CHAPTER IT Methodology In spite of a considerable increase in recent years in efforts to research many areas of rehabilitation psychology, virtually nothing has been done to relate salient personality theories to a developing psychology of disability. Although a little is known as to "why" physically disabled persons react as they do to disablement (McDaniel, 1969), even less 1s known about "why" the physically disabled are stignatized (Yuker, Bock and Campbell, 1966, and English, 1971). Certain major theoretical principles and positions have obtained popularity in the psychology of chronic illness and disability end have more potential value than others, Occasionally these theories have been used to try and explain the inpact of disablement on disabled persons. The theories which will be examined are: 1. Peychoanalytie Theory 2, Indtvidual Peychology 3. Rody Image Theory 4. Social Pole Theory 1. Peychoanalytie Theory, Psycheanalytic Theory developed by Sigmun4 Freud in the Jete 1800's end early 1900's has applicability to explaining e psychology of disability. Freud conceptualtret a49 duality of existence where people are umans and animals. He believed that people exist at different levels of growth and development, the lowest levels corresponding to the basic animal side of men, At lover maturational levels man operates in accordance with basic instinctual drive involving sex and security needs where only the fittest individuals survive. A central tenet of psychoanalytic theory sens to be that "competition" rules the lives of men, and nen continue to compete for "psychological superiority". Psychoanalytic theorists believe that most behaviour cccurs in the formative pre-school years. If this view of psychoanalytic theory 1s applied to etigna, we might hypothesize that a nondieabled person who is prejudiced toward the disabled is e« relatively immature individual with unexpressed hostilities and # need to feel psychologically superior. In terms of disabled themselvee, psychoanslytic theories would believe that disablement alnost alvays has an adverse effect on personality, especially sf tt occurs in early childhood. They are Likely to be paseive-agcressive types. Persone disebled after schoo} begins probably would not experience eny eubstentie) chanses im perronality, according te peychoenalytic thinking. 2 vidual Peycholory. A nee-peychosnalytic theory of personality which te often rentioned ar "individual peychology" was developed by Alfred Adler (1927). Adler's personality theory50 departed from Freud's psychoanalytic theory in it's emphasis on social motivation and individuality, rather than sexual impulses. Adler believed that 211 people possess an innate drive to strive for superiority. He felt this drive evolved into a pattern or life style from early childheod and that it van motivated to compensate for certain innate feelings of inferiority. Proponents of indtvidual psychology believe that physically disabled persons attempt to compensate for = defective organ by strengthening it. In their view, physicel or mental defornities are principal causes of a "faulty" life style. Individual psychology theorists probebly Believe there ts 2 higher incidence of emotional disturbance smong the disabled than the nondisabled (McDaniel, 1969). 3. Body Image Theory. Another non~psychosnalytic syaten Prominent in explaining the psychology of disability 1s "body fmage theory". ‘he individual who has contributed wore than anyone else to body image theory ie Paul Schilder (1950), as far buck as 1935. It 1s defined as a picture every person has of himself and his own body, In tha development of personality, the body image plays a very important role. It determines an individual's idea of his om self. Yer a disabled person, it hus to be reorganized. Im the initial stage it is difficult for the disabled imfividual to find place for deformity in his body image. ‘This Jeads to denial of the disability or eseapa into fantasy.51 4, Social Role Theory. A relatively recent trend of thought which is valuable to the study of psychological responses to disability and rehabilitation is social role theory. ‘he major contributor in this area has been Talcott Parsons, a sociologist (1951 and 1958). A basic construct ia role theory is that of = "status" which is simply a collection of rights and duties (Linton, 1936). 4 ole represents the dynamic aspect of a status where individuals put the rights and duties which constitute a particular status into effect. In terms of disability, it has been hypothesized that persons primarily enact roles according to their expectations for and about the so-called "sick role" (Gordon, 1966). In Parsons" (1951) view, the major dyadic relationship influencing disability roles are between the physician and the patient and the patient and his fanily. These relationships must be viewed in terms of four behavioural presumptions of the sick role. First is the presuaption that siek persons are exempt from social responsibility. Second is the presumption that the sick person cannot be expected to take care of himself, Illness or disability produces incapacity and consequently limite or inhibits the performance of routine duties. Parsons’ third behavioural presumption is that sick persons should wish to get well because health is viewed as necessary for the52 optinal performance of most important life tasks. Fourth, there ie the presumption that sick