Associations of dynamic versus static disability with experiences of stigma and mental health

Prior research recognizes that the visibility of an individual's disability is salient to understanding experiences, such that greater visibility is associated with higher levels of stigma and symptoms of anxiety and depression. Yet, the dynamicity of a disability, defined as the extent to which severity of an impairment fluctuates, has been relatively understudied. We conducted the first known quantitative examination of dynamicity.

We hypothesized that mental health and chronic illnesses would be most frequently characterized as dynamic. We also expected that dynamicity would be associated with greater symptoms of anxiety and depression, and that these relationships would be mediated by greater experiences with discrimination and microaggressions.

The sample included 125 participants with disabilities who answered the Ableist Microaggression Scale, the Everyday Discrimination Scale, the Generalized Anxiety Disorder Screener-7, the Center for Epidemiological Studies Depression Scale, and an author-created six-question measure of disability dynamicity.

Mental health conditions were rated by participants as highly dynamic. Consistent with our hypotheses, four linear regressions supported that, above and beyond demographic factors and disability visibility, dynamicity predicted more ableist microaggressions, discrimination, anxiety symptoms, and depressive symptoms. In mediation models, discrimination predicted both depressive and anxiety symptoms, whereas ableist microaggressions did not. Confidence intervals further supported that discrimination, but not microaggressions, mediated the relationship of dynamicity with anxiety and depressive symptoms.

Disability dynamicity appears relevant to understanding stigmatizing experiences and resulting anxiety and depression symptoms. Recognition of this association can contribute to advancement of culturally competent mental health care for people with dynamic disabilities.