Psychological adjustment to lower limb amputation

Rationale: Clinical reports have indicated that a significant number of lower limb amputees experience psychological adjustment problems. Research had demonstrated a relatively high prevalence of depression in this population but there has been inadequate attention to other aspects of adjustment. This study aimed to identify variables associated with increased psychological distress. Particular attention was given to cognitive models of emotion which postulate a key role for self-consciousness and appearance-related beliefs.;Methods: A cross-sectional correlational design was employed. Participants were 67 lower limb amputees. Measures gathered information about different types of self-consciousness, appearance-related beliefs, psychological adjustment, and a range of amputation-related factors including activity restriction, prosthesis satisfaction, phantom and residual limb pain and other medical issues.;Results: The prevalence of anxiety was 29.9% and the prevalence of depression was 13.4%. Activity restriction, prosthesis satisfaction and appearance-related beliefs were associated with both distress and psychosocial adjustment difficulties. Public self-consciousness was associated with distress and psychosocial adjustment difficulties but this was not the case for private self-consciousness. Psychological distress was more common amongst those who reported amputation-related pain or additional health problems. Distress was not influenced by age, time since amputation, cause of amputation or level of amputation.;Implications: Clinicians need to monitor amputees for distress over a long time period. It is particularly important to assess for anxiety. Interventions that target appearance-related beliefs may be of benefit to this population. Limitations of the current study are addressed and areas for further research are highlighted.