Description

The Reactions to Impairment and Disability Inventory (RIDI-60) is a multidimensional psychometric instrument designed to assess the personal psychological reactions experienced by individuals facing physical impairment, functional limitation, or disability. Its primary purpose is to provide a systematic assessment of how individuals psychologically and emotionally respond to changes associated with impairment and disability.

The RIDI was developed by Livneh and Antonak in 1991 and consists of 60 statements describing possible reactions to physical impairment or disability. The instrument conceptualizes psychosocial adaptation as a multidimensional process involving a range of emotional, cognitive, and behavioral responses.

The inventory comprises eight subscales: Shock, Anxiety, Denial, Depression, Internalized Anger, Externalized Hostility, Acknowledgment-Acceptance, and Adaptation. These dimensions are associated with a hypothesized temporal structure of adaptation, according to which reactions that are less conducive to adjustment are associated with chronicity and may be experienced more frequently in the past than in the future.

By assessing these dimensions separately, the RIDI-60 provides a detailed representation of the individual’s reactions to impairment and disability rather than reducing psychological adjustment to a single overall indicator. This multidimensional approach makes the instrument particularly relevant to research concerning disability, chronic illness, psychological adjustment, rehabilitation, and psychosocial functioning.

Data Analysis and Use

Analysis of the RIDI-60 is primarily conducted at the subscale level. Although all 60 statements are presented to participants as a unified questionnaire, responses are allocated to the eight specific dimensions represented by the instrument. Consequently, eight separate scores are calculated for each participant by summing the responses corresponding to the items of each subscale.

Descriptive statistical analysis can be used to calculate means, standard deviations, score distributions, and other indicators for each dimension. The subscale scores may also be examined in relation to demographic, clinical, functional, or psychosocial variables, depending on the objectives of the study.

The multidimensional structure of the instrument additionally permits the use of factor analysis to investigate whether the proposed structure of psychological reactions is reproduced within a particular population. Correlation analysis, group comparisons, and multivariable statistical models may also be applied when researchers wish to examine relationships between reactions to disability and other psychological or clinical characteristics.

Interpretation should be performed separately for each dimension. For example, a higher score on the Depression subscale represents a greater frequency of depressive reactions, whereas a higher score on the Adaptation subscale indicates a greater frequency of adaptive reactions.

The RIDI-60 can therefore provide a multidimensional profile of psychological responses to impairment and disability and may be particularly useful in rehabilitation research, health psychology, clinical psychology, counseling, and studies of psychosocial adaptation to chronic illness or disability.

Objective

The primary objective of the Reactions to Impairment and Disability Inventory (RIDI-60) is to assess the personal psychological reactions of individuals experiencing physical impairment or disability.

Through its eight dimensions, the instrument provides information regarding different emotional and psychological reactions that may accompany the process of living with and adapting to impairment or disability.

The RIDI-60 may consequently contribute to a more comprehensive understanding of psychosocial adaptation, allowing researchers and professionals to identify different patterns of response and investigate how these reactions relate to broader psychological, functional, and social outcomes.

Scoring

The 60 items of the RIDI-60 are presented together and answered using a four-point Likert-type frequency scale. A response of 1 = Never indicates that the reaction is never experienced. A score of 2 = Rarely indicates that the reaction occurs approximately 1–4 times per month. A score of 3 = Sometimes corresponds to approximately 5–9 occurrences per month, while 4 = Often indicates that the reaction is experienced 10 or more times per month.

The Shock subscale consists of items 28, 34, 38, 43, 49, 56, and 59. The Anxiety subscale includes items 8, 17, 21, 24, 31, 42, 44, and 53. The Denial subscale consists of items 2, 5, 13, 22, 41, 50, and 52, while the Depression subscale includes items 1, 3, 6, 12, 16, 20, 29, and 37.

The Internalized Anger subscale includes items 4, 9, 10, 23, 26, 32, 33, and 39. Externalized Hostility is assessed through items 18, 25, 45, 47, 48, 54, and 57. Acknowledgment-Acceptance consists of items 14, 19, 35, 36, 40, 51, and 58, while Adaptation is calculated from items 7, 11, 15, 27, 30, 46, 55, and 60.

Scores are obtained by summing the corresponding item responses within each subscale. A higher score on a particular subscale indicates that the corresponding psychological reaction is experienced more frequently. Thus, higher scores should not automatically be interpreted as either favorable or unfavorable without considering the specific dimension being assessed.

Validity

According to the available source, the RIDI was not originally developed or standardized in Greece. Its factorial structure was therefore examined within the sample in which it was applied. Factor analysis supported the multidimensional nature of the questionnaire.

The instrument has demonstrated good convergent and discriminant validity, particularly with respect to the Anxiety and Depression subscales. Evidence regarding construct validity is described as only partially established.

Associations between the RIDI Acknowledgment-Acceptance and Adaptation subscales and measures of acceptance and disability provide additional evidence supporting the criterion-related validity of the instrument. However, findings reported by Livneh and Antonak provide only partial support for the proposed structure of reactions to impairment and disability.

Reliability

The RIDI-60 demonstrates good internal consistency and satisfactory psychometric characteristics. The eight subscales have been reported to show both homogeneity and relative independence from one another.

The reported Cronbach’s alpha coefficients for the eight subscales are 0.75, 0.73, 0.69, 0.78, 0.74, 0.79, 0.77, and 0.85, respectively. These coefficients indicate satisfactory internal consistency for most dimensions. The Denial subscale presents the lowest coefficient, at α = 0.69, while the remaining dimensions demonstrate good internal consistency according to the criteria used in the source.

References

Antonak, R. F., & Livneh, H. (1991). A Hierarchy of Reactions to Disability. International Journal of Rehabilitation Research, 14, 13–24.

Livneh, H., & Antonak, R. (1990). Reactions to Disability: An Empirical Investigation of Their Nature and Structure. Journal of Applied Rehabilitation Counseling, 21(4), 13–21.

Livneh, H., & Antonak, R. (1991). Temporal Structure of Adaptation to Disability. Rehabilitation Counseling Bulletin, 34, 298–319.

Livneh, H., & Antonak, R. (1997). Psychosocial Adaptation to Chronic Illness and Disability. Gaithersburg, MD: Aspen Publishers.

Livneh, H., Martz, E., & Bodner, T. (2006). Psychosocial Adaptation to Chronic Illness and Disability: A Preliminary Study of Its Factorial Structure. Journal of Clinical Psychology in Medical Settings, 13(3), 251–261.

Siu, A. M., Chan, S. C., Shek, D. T., Cheung, M. K., Mo, C., & Lai, S. (2021). Translation and Validation of the Reaction to Impairment and Disability Inventory for Chinese Population in Hong Kong. Disability and Rehabilitation, 1–9.