person should seek medical advice and co-operate with medical experts. Role theory can be extended still further to explain the psychological impact of disability on so-called disabled and non-disabled individuals. In terns of disebled thenselves, it has been hypothesized that the response to disablement is quite individualized (Gordon, 1966). It has further deen hypothesized (Parsons, 1958) that illness or diesbility disrupts established role patterns and leads to a reorganization of roles. These hypotheses have all been studied to come extent and are generally supported by research findings. The relationship between physical defect and creative ability has been the source of mich literary speculation. The suffering caused by crippling renolds personality. It acts es a challenge end a stimulus and dravs out what is latent in the individual. Some outstanding physically handicapped personalities were Darwin, Stevenson, Edison, Alexander the Great, and Vasco-le~Cama, It 4s, however, wrong to think that a disability invariably produces 4 genius. It 4s thought that there are several factors which affect the adjustment of the physically handicapped to their disability, ‘They are: 1. duration of the disability2. severity or extent of the disability 3. type of disability 4, age of onset of the disability 5. level of intelligence 6. attitudes of the family and society The age of onset of the disability 1s considered to be a factor in determining the personal adjustment of the individual. It de relatively easier for a child whose nodes of behaviour are not well settled, to adjust himself to disability. The further he progresses up the are seale, the nore difficult adjustment becomes. ‘The habit and nodes of living are well established tn an edvlt, therefore, difficult for him to cherre over to # new vey of I4fe. Study of ere of onect of the dfeehitity en? ft's effects on anxiety, adjustment, anf echfevenert was, therefore, undertaken tn the hore that ft vould throw rene Y4eht on the probler of the handfespped end ulttuately, tt Se hoped, weuld help fn thetr rebebititetion. Modification of the Arxtety Scale Yn the present project, erxiety scale used Je x modification of Taylor's Manifest Anxiety £ (1951), Sinke's Anatety Scale (1966), end Dutt's PersoneMty Inventory (18(C). The wodification was doze for obviccs reascas. All three tests measure anxtetyProneness of the individual. Taylor's Manifest Anxiety Scale (MAS) was developed by Jenet A. Taylor in 1951. The MAS 1s available in two forms, ‘The original test consisted of fifty anxiety itens, while the Later refinement consists of revised twenty-five itens which have been found to denoustrate very well the difference in the anxiety levels of different individuals. The validity of this test is satisfactory and reliebility is around .80 as clained by the author. Sinha's Anxiety Test is known better as Sinha W.A. Self Analysis forns in Hindi was developed in 1966 by Dr. Durganand Sinha, Tt had one hundred itens of Yes-No type. It was assumed that anxiety vould be revealed by the reported behsviour, not in any one situation, but by his average behaviour in a great number of these situations. Dutt's Personality Inventory was developed by Dutt in 1966 for ¢linieal disgnosis and for measuring anxiety. This test can be administered to persons above fifteen years of age. It is a questionnaire with three response categories and it is available in Hindi and English form, It consists of forty items and there is no time limit for it's administration. Dutt claims that its validity against MAS and Sinha's Anxiety Scale are found to be satisfactory. It's reliability is .87 to .95. These three scales consist ofone Iundred and sixty eight itens and fifty items coumon in all the three tests were selected for amiety scale of this project. ‘These itens were translated into Marathi and possibly simple terns were used to make it more understandable. The iteus vere arranged in random order, and to prevent fake answers, positive and negative statements vere arranged together. A pilot study was conducted on the sample of twenty-five handicapped persons, It was noted that they did not find any difficulty in answering the statements. This test has no tine limit but it requires about twenty to thirty minutes. Seoving ‘This modified version of the questionnaire has three response categories, The subject has to respond with either True, Yalse, or Undecided. "rue" ansvers get two points, "Undecided" answers get one point, and "False" answers get no points (0). Thus, maximum possible score for this test could be one hundred points and the ange of score could be from zero to one hundred. ‘The persons having high score on thie test will have high anxiety level, and vice versa. Instructions Following instructions vere given before administration of this test. "There are fifty statements given below. ead it carefully. If you feel that it is true in your case, then mark56 the sign () on the vord "true" whieh is written against each stateuent. If you feel that {t is not true in your case, then mark the sign (-) on the word "Valee", and if you are uncertain about the anewer, then mark the sign (-}) on the question mari: sign (7). As far as possthle, mark true or false answers, All statouents should be answered honestly, There is no time limit for this test, but try te finish it quickly." Modification of the Adjustnent Inventory ‘The adjustment inventory is « quick screening device meant to separate the poorly adjusted people from better adjusted people. There ave munerous edjustaent inventories available for research purposes, but no inventory is designed especially for handicapped Populstion. Therefore, the researcher decided to modify the adjustnent inventory to suit the handicapped population. For this inventory, the following areas of adjustment were selected. 