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Predictors of Functional Disability in Disability Welfare Claimants

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Abstract

Background People unemployed and claiming welfare due to poor health are by definition functionally disabled. Understanding the factors associated with such disability is crucial in the development of biopsychosocial formulations and associated occupational rehabilitation. Method A cross-sectional design in a sample of claimants (n = 4,119) of health-related welfare, unemployed due to mental or physical health problems. Participants provided socio-demographic information and completed validated measures of psychological distress, self-efficacy and disability. Hierarchical multiple regression analyses then tested which psychological and socio-demographic factors were associated with disability. Results Despite equal rates of functional disability across health condition groups, differing variables were associated with disability for mental and physical health conditions. Psychological distress was the strongest predictor of disability across all health conditions. For physical conditions, lack of previous employment was the only additional variable associated with current disability and for mental health conditions age and self-efficacy were additional factors. Conclusion Results are discussed in terms of biopsychosocial formulations of health-related unemployment, the potential mechanisms by which psychological distress can influence disability, the methodological limitations of cross sectional regression analyses and the implications for condition-specific occupational rehabilitation.

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References

  1. Druss BG, Hwang I, Petukhova M, Sampson NA, Wang PS, Kessler RC. Impairment in role functioning in mental and chronic medical disorders in the United States: results from the National Comorbidity Survey Replication. Mol Psychiatry. 2009;14:728–37.

    Article  PubMed  CAS  Google Scholar 

  2. World Health Organization. ICF: international classification of functioning, disability and health. Geneva: World Health Organization; 2001.

    Google Scholar 

  3. Rigg J. Labour market disadvantage amongst disabled people: a longitudinal perspective. Centre for Analysis of Social Exclusion, report 103, 2005.

  4. Mclean C, Carmona C, Francis S, Wohlgemuth C, Mulvihill C. Worklessness and health—what do we know about the causal relationship? Evidence review. London: Health Development Agency; 2005.

    Google Scholar 

  5. Jin RL, Shah CP, Svoboda TJ. The impact of unemployment on health: a review of the evidence. Can Med Assoc J. 1995;153:529–40.

    CAS  Google Scholar 

  6. Fryer D. Benefit agency? Labour market disadvantage, deprivation and mental health. Psychologist. 1995;8:265–72.

    Google Scholar 

  7. Wanberg C, Griffiths R, Gavin M. Time structure and unemployment: a longitudinal investigation. J Occup Organ Psychol. 1997;70:75–95.

    Article  Google Scholar 

  8. Waters L, Moore K. Reducing latent deprivation during unemployment: the role of meaningful leisure activity. J Occup Organ Psychol. 2002;75:15–32.

    Article  Google Scholar 

  9. Warr P. Work, unemployment and mental health. Oxford: Oxford University Press; 1987.

    Google Scholar 

  10. Jackson T. Differences in psychosocial experiences of employed, unemployed, and student samples of young adults. J Psychol. 1999;133:49–60.

    Article  PubMed  CAS  Google Scholar 

  11. Grove B. Escaping from incapacity—a biopsychosocial approach to overcoming health-related unemployment. 2006. Available at http://www.unum.co.uk/Home/AccessiblePDF/CMOreport2006.htm#4.

  12. Creed P, Watson T. Age, gender, psychological wellbeing and the impact of losing the latent and manifest benefits of employment in unemployed people. Aust J Psychol. 2003;55:95–103.

    Article  Google Scholar 

  13. Clay FJ, Newstead SV, Watson WL, McClure RJ. Determinants of return to work following non life threatening acute orthopaedic trauma: a prospective cohort study. J Rehabil Med. 2010;42:162–9.

    Article  PubMed  Google Scholar 

  14. McKee-Ryan F, Song Z, Wanberg C, Kinicki A. Psychological and physical well-being during unemployment: a meta-analytic study. J Appl Psychol. 2005;90:53–76.

    Article  PubMed  Google Scholar 

  15. Waddell G, Burton K. Is work good for your health and wellbeing?. London: TSO; 2006.

    Google Scholar 

  16. Schaufeli WB, Van Yperen NW. Unemployment and psychological distress among graduates: a longitudinal study. J Occup Organ Psychol. 1992;65:291–305.

    Article  Google Scholar 

  17. Waddell G, Burton AK. Concepts of rehabilitation for the management of common health problems. London: The Stationery Office; 2004.

    Google Scholar 

  18. Kertay L, Pendergrass TM. Biopsychosocial factors in claims for disability compensation: issues and recommendations. In: Schultz IZ, Gatchel RJ, editors. Handbook of complex occupational disability claims: early risk identification, intervention and prevention. New York: Kluwer; 2005.

    Google Scholar 

  19. Lee SK, Vinokur AD. Work barriers in the context of pathways to the employment of welfare-to-work clients. Am J Commun Psychol. 2007;40:301–12.

    Article  Google Scholar 

  20. Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K. Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry. 1995;52:11–9.

