies
54 Sexual and Gender Diagnoses of the Diagnostic and Statistical Manual (DSM)
Downloaded by [SDSU San Diego State University] at 12:46 06 February 2016
and are based in a model of educated self-determination, where gender
variance is respected, and clinicians serve as advocates and educators,
as well as evaluators of mental health.”
Although teachcrs are trained, the general public response may be otherwise.”

 

2) Culture and Identity matching with career:
Looking at clients who have various language skills, cultural identities and knowledge and eve gender communities and their most emotionally and socially complimentary work environments.

3) Work-world Resilience of Identity Management:
Exploring social roles, discretion of disability, when to disclose, whom to disclose, etc.”
“Firstly, Weinberg’s “Expectations and performance” provides a very scientific understanding of how self-efficacy works. From his article and his goal of creating an empirical study on the internal psychological phenomenon, I was inspired to investigate what ways technology can be applied to manipulate and hone a consumer’s talent tapping needs. Self-motivation and empowerment are a basis for success for VR consumers and it’s great to know that Weinberg created a method in physically looking at how the self-talk can actually lead to advancement.
The qualitative, case study basis of the information gathered by the articles is especially helpful. Looking at how the individuals and their experiences in varying social contexts and in adversity like racism, sexism, ageism, ableism, etc, this assortment of articles brings a very helpful and broad view.

Adamson’s “Self-image, adolescence, and disability” definitely gives me framework on where interpretations could lead and underlying factors. I can definitely utilize the article on many general points although I think the socialized healthcare and welfare national context from which it comes creates results that may be very different than American references.

Levine’s “Denial and self-image” gives a great in depth look at acquired that also provides a great contrast to Adamson’s congenital disability focus. In addressing range it helps for my understanding how self-imaging processes differ developmentally. In line with the others, both Schieman’s “Age variations in personal agency and self-esteem” and Krezmien’s ”Suspension, race, and disability” provide me a better idea on the diversity of disability and its interaction with other characteristics. In helping consumers realize their potentials, knowing the interplay of other factors like sex and ethnicity provides a much more tailored and empathic repertoire.”

This article provides many correlative sources to understand how self-efficacy, self-esteem, health control in particular as items that contribute to self-identity and self-image can be adversely affected. How those adverse effects contribute to dysmorphia are integral to my thesis. I’d like to explore and break down how self-image works in a reverse engineering fashion in order to look at dysmorphia and its relationship with disability. Additionally in helping me accomplish that goal, this source provides me we reference on aging and ageism and its effects on self-image and dysmorphia.

Schieman, S., & Campbell, J. E. (2001). Age variations in personal agency and self-esteem: The context of physical disability.Journal of Aging and Health, 13(2), 155-85. Retrieved from http://search.proquest.com/docview/215851694?accountid=13758

The article “Age variations in personal agency and self-esteem: The context of physical disability” gives an in depth analysis and a study focused on the social and psychological aspects of disability, positive self-identity, aging and disability. The study is conducted with a sample of 1,549 Canadians with and without disabilities in 1985. Its results conclude that older respondents reported lower scores at a percentage of 43% with reasons for lower health control rooted in physical impairments, global health, empathy and introspectiveness including more than half lower score reporting being rooted in low self-esteem. The article reinforces the social effects of aging on the self-esteem, efficacy and control over health. Integral are the comparison of the two views, “age as decline” a cognitive pattern associating loss of roles and physical function with aging, undermining social integration, potency, and the sense of self-worth. In opposition, “age as maturity” views older people as developing new capabilities to meet expectations and hardship.
“This results of the study reported that individuals generally marked high with due reason. The researchers provide two suggestions as to why: 1) earlier identity formation due to coping with easily discernable physical differences; 2) better socialization due to being exposed to persons outside of the home such as medical and educational staff. However those remain suggestions of the study because of contradictory evidence that was also gathered. The oldest and most mildly affected affected CP subject expressed a more negative self-image and the researchers suspect it had to do with internalizing non-self generated criticisms received elsewhere. This report is particularly helpful because of it’s focus on congenital disability. For non-cognitive, non-acquired disorders it gives a great example of the development of self image and the social context in which it occurs.”

Adamson, L. (2003). Self-image, adolescence, and disability. American Journal of Occupational Therapy, 57(5), 578-581.

“The article takes a look at healthiness of self image among several students with cerebral palsy, three girls and four boys between the ages of 12 and 17 in sweden. The study utilized the “I think I am” personality inventory which is commonly used in general Swedish education in conjunction with transcribed interviews. The test is Likert based on a four point scale and express results in areas of physical characteristics, psychological well-being, skills and talents, relationships with family and relationships with others. Scores are expressed in integers in which high integers indicate a high self-image whereas negative indicate negative self-image. The participants were then interviewed with a semi-structured set of questions over a period of four months in a conversational format in order to properly assess the person’s thought pattern.”