1, Health and Physical, 2, Social and Fantly. 3. Sensitivity and Confidence, 4. Work, Career, and Future, 5, Sex and Marriage. 6. Mild Neurosis. 7, Self and Self-Image. 8, Reonomie and Lack of Facilities,37 1. Health ond Phywical. This area is concerned with the individuol's health and hendicap, Tt eovurs the items concerning whether bis handicap interferes with the routine activities, whether he feels inferior due to disability, ani vhether he can participate in games ani sports, High score indicates that persom lias realistic perception of his handicap and thus well adjusted. 2. Social and Fauiiy, The very fundamental area of adjustment ie home, Individual is the product of his enviroument, He has to Live in the fantly and society, There are many situations which call for specific adjustments, The inventory consists of statenents regarding the individuel's home adjustment and social sdjustment fie. his relations with parents, siblings, and their attitudes towards him, his position in the home, It also consists of the statements, vbether the person is very popular - prefers fow or wore friends, likes to be social and friendly with strangers, ete. High score indicates satisfactory adjustment. 3. Sensitivity and Confidence, Whether the person is over eritical, fault finding, or vhether he has faith and confidence in himself and others, are the matters covered in this area. It also covers fluctuations of mood, worry, excitability, calmess, control over emotions, etc. Person with high score is considered to be emotionally stable, 4. Work, Career, and Future. Under this area the statements58 on employment and future prospects for the orthopedically handicapped are included. Euploynent situation faced by these persons differ from the situation faced by able bodied persons. High score shows that be is avare of the situation and thus, well adjusted. 5. Sex and Marriage. It is rather difficult for the handicapped Person to get married and it is most common in female handicapped. Sexual adjustment 1s believed to be a fundamental aspect of medical and psychological rehabilitation. This area consists of items like whether they can mix freely with the persons of opposite sex and their ideas about marriage, High score means person has no sex and marriage problens. 6. Self and Self-Image. Yor better adjustment, person should have real self and self-image of himself. This area consists of the items on self-image. If the person devaluates himself, it could lead to maladjustment. Thus, well adjusted person will have high ecore in this test. 7. Heonomte and Lack of Facilities. Majority of the disabled Persons belong to lover niddle class and lover class of the society. ‘Thus they have to face economic crisis, most of the tine, and this might lead to negligence of health. This ultimately adds to their adjustment problems, Again, high score indicates better adjustment. Mild Neurosis. The most visible sign of a neurotic problem is the existence of anxiety, which signals the faulty operation of39 control mechanism and the potential flooding of the personality with dangerous impulses, Well adjusted person will have « high score, The modified adjustment inventory used in this project 1s based on the following adjustment inventories, 1, Bell's Adjustuent Inventory (1934-1939). 2, Adjustment Inventory by R.M. Pagedar, J.J. Gajjar and Prem Paricha (1963). 3. Adjustment Inventory by Asthana (1967). 4, Adolescent Adjustment Inventory by N.Y. Reddy (1964). 5. Adjustment Inventory by S. Bhattacharya, M.M. Shah and J.C. Pareth (1967). 1, Bell's Adjustment Inventory consists of questions intended to evaluate the subject's status in respect to home, health, social adjustment, emotional sdjustment, and occupational adjustment, It 1s available in two forms i.e. student and adult forms, and it has three response categories (Yes, No, or ?). It was developed by Bell between 1934 and 1939, 2, Adjustment Inventory of Prem Paricha, R.M. Pagedar and JJ. Gajjar (1963) ie @ check list containing two hundred and thirty-two items. It covers areas of adjustment like health and physical, sensitivity and confidence, economics and lack of facilities, self echedule and independence, mild neurosis, selfand self-image, sex and marriage, social and family, studies, schools and teachers, work, career and future. 3, Adjustment Inventory devised by Asthana H.S. (1967) contains forty-two items and can be given to persons above fourteen years. It is designed to segregate the poorly adjusted persons who need psychodiagnostic study and counselling. 