Normal personality and adults with learning disabilities: rehabilitation counseling implications.

Rehabilitation Counseling Implications

Almost by definition, individuals with learning disabilities (LD) have experienced a history of difficulty achieving at a level consistent with their potential in such areas as academics, receptive and/or expressive language, memory, and social and vocational adjustment (Geist & McGrath, 1983; Fafard & Haubrich, 1981; Cox, 1977). A history of struggling to achieve and frequent failure almost inevitably impacts on the self-image of adults with learning disabilities, and rehabilitation professionals are often faced with the cumulative effects of this history (Quinn, 1984). Even if adults with LD can adequately perform required job tasks, they must still be able to function adequately in a personal, social, and emotional context both on and off the job or failure may be inevitable (RSA, 1990). Often individuals with LD develop both overt and covert maladaptive ways of coping with the stresses encountered during their life. Conversely, others with similar stressors appear to cope without significant difficulty. Consequently, an understanding of variables that may influence coping and adjustment in individuals with LD would be useful to rehabilitation professionals providing services to this population.

There is a need to develop a better understanding of "the relationship between learning disabilities and adult psychosocial maladjustments, including substance abuse, depression, and suicides" (National Joint Committee on Learning Disabilities, p. 174, 1987). Relatively few studies appear in the literature which focus on personality and adjustment in adult populations with learning disabilities (Spreen, 1987). Since such research has dealt primarily with adolescent and childhood populations (Glosser & Koppell, 1987; Weintraub & Mesulam, 1983), the findings may be of limited usefulness in understanding adult populations with LD (Polloway, Smith, & Patton, 1984; Patton & Polloway, 1982). Lack of information about the adult psychosocial adjustment of these clients exacerbate the rehabilitation counselor's problem in ensuring appropriate planning and subsequent placement.

Porter and Rourke (1985) discuss several major problems with previous research in the area of learning disabilities, including variability in the operational definition of LD, failure to consider potentially confounding developmental issues as well as variability in the assessment of adjustment. They also discuss research limitations in terms of the "Homogeneity Hypothesis" (Porter & Rourke, p. 261, 1985), in which undifferentiated groups of subjects with LD are compared with a non LD sample. Within group differences are often obscured with such an approach and there is also the concomitant risk of developing overgeneralized assumptions about the relationship between learning disabilities and the parameter in question.

Additionally, the predominant focus in research studies has been on psychopathology (Bigler, 1989; Livingston, 1985; Rourke, Young, & Leenars, 1989; Spreen, 1988) of persons with LD often being drawn from clinical settings. Typically the instrument of choice in measuring personality has been the Minnesota Personality Inventory (MMPI) which is primarily a measure of psychopathology (Ackerman, McGrew, & Dykman, 1987). Often research studies on personality lack sufficient external validation or demonstration to document that the maladaptive behaviors actually exist. Very few studies have focused on "normal" personality traits in a LD sample. Normal personality traits may be more useful in describing how such an individual perceives oneself, how others view the individual, and how the person copes with everyday situations.

The purpose of this paper is to present a conceptual model for considering the role of personality in providing rehabilitation services to adults with learning disabilities. Supportive data for this model are reported from a study that evaluates (1) the "homogeneity hypotheses" in terms of a single LD personality type, and (2) the relation between personality types and self-rated problems of adjustment.

Personality Types and Rehabilitation Counseling

Why do some adults with LD appear sullen and distrustful, while others seem insecure, dependent, and distractable? Why do some adults with LD seem to be well adjusted, while others pose seemingly endless challenges in temperament, adjustment, and maturity to the rehabilitation professional? Developing an appreciation for the mediating role that normal personality has on how the individual with LD copes with the demands of the world can facilitate (1) a better understanding of occasional maladaptive behavior, and (2) the development of ways to best individualize rehabilitation services. The ability to predict potential difficulties that a given client with LD may encounter when experiencing the inevitable stressors of an achievement oriented society can greatly facilitate counseling, and help to infuse the practitioner's orientation with empathy and understanding. While non LD individuals often experience the same stressors based on a prior history of failure, etc., these same stressors may be especially devastating to the client with LD.

Presented is a brief discussion of four basic personality types including: (1) characteristic behaviors of individuals with LD; (2) potential maladaptive tendencies under stress; and (3) implications for rehabilitation services. The goal is to facilitate an understanding of the personality of clients with LD from a nonpsychopathological perspective and to facilitate the use of more prescriptive adaptive procedures.

