SOCIAL AND PSYCHOLOGICAL-FACTORS IN ADJUSTMENT TO LIMB AMPUTATION

Research provides ample evidence that limb amputation poses serious th reats to psychological well being, yet little is known about the speci fic factors that predict increased risk. In this study, a conceptual m odel was tested in which it was hypothesized that restriction of norma l activities (e.g., self-care, visiting friends, doing household chore s) would play a pivotal role in the association between antecedent var iables and symptoms of depression. Consistent with the model, greater activity restriction and less satisfaction with social contacts were c losely related to more symptoms of depression. In addition, the effect s of prosthesis use and household income adequacy on depressed affect were mediated by activity restriction. Amputees who used a prosthesis less and those whose incomes were not adequate to meet their needs rep orted more restriction of routine activities as a result of their ampu tation. Activity restriction in turn predicted greater depressive symp tomatology. Perceptions of primary and secondary control are discussed as potential mechanisms underlying the association between activity r estriction and emotional distress.