4, Adolescent Adjustment Inventory by N.Y. Reddy (1964) measures Personal and social adjustment. It contains eighty-eight items and has a three point system, This test can be administered to the adolescent. Se + Bhattacharya, M.M. Shah and J.C, Parikh (1967) have developed adjustment inventory in Gujarathi end English, It can be administered to the adolescent school student, It contains fifty- five itens. ‘The five adjustaent inventories mentioned above have a total of five hundred and seventy-seven ites. These iteus were grouped according to their repetition in all the tests. Seven iteus were found to be common in all the five tests, eleven iteas ware common 4m four tests, twelve items vere comon in three tests, and twenty-four itens were common in tvo tests. Total number of these tems is sixty-four. Six items related to the adjustment problems of physically handicapped were added to make a total of seventy. As far as possible, repetition was avoided. Original test itenswore in English and translated in simple Marathi and arranged randomly. A pilot study was conducted on twenty-five persons #0 4 to see vhether the test is followed by then. Results revealed that statements, except very few, were easy to understand. Difficult words were again replaced by simple words, Seoring i This questionnaire is also three response categories. The eubject has to write "True", "Vales", or "Uncertain", The ansver "True" carries @ score of two points, that of "Uncertsin" one point, and no point for "False" ansvers, Thus, maximm possible score on this test could be one hundred and forty points and the range of score could be from zero to one hundred and forty points. The persons vith high score on this test will have better adjustment and vice versa. Instructions Following instructions were given before administering the test: “There are seventy statenents given below. Head and understand each very carefully. ‘Then decide whether it is true or false in your case. If you feel that it is true, then make the sign (-) on the word "True" which is written against each statement. Tf you feel that it does net apply to you, then mark the sign (-) on the word "False", and if you are uncertain about the anaver, then mark the sign (+) on the question mark sign (1). As far as62 possible, mark true or false anowers. All statements should be ansvered honestly and there is no time limit, but try to finish it soon. Achievement Motivation The need for achievement was anong the list of hunan needs given by Murray (1938). According to him, it represents « tendency to do things rapidly and as well as possible. Subsequently this came to be conceptualized es achievenent motivation or achievement need. The work of McClelland (1961) has revealed that the progress of Society was positively correlated with the strength of the need for achievement of it's people. At a common sense level, need for achievement reflects itself in behaviour showing an effort to accomplish something great and to excel others in Performance. The need for achievement, as it is understood today, implies a desire to do one's best, to take calculated risk, to set up reasonably high goals, to enter competitive situations, and to accomplish something of great significance. For the purpose of the present study, only the verbalized aspect of need for achievenent as conceptualized by Mukherjee (1964) is taken. Mukherjee's Sentence Completion Test. In the present study the need for achievement was assessed by the forced choice scale developed by Mukherjee (1964, 1965). It consists of fiftyincomplete sentences to be completed by respondent by endorsing ‘one of the three alternatives offered in each of the fifty items, ‘The three alternatives in each case, which are matched for social desirability, are of equal attractiveness. The evidence of it's reliability has been highly satisfactory. Kuder Richardon's reliability estimate for the Sentence Completion Test (SCT), has been found to be 0.716 for a sample of two hundred and forty-five students. The test retest reliability of the test after an interval of two months, was found to be ranged from 0.71 to 0.75 in different studies. The results of the validity studies of the SCT has been found to be quite Promising. The evidence of construct validity of SCT comes from three separate studies. In one of them, subjects with a high score on the SCT rated themselves significantly higher for persaverance. In an investigation of the hypothesized relationship between achievement motivation and the rate of performance on a sample perceptual speed task, it was found that the high score of ‘SCT was associated with a high rate of performance fro the second trial to the end of practice. Additional support for the validity for SCT as a measure of verbalized need for achievement came from the studies conducted in the framevork of a level of aspiration experiment. ‘The form of SCT used in the present study was in Marathi.64 ‘The Marathi version was standardized for research purposes in the College of Education and Department of Psychology of Nagpur University. ‘The validity and reliability of Marathi adaptation have been ascertained, Seoring A score of one is given for every response in a keyed direction. The scoring is done in such a way that higher socre indicates stronger need for achievement. The range of score is from zero to fifty points. Instructions ‘The following instructions were given before administering the test. “You will see some statements given below. Each group has three statements. You have to select any one out of these which you like most. Then put (-) mark in appropriate box provided in front of the statement. Renember that there are no right or wrong answers. Attempt all statements. There 16 no tine limit, but try to finish soon. Data Collection It was decided to collect the sample fron various places of Maharashtra State, The