Sayer Nina A, Spoont Michele, Nelson Dave
Center for Chronic Diseases Outcomes Research, Veterans Affairs Medical Center 116A6, One Veterans Drive, Minneapolis, MN 55417, USA.
Soc Sci Med. 2004 Jun;58(11):2133-43. doi: 10.1016/j.socscimed.2003.08.009.
Assumptions about the characteristics and motivations of individuals pursuing disability status are well known. However, policy, programming and interventions need to be based on information about the actual sociodemographic characteristics of disabled individuals, as well as their goals in seeking disability status. In this study, we focus on veterans seeking disability compensation for post-traumatic stress disorder (PTSD) from the United States Department of Veterans Affairs. We present information on their life circumstances and their self-reported reasons for valuing the obtainment of veterans' disability status on the basis of PTSD. There was considerable variability in the background of veterans seeking disability status on the basis of PTSD. Of concern, only about half of these individuals were receiving any mental health treatment at the time of application. Most claimants reported seeking disability compensation for symbolic reasons, especially for acknowledgement, validation and relief from self-blame. Reasons having to do with improved finances were less frequently endorsed, although the importance of obtaining improved solvency through disability status decreased as income increased. The sense of investment in obtaining a sense of self-acceptance and acceptance from others through disability status varied by sociodemographic variables. Overall, findings suggest that individuals seeking disability benefits may have unmet mental health care needs, and that policy makers, investigators and providers should consider material benefit as one of many possible reasons for engaging in a disability compensation system.
关于追求残疾身份的个人的特征和动机的假设是众所周知的。然而，政策、项目和干预措施需要基于有关残疾个体实际社会人口特征的信息，以及他们寻求残疾身份的目标。在本研究中，我们关注的是向美国退伍军人事务部申请创伤后应激障碍（PTSD）残疾补偿的退伍军人。我们展示了他们的生活状况以及他们自述的基于PTSD而重视获得退伍军人残疾身份的原因。在基于PTSD寻求残疾身份的退伍军人背景方面存在相当大的差异。令人担忧的是，这些人中只有大约一半在申请时正在接受任何心理健康治疗。大多数索赔人报告称，寻求残疾补偿是出于象征性原因，特别是为了获得认可、确认以及摆脱自责。与改善经济状况相关的原因较少被提及，尽管通过残疾身份获得更好偿付能力的重要性会随着收入增加而降低。通过残疾身份获得自我接纳感和他人接纳感的投入感因社会人口变量而异。总体而言，研究结果表明，寻求残疾福利的个人可能有未得到满足的心理健康护理需求，并且政策制定者、研究人员和提供者应将物质利益视为参与残疾补偿系统的众多可能原因之一。
