Self-Esteem of Adults with Visual Impairments

Self-esteem of Adults with Visual Impairments

Papadopoulos Konstantinos1, Kartasidou Lefkothea2, Papakonstantinou Doxa3, Koutsoklenis Athanasios4, Koustriava Eleni5

1 Assistant Professor, Department of Educational and Social Policy, University of Macedonia, 156 Egnatia st., P.O. Box 1591, 54006, Thessaloniki, Greece, +30 2310 891403, e-mail: [email protected]

2 Lecturer, Department of Educational and Social Policy, University of Macedonia, 156 Egnatia st., P.O. Box 1591, 54006, Thessaloniki, Greece, +30 2310 891350, e-mail: [email protected]

3 PhD Student, Department of Educational and Social Policy, University of Macedonia, 156 Egnatia st., 54006, Thessaloniki, Greece, +30 2310 853003, e-mail: [email protected]

4 PhD Student, Scholar of the Alexander S. Onassis Foundation, Department of Educational and Social Policy, University of Macedonia, 156 Egnatia st., 54006, Thessaloniki, Greece, +30 2310 891403, e-mail: [email protected]

5 MA, Department of Educational and Social Policy, University of Macedonia, 156 Egnatia st., 54006, Thessaloniki, Greece, +30 2310 891403, e-mail: [email protected] Introduction

Vision loss is associated with affective disorders including reduced feelings of self-esteem (Branch, Horowitz & Carr, 1989). The acceptance of a visual impairment is a lifelong process that consists of the following phases: shock and denial, mourning and withdrawal, depression, reassessment and reaffirmation, coping and mobilization, self-acceptance and self-esteem (Tuttle, 1987).

The self-concept is an individual’s fundamental reference point and the foundation from which an individual’s actions are based (Rosenberg, 1979). Self- esteem and self-concept are related and complementary - a positive self-concept implies positive self-esteem (Burns, 1982; Lopez-Justicia & Pichardo, 2001). Self-esteem is a measure of feelings from within and is the product of the interactions between individuals and the significant others (Alexander, 1996).

Various researchers state that children with visual impairment often manifest egocentricity and greater social immaturity than sighted children, while the difficulties they face in observing and mimicking their peers may impede the development of positive self-esteem (Warren, 1994; Tuttle & Tuttle, 2004). Many individuals with visual impairment are described as individuals with low self- esteem, passivity, learned helplessness or limited assertiveness (Webster & Roe, 1998).

A number of theorists claim that the loss of vision causes a serious blow to self- esteem (Ponchillia & Ponchillia, 1996). The loss of vision which makes even the simplest everyday tasks seem difficult or impossible causes an devaluation of the self, while the pity expressed by well-meaning people contribute to the manifestation of low self-esteem (Ponchillia & Ponchillia, 1996).

According to Tuttle and Tuttle (2004), the psychological principles which are part of the dynamics in the development of the self-concept and self-esteem in a sighted individual, equally apply to a blind individual. Nevertheless, the same authors mention that the individuals with visual impairment may show reveal lower self-esteem due to a disproportionate number of negative interactions which they may experience in comparison to their sighted peers. The feeling of dependency, which the children with visual impairment experience, when assistance from others is absolutely necessary, may lead to low self-esteem, even when a student with visual impairment accepts only some assistance to carry out everyday living tasks (Tuttle & Tuttle, 2004).

A review of the relevant literature clearly indicates a lack of agreement amongst the researchers’ results (Huurre, Komulainen & Aro, 1999) which are relevant to the self-concept and self-esteem in the individuals with visual impairments (children, teenagers and adults). There are studies which have shown that the individuals with visual impairments reveal an average level of self-esteem (Cardinali & D’Allura, 2001); studies which indicate that they show more positive self-esteem than individuals with normal vision (Kef, 2002) as well as studies which indicate that there are no major differences between the two groups (Beaty, 1994; Pierce & Wardle, 1996; Huurre, Komulainen & Aro, 1999; Griffin- Shirley & Nes, 2005).

The relevant literature indicates that the individuals with visual impairments are able to develop a positive self-concept (Martinez & Sewell, 1996). Moreover, even though proof that a handicap may put children and adolescents at psychosocial risk, it isn’t a given that it will negatively influence their self-esteem (Pierce & Wardle, 1996).

High self-esteem in individuals with visual impairments is positively linked to the social support (Huurre & Aro, 1998; Huurre, Komulainen & Aro, 1999; Huurre, 2000), independence in conducting activities of daily living (Beach, Robinet & Hakim-Larson, 1995), perceived independence (Tuttle, 1984) and benefits of sports (Ponchillia, Strause & Ponchillia, 2002).

The aims of the present study are: a) the investigation of possible differences in the self-esteem amongst sighted adults and adults with visual impairments and b) the investigation of the relationships between individual features of adults with visual impairments (vision status, gender, age, age at loss of sight, ability of independent movement, educational level and employment status) and self- esteem.

Method Participants One hundred and two adults with visual impairments (blind and individuals with low vision) and one hundred and fifty sighted adults took part in study. The group of sighted adults consisted of 56 males και 94 females, aged from 18 to 58 years old (mean= 31.08, SD= 12.87). Of the 102 participants with visual impairment, 63 were either individuals with blindness or severely reduced vision and 39 were individuals with low vision. The age of the visually impaired participants ranged from 18 to 73 years old (mean= 36.39, SD=13.57). The sample consisted of 63 males and 39 females.