The Personal Styles model (Kunce & Cope, 1987) provides a framework for describing personality attributes of adults with LD. The Personal Styles model was developed to define personality in terms of enduring, commonplace personality characteristics. Two basic bipolar dimensions of personality (a) Introversion versus Extroversion, and (b) Change versus Stability provide the basis for conceptualizing eight basic personality traits. Each trait is defined in terms of three types of behavior: ways of expressing emotion, ways of doing things, and ways of thinking about things. The eight traits and associated personal styles are related to each other according to a circular or "circumplex" format.

From this model, it is possible to delineate two personality subtypes of extroversion and two subtypes of introversion.

Each of the four personality types has unique ways of viewing and interacting with the world around them. The basic characteristics are described in nonpsychopathological terms. However, when encountering stress, each of the four personality types may be prone to different types of maladaptive tendencies.

A major premise of the Personal Styles model is that "basic personality characteristics should have implications for both normal and psychopathological behaviors" (Kunce, Cope, & Newton, 1991). The conceptual basis for this model is derived from the research and theorizing of Krauskopf and Davis (1969), Kunce and Anderson (1976, 1984), Kunce (1979), Kunce and Cope (1987), Leary (1957), and Kunce and Tamkin (1981). Research on the adaptive and maladaptive implications of the personality traits as assessed by the Personal Styles Inventory is summarized by Kunce, et al. (1991).

Personality Types and Treatment Recommendations

In this section, four basic personality types are presented in relation to behaviors that may be especially characteristic of clients with LD. Rehabilitation considerations based on research on corresponding behavioral correlates of each type are then discussed.

Stability-oriented Extroverts. Individuals with this personality type tend to be amicable interpersonally. Emotionally, they are encouraging and sympathetic, tend to avoid conflict and seek to maintain equilibrium and balance. They are often seen as good team players, and are not particularly hostile to authority since they welcome the input and assistance of others.

This personality type is likely to be perceived by the rehabilitation professional as relatively well adjusted, since they are receptive to guidance and are easy to engage interpersonally. The potential risks encountered when working with these clients include the possibility that they may be too easily led or influenced by the counselor or by significant others, including the media, friends, parents, spouses, etc. In other words, in their desire to be agreeable and please others, they might accept a rehabilitation plan proposed by the counselor without adequate personal commitment and with little consideration of their own desires and needs. A tendency to become overly dependent on others for support and guidance may also be seen. When encountering stressful situations, they are likely to defend by avoiding and ignoring the source of stress. They are unlikely to openly admit to difficulties or concerns they experience in daily functioning.

The challenge to the rehabilitation professional is to assist stability-oriented extroverts with LD to fully consider their own wants, needs, and desires as well as the range of career options available to them. By assisting them to make their own decisions commitment to the decision is optimized. These clients are often too quick to accept the advice of persons in authority, even when they do not agree with it, which often leads to subsequent problems. The counselor needs to be cautious about the premature acceptance of rehabilitation plans because of client tendencies to ignore or deny potential problems.

Change-oriented Extroverts. Individuals of this personality type are likely to be energetic, active, and easily bored. Behaviorally, they are open and flexible, and will often meet their needs by actively attempting to change or manipulate their environment. They are at ease with people, appear confident, and are facile at expressing themselves. They are frequently the center of attention, and often seek out leadership roles.

The rehabilitation professional may initially find these clients pleasant, motivated, and actively goal-directed. However, some of the clients with LD may have special difficulty attending to relevant details when considering options and may make impulsive decisions. They may have trouble adhering to and following through with tasks, particularly if the fit between the tasks and the individual's personality styles are not optimal. It becomes incumbent upon the rehabilitation counselor to encourage them to take time to explore and fully consider pertinent details and options before making a decision. Such individuals are at risk for "not seeing the trees for the forest." In academic and vocational planning, this group may be especially suited for careers in which public contact with others is important and where variety of job tasks is possible.

When encountering stressful situations, Change-oriented Extroverts may be prone to openly express intense emotions (particularly anger), which are typically short-lived. They may defend against stress and threats to self-esteem by externalizing and blaming others for negative outcomes, or if this is not effective, by attempting to change or leave the environment. Being aware of these tendencies can enable the rehabilitation professional to avoid reacting personally to their fleeting, intense emotional reactions. Developing client insight into these natural tendencies could also facilitate more effective personal problem-solving and overall adjustment.

