IMPACT OF FUNCTIONAL SEVERITY ON SELF-CONCEPT IN YOUNG-PEOPLE WITH SPINA-BIFIDA

This study examines the relationship between medical and functional se verity of disability and levels of self esteem and self concept in 79 young people with spina bifida. Greater feelings of global self worth and of self esteem in physical appearance were associated with greater severity of disability. This was only in part an effect of lower IQ a mong the most disabled young people. Many of the least disabled had ma rked impairment of self esteem. Analysis of the impact of individual a spects of disability confirmed the association between increased self esteem in physical appearance and global self worth, and diminished fu nctional ability. Academic self ratings, however, were higher in the l ess disabled. Hydrocephalus and continence appeared to have minimal ef fect on self esteem. The relationship between severity of disability i n spina bifida and self concept is complex and mediated by a range of factors. It is incorrect to assume that the psychological impact is le ss in the mildly disabled young person.