    Article  PubMed  CAS  Google Scholar 

  21. Geerlings SW, Beekman ATF, Deeg DJH, Twisk JWR, Van Tilburg W. The longitudinal effect of depression on functional limitations and disability in older adults: an eight-wave prospective community-based study. Psychol Med. 2001;31:1361–71.

    Article  PubMed  CAS  Google Scholar 

  22. Ericsson M, Poston WSC, Linder J, Taylor JE, Haddock CK, Forey JP. Depression predicts disability in long-term chronic pain patients. Disabil Rehabil. 2002;24:334–40.

    Article  PubMed  CAS  Google Scholar 

  23. Rai D, Kosidou K, Lundberg M, Araya R, Lewis G, Magnusson C. Psychological distress and risk of long-term disability: population-based longitudinal study. J Epidemiol Community Health. 2011. doi:10.1136/jech.2010.119644.

  24. Manninen P, Heliövaara M, Riihimäki H, Mäkelä P. Does psychological distress predict disability? Int J Epidemiol. 1997;26:1063–70.

    Article  PubMed  CAS  Google Scholar 

  25. O’Leary A. Self-efficacy and health. Behav Res Ther. 1985;23:437–51.

    Article  PubMed  Google Scholar 

  26. Brouwer S, Reneman MF, Bültmann U, Klink JJL, Groothoff JW. A prospective study of return to work across health conditions: perceived work attitude, self-efficacy and perceived social support. J Occup Rehabil. 2010;20(104):112.

    Google Scholar 

  27. Turner JA, Ersek M, Kemp C. Self-efficacy for managing pain is associated with disability, depression, and pain coping among retirement community residents with chronic pain. J Pain. 2005;6:471–9.

    Article  PubMed  Google Scholar 

  28. Jang Y, Haley WE, Small BJ, Mortimer JA. The role of mastery and social resources in the associations between disability and depression in later life. Gerontologist. 2002;42:807–13.

    Article  PubMed  Google Scholar 

  29. Department of Health. National service framework for older people. 2001. Available at http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4071283.pdf.

  30. Hunt SP, McEwan J, McKenna SP. Subjective health assessments and the perceived outcome of minor surgery. J Psychosom Res. 1984;28:105.

    Article  PubMed  CAS  Google Scholar 

  31. Maddox G, Douglas E. Aging and individual differences. J Gerontol. 1974;29:555–63.

    PubMed  CAS  Google Scholar 

  32. Cornelius LR, van der Klink JJ, Groothoff JW, Brouwer S. Prognostic factors of long term disability due to mental disorders: a systematic review. J Occup Rehabil. 2011;21(2):259–74.

    Article  PubMed  CAS  Google Scholar 

  33. Merill SS, Seerman TE, Kasl SV, Berkman LF. Gender differences in the comparison of self-reported disability and performance measures. J Gerontol A Biol Sci Med Sci. 1997;52A:M19–26.

    Article  Google Scholar 

  34. Harvey SB, Henderson M, Lelliott P, Hotopf M. Mental health and employment: much work to be done. Br J Psychiatry. 2009;194:201–3.

    Article  PubMed  Google Scholar 

  35. Black C. Working for a healthier tomorrow. London: TSO; 2008.

    Google Scholar 

  36. Barnes H, Hudson M. Pathways to work: qualitative research on the Condition Management Programme. Department for Work and Pensions Research Report 364. Leeds: Corporate Document Services; 2006.

  37. Department for Work and Pensions [DWP]. Pathways to work: helping people into employment. London: Author; 2002.

  38. Mundt J, Marks IM, Shear MK, Greist JH. The Work and Social Adjustment Scale: a simple measure of impairment in functioning. Br J Psychiatry. 2002;180:461–4.

    Article  PubMed  Google Scholar 

  39. Cella M, Sharpe M, Chalder T. Measuring disability in patients with chronic fatigue syndrome: reliability and validity of the Work and Social Adjustment Scale. J Psychosom Res. 2011;71:124–8.

    Article  PubMed  Google Scholar 

  40. Reme SE, Kennedy T, Jones R, Darnley S, Chalder T. Predictors of treatment outcome after cognitive behavior therapy and antispasmodic treatment for patients with irritable bowel syndrome in primary care. J Psychosom Res. 2010;68:385–8.

    Article  PubMed  Google Scholar 

  41. Skerrett TN, Moss-Morris R. Fatigue and social impairment in multiple sclerosis: the role of patients’ cognitive and behavioral responses to their symptoms. J Psychosom Res. 2006;61:587–93.

    Article  PubMed  Google Scholar 

  42. Mclaughlin TJ, Aupont O, Bambauer KZ, Stone P, Mullan MG, Colagiovanni J, Polishuk E, Johnstone M, Locke SE. Improving psychological adjustment to chronic illness in cardiac patients. J Gen Intern Med. 2005;20:1084–90.

    Article  PubMed  Google Scholar 

  43. Evans C, Connell M, Barkham M, Margison F, McGrath G, Mellor-Clark J, et al. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. Br J Psychiatry. 2002;180:51–60.