Additionally, based on their age at onset of visual impairment, the participants were divided into two groups on the basis of: a) being visually impaired at birth (n=54, 52.9%), and b) acquiring a visual impairment at a later age (n=48, 47.1%). With regards to the educational level of the participants, 4 (3.9%) were elementary school leavers, 13 (12.7%) secondary school graduates, 46 (45.1%) lyceum graduates, 14 (13.7%) university undergraduate students, and 15 (24.5%) university graduates. Most of the participants (n=58) stated that they can always move by themselves (without a sighted guide), 14 do not have the ability of independent movement and almost in every case a sighted guide is required for their movement, and 30 declared that their mobility is restricted within familiar environments. A total of 44 participants stated that they are consistently or most of the time reliant on a sighted guide.The sample was randomly selected and none of the participants have additional disabilities.

Measures and Procedure Two questionnaires were used for the purposes of this study: a) the Rosenberg Self-Esteem Scale (1965) and a) an informal questionnaire for the recording of the demographic/personal data of the participants with visual impairments. That were the following: visual status (blindness/severely reduced vision or low vision), gender, age, age at loss of sight (congenital or adventitious), level of independent mobility (with or without a sighted guide), educational level and employment status (employed or unemployed). The Rosenberg Self-Esteem Scale comprises of ten questions. The participants based their responses on a four multiple choice answers system (strongly agree, agree, disagree, strongly disagree). The questions were answered orally by the participants, while the researcher read out the questions.

Results Initially, the means and standard deviations of participants’ scores were calculated for each group separately (see Table 1).

Table 1. Means and standard deviations of each group. Group N Mean SD Sighted individuals 150 23.21 4.229 Blind or severely V. I. 63 22.22 4.252 Low vision 39 21.62 4.121

The implementation of T-test, revealed that there is statistically significant differences (t= -2.249, df= 250, p<0.05) amongst the sighted participants and participants with visual impairments. However, the application of ANOVA (LSD post-hoc test) revealed that only the adults with low vision show a lower score on the self-esteem scale (p<0.05) compared with the sighted adults. Moreover, there is no statistically significant differences amongst the blind or severely visually impaired participants and participants with low vision as well as sighted participants.

In addition, a multiple regression analysis implemented, using the variables visual status, gender, age, age at loss of sight, ability of independent movement, educational level and employment status to predict self-esteem. The analysis yielded an adjusted R2 of 0.118 (F=2.588, p<0.05). Significant individual predictors of self-esteem were the age at loss of sight (β= -0.201, p<0.05) and the educational level (β= 0.255, p<0.05). Vision status, gender, age, ability of independent movement and employment status were not significant individual predictors of self-esteem (see Table 2).

Table 2. Multiple regression for variables as predictors of self-esteem. Variable B Std. Error Beta t p Vision status -.351 .838 -.041 -.419 .676 Gender .540 .858 .063 .629 .531 Age -.007 .031 -.023 -.231 .818 Age at loss of sight -1.677 .839 -.201 -1.998 .049 Independent .298 .867 .034 .343 .732 movement Educational level .961 .376 .255 2.555 .012 Employment status -1.031 .906 -.118 -1.138 .258 Note. Adjusted R2 = 0.099, p<0.05.

Conclusion

The findings of this study reveal statistically significant differences with regards to the self-esteem amongst sighted adults and adults with low vision. Adults with low vision have less self-esteem when compared to sighted adults. Sacks (1996) supports that adults with low vision demonstrate a more negative self-perception in comparison to blind and/or sighted adults. Moreover, the study of Roy & MacKay (2002) – even though based on a small sample of participants – suggests that low vision may generate a more negative effect in self-perception compared to the self-perception associated with blindness. In the present study, the self-esteem of the participants with low vision is lower than that displayed by blind or severely visually impaired participants. However, this difference is no statistically significant. Our findings concur with other studies according to which no significant differences lie with regards to the self-esteem experienced by people with various degrees of visual impairment (Meighan, 1971; Huurre, Komulainen & Aro, 1999).

Roy and MacKay (2002) state that different coping strategies are required from people with congenital and adventitious visual impairment. Individuals with adventitious visual impairment often go through disturbed emotional states (Roy & MacKay, 2002). The present study identified a significant correlation between self-esteem and the age at onset of visual impairment. People experiencing a visual impairment at birth usually display higher scores of self-esteem. These findings are shared with those of other studies (Tuttle, 1984, Roy & MacKay, 2002), which support the view that adjusting to a visual disability is relatively easier when it is identified during the infancy or early childhood rather than when is identified during adolescence or adulthood. However, other studies (e.g. Huurre, Komulainen & Aro, 1999) support the view that self-esteem is not significantly influenced by the age at onset of visual impairment.

With regards to the differences in self-esteem between the two genders, the findings of this study seem to share common grounds with those of other studies (Meighan, 1971; Lopez-Justicia & Pichardo, 2001), according to which no significant differences exist between male and female participants with visual impairment. References

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