ابعاد کنترل روانشناختی والدین: ارتباطات با پرخاشگری فیزیکی و رابطه پیش دبستانی در روسیه

This paper investigates whether education buffers the impact of physical disability on psychological distress. It further investigates what makes education helpful, by examining whether cognitive ability and occupational class can explain the buffering effect of education. Two waves of the 1958 British National Child Development Study are used to test the hypothesis that the onset of a physical disability in early adulthood (age 23 to 33) has a smaller effect on psychological distress among higher educated people. In total 423 respondents (4.6%) experienced the onset of a physical disability between the ages of 23 and 33. We find that a higher educational level cushions the psychology impact of disability. Cognitive ability and occupational class protect against the effect of a disability too. The education buffer arises in part because individuals with a higher level of education have more cognitive abilities, but the better social position of those with higher levels of education appears to be of greater importance. Implications of these findings for the social gradient in health are discussed.

The onset of a physical disability is a major event in the lives of individuals. Becoming disabled often results in an increase in psychological distress (Burchardt, 2003;Choi and Marks, 2008, Llena-Nozal et al., 2004, Manor et al., 2001 and Turner and Noh, 1988). It negatively affects job opportunities and can seriously impact one’s relationships and social network. In a given year in the UK, depending on the definition used, about 13–47 per 1000 people of working age experience the onset of a disability (Burchardt, 2003; Jenkins & Rigg, 2004). On average, people who faced a structural decline in physical health because of a disability, report lower well-being and more depressive symptoms. However, not everyone who experiences the onset of a physical disability becomes psychologically distressed, and those who are negatively affected by disability differ considerably in the magnitude of the psychological impact (Sharpe and Curran, 2006 and Stanton et al., 2007). Relatively little is known about the factors that cause some people to be affected very strongly by a disability whereas others appear to cope well and experience no or only small changes in psychological distress. Previous research found that a lack of social support could exacerbate the negative effects of a disability, whereas a supportive social network may alleviate stress (Turner & Noh, 1988). Also psychological resources, such as sense of mastery and locus of control, seem to cushion the impact of a disability (Bisschop et al., 2004 and Turner and Noh, 1988). To our knowledge, no studies so far have examined the moderating role of education. This is surprising as education is an important social determinant of health and well-being (Dupre, 2008, Link et al., 2008, Ross and Wu, 1995 and Zimmer and House, 2003). We argue that there is ample reason to expect that education buffers the impact of a disability because education provides people with behavioral, material, and psycho-social resources that are positively related to health (Link et al., 2008, Ross and Wu, 1995 and Stronks et al., 1996). Education enables and motivates people to take control over their lives. Some of the beneficial effects ascribed to education, may be due to the better socio-economic standing of higher educated people. Education is not just an indicator of socio-economic status; it precedes socio-economic status (Ross & Mirowsky, 2006) and the benefits that a higher education bestows on an individual are permanent (Ross & Mirowsky, 2006), unlike the benefits to a better job. Education indicates human capital, both innate ability and learned skills. The more motivated and able may be selected into higher levels of education, which in part may drive the education–health connection. To get a better grip of why educational level may differentiate the impact of disability, we will examine the role of education simultaneously with measures of ability and economic resources. To sum up, our main research question is: To what extent does a higher level of education buffer the impact of the onset of a physical disability on psychological distress? Furthermore, in case we find that education buffers the impact of a disability, we aim to find out what it is about education that buffers the negative effects of the onset of a disability. That leads to our second research question: To what extent do buffering effects of education remain if we control for ability and economic resources? We investigate these questions using the National Child Development Study (NCDS), one of the large UK birth cohort studies. We study the effects of disability on psychological distress in early adulthood, between ages 23 and 33. We aim to contribute to the literature in three respects. First, this study integrates two largely distinct literatures on the effect of disability on mental health and on educational disparities in health. By doing so, it improves our understanding of how disparities in health take shape over the life course and how social inequalities influence the relationship between health and well-being. There has been relatively little attention for socio-economic factors in the literature on disability onset and mental health; we found only one longitudinal study (Smith, Langa, Kabeto, & Ubel, 2005). Smith et al. (2005) found that, among older people, those who were wealthier prior to the onset of a disability suffered a smaller decrease in well-being than those below the median wealth level. Our second contribution is that we study the non-elderly general population. A number of longitudinal studies has investigated the well-being of samples of patients and disabled people in relation to their socio-economic circumstances (e.g.: Waltz, Badura, Pfaff, & Schott, 1988), but these studies lack control groups and are hard to generalize to the general population. Most previous research that looked into possible moderators focused on the elderly (e.g.: Yang, 2006; for an exception see: Turner & Noh, 1988). The onset of a disability, however, is a negative and often unexpected event, especially for younger people. People who become disabled at a young age have many years of bad health awaiting them. Gaining insight into the consequences of early disabilities is thus of high importance. Third, we aim to make an empirical contribution. The NCDS contains detailed information on health and socio-economic resources of a large cohort of individuals; as a result we observe a sizeable number of people who become disabled. As such, the NCDS offers a unique opportunity to examine variation in the effect of becoming disabled on psychological distress.

Does education buffer the effect of the onset of a disability on psychological distress? To our knowledge this study is the first to investigate that question. In a large cohort of young British adults followed from their 23rd to their 33rd year of age, about 1 in 20 experienced the onset of a disability. In line with previous research, we found that the onset of a disability leads to a sharp increase in psychological distress. The results support our hypothesis that a higher educational level lessens the impact of the onset of disability on psychological distress. In addition, we investigated to what extent the beneficial buffering effects of education could be ascribed to the higher cognitive abilities of people with a higher level of education or to their better economic resources. As expected, people with higher cognitive ability and higher occupational class suffered less from the impact of a disability. People who had a job at baseline did not do better; it is the kind of job that matters. In simultaneous analyses, the buffering effect of education is reduced somewhat if we control for cognitive ability or occupational class. The education buffer remains significant and substantial, however, even if we control for cognitive ability and occupational class simultaneously. A further striking finding is that the buffering effect of cognitive ability completely disappeared once we controlled for buffering effects of education or economic resources. We conclude that education buffers the impact of a disability. The buffering effect of education probably arises only in part because the higher educated have better economic resources and to an even lesser extent because they have higher cognitive abilities. Furthermore, there remained a substantial direct education buffer. This suggests that acquired skills and knowledge, and other benefits of education (socio-cultural resources) are of great importance to people who experience the onset of a disability. For example the better educated may be better able to verbalize their needs to health professionals and to mobilize the resources in their social network. This study has shown the importance of personal resources in shaping the psychological impact of health decline in young adulthood. The onset of a disability is a major distressing event, but for people with a higher level of education this appears to be much less the case. Interestingly, we find that education offered a general protective effect (disparities along educational boundaries in psychological distress widened over time). On top of this general effect, education was more beneficial for people who became disabled. This shows that a protective factor such as education may be more beneficial under specific circumstances. Researchers should thus be careful in dismissing or adopting a protective factor based on average effects. The onset of a disability is a rare event, but many people will suffer the onset of a disability during their adult life, as such the buffering effect of education may contribute to health disparities even though the overall effect of education appears to be moderate.