Personal and family stress in individuals with diabetes and vision loss.

The intrapersonal distress and the impact of diabetes and vision impairment on marital functioning were assessed. Significant degrees of intrapersonal distress were demonstrated by the Beck Depression Inventory, Rosenberg Self-Esteem Scale, and Rand Mental Health Index. Family functioning as assessed by the Family Assessment Device was significantly compromised. Vision impairment was a major stressor in the spousal relationship. Of 18 subjects who had been involved in a committed relationship at the onset of vision impairment, 9 had separated. Separation occurred at a mean of 1.6 years after the vision impairment. Totally blind individuals were at greater risk for separation than those who were legally, but not totally, blind. Psychological intervention was a limited benefit. Studies are necessary to identify the appropriate timing for further interventions.