“This article’s study found higher disparity scores on the questionnaire versus the adjective list, and higher on the now assessments versus the before assessments. A key quote on the conclusion of the study is that the findings “indicate mechanisms employed by individuals with major illnesses have more to do with denying their aspirations as gauged by the real-ideal-self-measure than with denying their real level of functioning.” The stroke patient group particularly rated lower than both the control group and the other patient groups regarding normal aspirations in order to achieve a sense of well-being. The studies indicate and reinforce that denial is a defense-mechanism that is critical for the survival of the seriously ill against susceptibility to frustration and despair. It gives a great amount of support in advocacy for people with disabilities’ vital need for self-image support for not just their real-self (physiological) but also their ideal-self (psycho-emotional) in order to be productive and satisfied.”

Levine, J., & Zigler, E. (1975). Denial and self-image in stroke, lung cancer, and heart disease patients. Journal of Consulting and Clinical Psychology, 43(6), 751.

“In psychological and sports psychological writings ideas of self-confidence and self-efficacy are often reinforced as affecting a person’s performance. This article assesses Bandura’s 1977 theory of self-efficacy. He views “behavioral change as being mediated by a common cognitive mechanism, self-efficacy, which is defined as the strength of one’s conviction that he or she can successfully execute a behavior to produce a certain outcome”. Although the framework provides a means of conceptualizing, the article looks at a a study that set out to empirically gather data based upon Bandura’s self-efficacy theory. At the time of publication although Bandura’s ideas were supported, the scientific method of most of the studies suffered some error. The study is accomplished by looking at 30 male and 30 female students at North Texas State University who ranged from 18-24 years old. They were each randomly assigned to a high or low self-efficacy condition in a two by two by two, type of sex by type of self-efficacy by type of trial design. The experiment involved accomplishing a task of physical endurance. A trial was done to collect a baseline time for all participants. The participants then performed a task using the same muscles in another task on an isokinetic leg-strength machine. Subjects who reported low-self efficacy in the pre-test were then compared to those with high self-efficacy in the test and vise versa. Then they rigged the trial to be a competition in which one was a subject and the other was a confederate and the subject would lose. The experiment had two trials and culminates in the end with a post-experimental seven scale Likert questionnaire.”

“This results from the article state “Substantial performance differences accompanying the subjects’ changes in efficacy expectations”. This indicates that high-efficacy resulted in higher endurance rates whereas low-efficacy indicated lower. Subjects with high-efficacy demonstrated increased exertion after failure. Low-efficacy subjects decreased their efforts after failure. While the confirmation of Bandura’s self-efficacy theory is handy for my interest in Disability and Self-Image, the article introduced me to some new ideas that include the learned helplessness theory which is described as “organisms are aware of contingencies and noncontingencies in their environments and that an experience with noncontingency in one situation may cause an expectation of noncontingency in a subsequent situation”. Although the study concluded that helplessness theory wasn’t suited, it introduced the idea of “learned skepticism”. Even of more interest, because the study addressed gender as an attribute, commenting, “It is highly possible that the females in this investigation perceived ‘leg strength’ performance as male-oriented, thus demonstrating lower expectations and a higher frequency of negative self-talk than their male counterparts”. The conductors of the study also speculated that accordingly male participants may have “underreacted to failure” by attributing reasons elsewhere in spite of more affirmational statements.”

Weinberg, R. S., Gould, D., & Jackson, A. (1979). Expectations and performance: An empirical test of Bandura’s self-efficacy theory. Journal of sport psychology, 1(4), 320-331.

” In psychological and sports psychological writings ideas of self-confidence and self-efficacy are often reinforced as affecting a person’s performance. This article assesses Bandura’s 1977 theory of self-efficacy. He views “behavioral change as being mediated by a common cognitive mechanism, self-efficacy, which is defined as the strength of one’s conviction that he or she can successfully execute a behavior to produce a certain outcome”. Although the framework provides a means of conceptualizing, the article looks at a a study that set out to empirically gather data based upon Bandura’s self-efficacy theory. At the time of publication although Bandura’s ideas were supported, the scientific method of most of the studies suffered some error. The study is accomplished by looking at 30 male and 30 female students at North Texas State University who ranged from 18-24 years old. They were each randomly assigned to a high or low self-efficacy condition in a two by two by two, type of sex by type of self-efficacy by type of trial design. The experiment involved accomplishing a task of physical endurance. A trial was done to collect a baseline time for all participants. The participants then performed a task using the same muscles in another task on an isokinetic leg-strength machine. Subjects who reported low-self efficacy in the pre-test were then compared to those with high self-efficacy in the test and vise versa. Then they rigged the trial to be a competition in which one was a subject and the other was a confederate and the subject would lose. The experiment had two trials and culminates in the end with a post-experimental seven scale Likert questionnaire.”

Cooper, P. S. (1993). Self-esteem and facial attractiveness in learning disabled children. Child Study Journal, 23(2), 79-89.

Investigated the relationship between facial attractiveness (FA) and self-esteem (SE) in 55 diagnosed learning disabled children (aged 8–13 yrs). Ss were 11 female and 44 male students. Each S was orally administered the Children’s Self-Concept Scale and a total score for SE along with 6 cluster scores were obtained. Facial photographs were taken of Ss and rated by adults and same age peers. A significant positive relationship emerged between FA and SE, and a significant difference was found between adult and peer mean rating of FA. No significant difference, however, was found between correlations of adult rating and total SE to peer rating and total SE. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

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