The Stability-oriented Introvert. Individuals in this type often prefer "hands-on" type activities of a practical nature. Interpersonally, they tend to be reserved, modest, and rather private. Emotions are handled in an introspective fashion, with a tendency to avoid public expression of emotion. They are very aware of their internal subjective states. Individuals in this personality group place great importance on self-control and personal responsibility and there is a tendency toward perfectionism. Consistency and predictability are preferred to excitement and change. Such clients may be overly self-critical of their deficit areas, and prefer environments in which the visibility of their personal deficits is minimized.

Rehabilitation interventions may need to assist these clients in developing a more positive attitude and awareness of personal strengths. Clients with LD may be especially prone to focus on personal inadequacies. Additionally, the clients may need help in making correct attributions for the difficulties and failures they have encountered, as there is a tendency not to recognize legitimate external factors that may contribute to these difficulties. Because of their reserved nature they may be slow in developing a therapeutic alliance with the rehabilitation counselor. Perfectionistic tendencies and privacy needs may make it difficult for this client to discuss weaknesses and potentially negative concerns. An understanding and encouraging approach, and allowing time to establish rapport can lead to an effective therapeutic relationship.

When encountering stress, the Stability-oriented Introvert has tendency to become self-punitive, and may be at risk for depression, guilt, and withdrawal. Perceived threats to stability and control may result in heightened efforts to maintain control, which in extreme instances could give rise to obsessive-compulsive behaviors. If a vocational choice or academic course of study meets these clients' needs for stability and provides an opportunity to capitalize on personal strengths, a good rehabilitation outcome can be anticipated.

Change-oriented Introvert. The adaptive qualities of this personality type include a tendency to be individualistic, improvising, and serious about interpersonal relationships. They may resist the influence and persuasion of others until they have satisfied their own need to evaluate the situation and make their own decisions. Once reaching a personal decision, these clients may be more likely to persist in the rehabilitation plan since the decision was made on the basis of their own needs and desires.

This same tendency can make clients with LD particularly difficult to work with in a rehabilitation setting. Their reluctance to accept traditional ways and established procedures makes them vulnerable to being perceived as uncooperative, unmotivated, and even rebellious. The challenge for the rehabilitation counselor is to avoid an overly directive or authoritarian posture. Exploration of options should proceed with a minimum of persuasion on the part of the counselor. They may need extra time to individually analyze and digest all the details before making a decision. Differences of opinion, or the failure of clients to consider all pertinent information, should be processed and discussed from a "partner and advocate" stance, rather than from an authoritative position. Individualized approaches, which are always desirable, are particularly important for this personality type. Development of a therapeutic alliance will require more time than is typical, as such individuals may be slow to trust others.

Clients with LD with this personality are at risk for excessive anxiety, worry, and alienation. Change-oriented Introverts tend to cope with stress by optimizing personal choice and freedom, which can often mean stretching or escaping structured situations. If escape is not perceived as possible, expression of hostility and rebellious acting out is possible. Individuals with LD in this group can be enabled to achieve academic, social, and vocational adjustment, but without an understanding of their normal personality style they are at risk for potential failure, i.e., either quitting or being prematurely discharged from services.

In summary, four basic personality types and their rehabilitation implications for clients with LD were presented. The model presented is "testable" and research studies should be designed to investigate the validity of the treatment suggestions.

Personality Types and Problem Behaviors

In this section, the findings of a research investigation of the personality attributes of adults with LD and their relation to self-reported problem behaviors are presented.

Participants

Forty-six adults with learning disabilities were selected from a larger study who qualified for services in a midwestern state's Division of Vocational Rehabilitation (Hinkebein, 1990). Only caucasian males 18 years or older were selected from that study in order to minimize potential confounds of gender and race. All participants had qualified for rehabilitation services in terms of having a diagnosis of learning disability by a licensed professional using recognized state VR and RSA guidelines. The learning disability constituted a significant handicap to employment for which there was a reasonable expectation that provision of vocational rehabilitation services would result in competitive employment. Also, all clients were considered severely disabled by rehabilitation criteria for LD.

The mean age of the sample was 20.9 years (SD = 4.1) with a range of 18 to 37. The mean years of schooling was 11.7 years with a range of 7 to 15 years.