primary purpose vas to have wider range of the sample. The list of the institutions and organizations working for the physically handicapped was collected from the Divisional Social Welfare Office of Government of Maharashtra, Aurangabad,The size of the sauple was predetermined. It was decided to collect a sauple of three hundred cases consisting Of two hundred and fifty male;and fifty female, It was also decided that the range of age should be from fifteen to forty- five years, Yor obvious reasons, the sample could not be random and may be deseribed as incidental. ‘The respondents, being veni~ educated and educated, had no problem in giving answers on the questionnaire. ‘The actual work of data collection started in December, 1982 ‘and was completed by the end of February, 1983, In the beginning the researcher wrote to the head of the institutions for permission to administer psychological tests on the handicapped persons of their institutes and they responded favourably. ‘The respondents were informed about the purpose of the visit to their institute. The researcher explained to them the method of anevering the statements. The instructions, though written on the questionnsire, vere again explained to them. Mukherjee's Achievement Motivation Test, being exhaustive, was given first. ‘Tt was followed by Anxiety Scale and Adjustment Inventory, As far as possible, this sequence was maintained. The answer papers were collected imediately after the administration of the tests. During the testing of institution based data, researcher observed that these persons were very co-operative. Most of then6 were worried about their employment and somehow felt that they are being ignored by the Government. ‘The researcher visited the folloving institutions for the purpose of data collection. 1, Government Sheltered Workshop for Physically Handicapped, Bhadkal Gate, Aurangabad. 2, Spinal Cord Injury Rehabilitation Centre and Department of Physical Medicine and Rehabilitation, Medical College Hospital, Aurangabad. 3. Rotary Club Physiotherapy Centre, Collector Office Road, Kolhapur. 4. Government Sheltered Workshop for Physically Handicapped, Mivaj. 5. Government Sheltered Workshop for Physically Handicapped, Juni Mangalvari, Nagpur. 6. Home for Aged and Handicapped, Untakhana, Negpur. 7, Queen Mary's Technical Institute for Disabled Indian Soldiers, Kirkee, Pune. 8, Civil Hospital, Solepur. 9, Wadia General Hospital, Solapur. 10, Sandhi Niketan, Anandwan, Warora. In addition, 1odividual con: were also made, Thus, sample indicated is representative of orthopedically handicapped persons67 in general becaune it contains institution and commmnity based eases. Addresses for individual contacts were collected from the following handiespped welfare associations. 1. Apang Punarwasan Sanstha, Kolhepur. 2, Apang Sahayyakari Sanstha, Pune, 3. Apang Kalyankeri Sanghatana, Solapur. Inddvidual contacts were nede with fev handicapped persons at their residence or work place. Most of these persons were employed and very few of them were not keen about the testing. Demographic information on age, sex, address, narital status, education, employment position, annual income of the family, age of onset of the disability, and nature of the defect was collected. Seding and Scoring ALL three hundred cases were coded according to their sex, educational qualification, employment position, location, marital status, social class, chronological age, and age of onset ef the Atsability. ‘The persons studied beyond Secondary School Certificate ($.S.C.) were coded as educated, and up to §.8.C. as semi-educated. ‘he persons residing in town or city having population of 100,000 of mora, were grouped as urban located and persons residing 4m town or eity below 100,000 population were grouped as rural located.To determine social class, semple was grouped according to emnual income. The persons having annual tncone of Re. 18000 and above were grouped in higher social class, income between Rs. 7200 to 18000 as middie class, and income below Rs. 7200 as lower class. ‘The employment position was divided into unemployed and employed groups. Persons in service, self-employment, or in any gainful employment were labelled as employed, and persons without any kind of employment, students or trainees were grouped as ‘unemployed. As stated earlier, the age range of sample is fifteen to forty-five years. This vas further divided into four groups. The Persons between sixteen and twenty-five, twenty-six and thirty-five, thirty-six and forty-five, forty-five and above, were coded as group A, B, C, and D respectively. ‘Age of onset of the disability was grouped into five categories. The persons who acquired disability before ten years Of age, between eleven and twenty years of age, twenty-one and thirty years of age, thirty-one and forty years of age, and above forty years of age, ware grouped as V, W, X, Y, and Z respectively. Coding was followed by scoring. A separate set of scoring stencils for each test was prepared by researcher. ‘Two stencile for Anxiety Scale, three stencils for Adjustnent Inventory, and five stencils for Achievement Motivation Test were prepared.oo For scoring stencil is kept between the margin line and counting of (-) marks was done through holes on the stencil, Thus, score obtained was entered in the colums provided at the and of the test. Undecided answers could be scored without using stencil.