    Article  PubMed  Google Scholar 

  44. Connell E, Barkham M, Stiles WB, Twigg E, Singleton N, Evans O, et al. Distribution of CORE-OM scores in a general population, clinical cut-off points and comparison with the CIS-R. Br J Psychiatry. 2007;190:69–74.

    Article  PubMed  Google Scholar 

  45. Kellett S, Bickerstaffe D, Purdie F, Dyke A, Filer S, Lomax V, et al. The clinical and occupational effectiveness of condition management for incapacity benefit recipients. Br J Clin Psychol. 2011;50:164–77.

    Article  PubMed  Google Scholar 

  46. Barkham M, Margison F, Leach C, Lucock M, Mellor-Clark J, Evans C, et al. Service profiling and outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies. J Consult Clin Psychol. 2001;69(2):184–96.

    Article  PubMed  CAS  Google Scholar 

  47. Schwarzer R, Jerusalem M. Generalized self-efficacy scale. In: Weinman J, Wright S, Johnston M, editors. Measures in health psychology: a user’s portfolio. Windsor: NFER-Nelson; 1995. p. 35–7.

    Google Scholar 

  48. Schwarzer R, Born A, Iwawaki S, Lee Y-M. The assessment of optimistic beliefs; comparison of Chinese, Indonesian, Japanese and Korean versions of the Generalised Self-Efficacy Scale. Psychologia. 1997;40:1–13.

    Google Scholar 

  49. Bender R. Introduction to the use of regression models in epidemiology. Methods Mol Biol. 2009;471:179–95.

    Article  PubMed  Google Scholar 

  50. Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression/correlation analysis for the behavioral sciences. 3rd ed. London: Routledge Academic; 2003.

    Google Scholar 

  51. Aiken LS, West AG. Multiple regression. California: Sage Publications; 1991.

    Google Scholar 

  52. Tabachnick BG, Fidell LS. Using multivariate statistics. 4th ed. Boston: Allyn and Bacon; 2001.

    Google Scholar 

  53. Bandura A. Guide for constructing self-efficacy scales. In: Pajares F, Urdan TC, editors. Self-efficacy beliefs of adolescents. Greenwich, CT: Information Age Publishing; 2006. p. 307–38.

    Google Scholar 

  54. Schulman BM. Worklessness and disability: expansion of the biopsychosocial perspective. J Occup Rehabil. 1994;4(2):113–24.

    Article  Google Scholar 

  55. Franche RL, Frank J, Krause N. Prediction of occupational disability: models, factors and outcomes. In: Schultz IZ, Gatchel RJ, editors. Handbook of complex occupational disability claims: early risk identification, intervention, and prevention. New York: Springer; 2009.

    Google Scholar 

  56. Beatty C, Fothergill S. Incapacity benefits in the UK: an issue of health or jobs? Centre for Regional Economic and Social Research, 2011. Available at http://www.social-policy.org.uk/lincoln/Beatty.pdf.

  57. Department for Work and Pensions. Employment and support allowance work capability assessment: official statistics. Author, 2010. Available at http://research.dwp.gov.uk/asd/workingage/esa_wca/esa_wca_27072010.pdf.

  58. Kawachi I, Berkman LF. Social ties and mental health. J Urban Health. 2001;78:458–67.

    Article  PubMed  CAS  Google Scholar 

  59. Lindstrom M. Social capital, the miniaturisation of community and self-reported global and psychological health. Soc Sci Med. 2004;59:595–607.

    Article  PubMed  Google Scholar 

  60. Smith TW, Aberger EW, Follick MJ, Ahern DK. Cognitive distortion and psychological distress in chronic low back pain. J Consult Clin Psychol. 1986;54(4):573–5.

    Article  PubMed  CAS  Google Scholar 

  61. Ray O. How the mind hurts and heals the body. Am Psychol. 2004;59(1):29–40.

    Article  PubMed  Google Scholar 

  62. Proudfoot J, Guest D, Carson J, Dunn G, Gray J. Effect of cognitive-behavioural training on job-finding among long-term unemployed people. Lancet. 1997;350(9071):96–100.

    Article  PubMed  CAS  Google Scholar 

  63. Tourangeau R, Yan T. Sensitive questions in surveys. Psychol Bull. 2007;133:859–83.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, University of Sheffield, Sheffield, UK

    Fiona Purdie

  2. Centre for Psychological Services Research, University of Sheffield, Sheffield, UK

    Stephen Kellett

  3. Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK

    Stephen Kellett

  4. South Yorkshire Condition Management Programme, Barnsley, UK

    Darren Bickerstaffe

  5. Department of Psychology, University of Sheffield, Sheffield, S10 2TN, UK

    Stephen Kellett

  6. Department of Psychology, Newman University College, Birmingham, UK

    Fiona Purdie

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  1. Fiona Purdie
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Correspondence to Stephen Kellett.

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Purdie, F., Kellett, S. & Bickerstaffe, D. Predictors of Functional Disability in Disability Welfare Claimants. J Occup Rehabil 22, 447–455 (2012). https://doi.org/10.1007/s10926-012-9368-y

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