Instruments

All participants were administered the Personal Styles Inventory (Kunce, Cope, & Newton, 1986), and an interview questionnaire designed to assess areas of problem behaviors commonly reported in the LD literature.

The Personal Styles Inventory (PSI) Form E, consists of two parts, a 250-item true-false section and a 24-item personal styles-self ratings component which utilizes a 10 point Likert scale. A shorter version of the PSI (PSI-120) has been made available since this study was conducted. The PSI has an eighth grade reading level. See Figure 1 for an illustration of the personality characteristics of the PSI.

Considerable research exists that supports the PSI's construct, content, and concurrent validity. Reliability estimates (KR-20's) for Form E personality traits range from .71 to .82 (Cope, Kunce, & Roland, 1990). Stability of the PSI traits over 60 days is demonstrated by a test-retest median correlation of .86 (Angelone & Kunce, 1990). For a review of research on the PSI see Kunce et al. (1991).

The interview questionnaire consisted of ten items addressing areas of psychosocial adjustment which the literature indicates are often problem behaviors for individuals who are LD. The ten items address difficulties in the areas of interpersonal communication, frustration tolerance, social perception, impulsivity, withdrawal, depression, anxiety, self-image, anger, and dependence. The items are answered by a yes or no response. While extensive validity and reliability data are not available, an earlier study demonstrated significant correlations with scales from a well-known, symptom derived measure, the SCL90-R (Hinkebein, 1990).

Procedure

All testing was administered by the principal investigator to reduce any artifact due to use of more than one test administrator. The Personal Styles Inventory was administered using a multimodal presentation (auditory paired with written presentation). The auditory presentation consisted of written items being read aloud by the test administrator, with the subject following the written test protocol. Previous investigators have recommended such a multi-modal presentation when there is a question regarding possible processing deficits in any given modality (Ackerman et al., 1987). All clients had met a minimum standard of competency for reading or oral comprehension sufficient for understanding the terms presented. Following the completion of the PSI, subjects were interviewed by the examiner and their responses to the adjustment items were recorded.

Analysis of Data.

The ten self-reported problem behaviors were analyzed using a 2 x 2 ANOVA to assess the effects of Extroversion/Introversion and Stability/Change and their interactions. (A general linear model was used to adjust for unequal cell sizes). Results approaching significance were also evaluated using a Z statistic for significant differences between proportions (p =.10) (Glass & Stanley, 1970). The F values and the Z values obtained in the two-step analysis approximated each other in terms of their statistical significance. Since the data is proportional, the Z values are reported in this study.

Participants were first classified as a member of one of four personality types (Stability-oriented Extrovert, Change-oriented Extroverts, Stability-oriented Introvert, and Change-oriented Introvert) on the basis of their PSI trait scores. For example, a subject was identified as a Stability-oriented Extrovert if the trait scores for Extroversion (Enthusiastic/Facilitating) and for Stability-orientation (Systematizing/Arranging) exceeded, respectively, the values for Introversion (Evaluating/Analyzing) and for Change-orientation (Innovating-Designing).

Results

The distribution of participants by personality type were: 33% Stability-oriented Extroverts; 33% Change-oriented Extroverts; 19% Stability-oriented Introvert; and 15% Change-oriented Introvert. The endorsement of problem behaviors ranged from 65% for frustration tolerance and for anxiety to 9% for low self-esteem (Table 1).

Endorsement of Problem Behaviors by LD Participants
Problem Behaviors              Percent Endorsement
Frustration tolerance                  65
Anxiety                                65
Impulsivity                            41
Interpersonal communications           39
Social perception                      39
Depression                             30
Anger                                  28
Dependency                             24
Withdrawal                             22
Low Self-esteem                         9
Table 1

Statistically significant differences in the self-acknowledgement of problem behaviors in relation to personality type for seven of the 10 problems and a nonsignificant trend for one are presented. A significantly larger portion of the introverted groups (both change and stability-oriented introvert) admitted to problems with effective interpersonal communication and to a tendency to withdraw socially.

