Purpose

This questionnaire aims to assess the personal psychological reactions of an individual experiencing physical impairment or dysfunction.

Questionnaire Analysis

The Reactions to Impairment and Disability Inventory (RIDI) was developed by Livneh and Antonak in 1991. It consists of 60 statements/questions representing potential reactions to the experience of physical impairment or disability. The tool comprises eight subscales aligned with a proposed temporal structure, suggesting that maladaptive reactions are more often associated with the past rather than the future. These subscales measure:

a) Shock (e.g., “I cannot absorb or accept all that has happened to me.”)
b) Anxiety (e.g., “I’m so nervous I can’t sit still.”)
c) Denial (e.g., “I believe my physical impairment will go away on its own.”)
d) Depression (e.g., “I find it difficult to find a reason to get up in the morning.”)
e) Internalized Anger (e.g., “When I think back on what happened to me, I feel bitter.”)
f) Externalized Hostility (e.g., “Everything in my life is still falling apart.”)
All statements/questions are presented as a single scale (Antonak & Livneh, 1991; Livneh & Antonak, 1990, 1991, 1997).

Scoring and Statistical Analysis

The 60 RIDI items are presented as a whole, and responses are recorded using a four-point Likert-type scale, where:
1 = Never (the reaction is never experienced),
2 = Rarely (experienced 1–4 times per month),
3 = Sometimes (experienced 5–9 times per month),
4 = Often (experienced 10 or more times per month).
Eight scores are calculated for each participant, based on the sum of scores in each subscale:
a) Shock (Items: 28, 34, 38, 43, 49, 56, 59)
b) Anxiety (Items: 8, 17, 21, 24, 31, 42, 44, 53)
c) Denial (Items: 2, 5, 13, 22, 41, 50, 52)
d) Depression (Items: 1, 3, 6, 12, 16, 20, 29, 37)
e) Internalized Anger (Items: 4, 9, 10, 23, 26, 32, 33, 39)
f) Externalized Hostility (Items: 18, 25, 45, 47, 48, 54, 57)
g) Acknowledgment/Acceptance (Items: 14, 19, 35, 36, 40, 51, 58)
h) Adjustment (Items: 7, 11, 15, 27, 30, 46, 55, 60)
For each subscale, a higher score indicates a more frequent experience of that reaction. For example, a high score on the Depression subscale indicates more frequent depressive responses, while a high score on the Adjustment subscale reflects more frequent adaptive responses.

Validity and Reliability

Since the questionnaire was not developed or standardized in Greece, its factor structure was studied as presented in the sample. Factor analysis revealed that RIDI is a multidimensional questionnaire, showing good convergent and discriminant validity, particularly for the anxiety and depression subscales (Treharne et al., 2004). Construct validity is only partially substantiated. Moreover, correlations between the RIDI subscales of Acknowledgment/Acceptance and Adjustment and the Acceptance of Disability Scale support its criterion validity (Livneh & Antonak, 1990). Finally, findings by Livneh and Antonak (1991) only partially support the structure of reactions proposed in the Acceptance of Disability Scale. The RIDI demonstrates good internal consistency and solid psychometric properties. Specifically, the eight subscales show homogeneity and relative independence. Their Cronbach’s alpha values are:
0.75, 0.73, 0.69, 0.78, 0.74, 0.79, 0.77, and 0.85, respectively.
These results indicate good internal consistency for all subscales except Denial.

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.