Differences in Adjustment Problems of Participants Categorized
as Extroverts Versus Introverts
Adjustment Problems   Extrovert   Introvert   Z       P
Interpersonal
Communication            30%         56%      1.75   .04
Withdrawal               10%         43%      2.44   .007
Table 2

A significantly higher proportion of change-oriented participants, regardless of extrovert/introvert status, endorsed difficulties in the areas of accurate social perception, impulsivity, and anger. The Stability-oriented subgroup of introverts were especially prone to admit to low self-esteem and depression. The Change-oriented subgroup of extroverts was especially prone to identify themselves as anxious (excitable). No significant difference were obtained for the ratings for dependency and for frustration tolerance and personality.

Differences in Adjustment Problems of Participants Categorized
on Stability-Oriented Versus Change-Oriented
Adjustment    Stability-    Change-     Z      P
Problem       Oriented     Oriented
Social
Perception    25%            55%      2.26   .01
Impulsivity   20%            69%      3.83   .0001
Anger         12%            49%      2.95   .0016
Table 3
Differences in Adjustment Problems of Subject Category by
Personality Types
Adjustment            Groups               Z     P
Problem
Depression    Stability-   Stability
              oriented     oriented
              Extrovert    Introvert
                (13%)        (55%)       2.24   .013
Anxiety       Change-      Stability
              oriented     oriented
              Extrovert    Introvert
                (80%)        (44%)       1.85   .03
Self-esteem   Change-      Stability-
              oriented     oriented
              Extrovert    Introvert
                (0%)         (22%)     1.48   .16
Table 4

Discussion

The findings of this exploratory study of personality type and problem behaviors is supportive of the usefulness of the Personal Styles Model of normal personality in understanding adjustment difficulties that may be encountered by adults with learning disabilities. Table 5 summarizes the most significant relation of personality type to problem behaviors.

Personality Types and Self-Acknowledged Problem Behavior
Stability-oriented Extrovert   Change-oriented Extrovert
        (N = 15)                    (N - 15)
No acknowledged problems       Social perception
                               Impulsive
                               Anxiety
                               Anger
Stability-oriented Introvert   Change-oriented Introvert
        (N = 9)                     (N = 7)
Interpersonal communication    Interpersonal communication
Withdrawal                     Social perception
Depression                     Impulsive
Poor Self-esteem               Withdrawal
                               Self-Image
                               Anger
Table 5

The significant relation between personality type and problem behaviors is theoretically consistent with what the PSI model would predict. Note, for example, that change-oriented participants admit to problems with anger, impulsivity, and accurate social perception, while introverted subjects admit to problems with interpersonal communication and withdrawal. It is perhaps not so much the presence or absence of a behavior that determines its gravity, but the intensity, duration, and frequency of that behavior that determines pathology.

Individuals in the Change-oriented Extrovert subgroup admit to problems with anxiety, which relates to a "nervous" energy that would be characteristic of the excitement seeking behavior of this personality group. Stability-oriented Introverts admit to more problems with depression, and are also more likely to admit to problems with self-image. This characteristic is consistent with their self-directed focus. Change-oriented Introverts tend to "over-report" a number of problems ranging from impulsivity, anger, and withdrawal. In sharp contrast, the Stability-oriented Extroverts do not acknowledge any problems. This finding superficially indicates that this type has fewer adjustment difficulties than the other three types. However, personality correlates for this type indicate the use of denial as a primary defense mechanism (Kunce et al. 1991). Because of their reluctance to admit to difficulties and a tendency to under-report problems it is particularly necessary for rehabilitation professionals to look "beneath the surface" for ongoing difficulties. In summary, a key implication of these results is that each personality type has certain assets and liabilities. Consideration of these normal characteristics in rehabilitation counseling and in terms of types of relevant job placements may make the difference between rehabilitation success or failure. By assisting these individuals to understand the strengths of their personality style, clients may become more effective "self advocates" in choosing occupational (as well as social) settings that match their own natural tendencies.

The results of this study provide support for the caveat discussed by Porter and Rourke (1985) challenging the assumption of homogeneity of personal attributes when studying and working with individuals who are learning disabled. Clearly, not all of the individuals with LD in this study had similar personality types. The only pervasive problems endorsed by the majority of the group were problems related to frustration tolerance, and anxiety. The Personal Styles Model offers a means for rehabilitation professionals to understand and individualize interventions taking into consideration normal personality characteristics and associated problem behaviors.

Adoption of a personality orientation in rehabilitation that centers on everyday personality characteristics as opposed to focusing on psychopathology (the traditional medical model), can greatly enhance rehabilitation outcomes of persons with learning disabilities. The Personal Style Model holds promise as a means of developing an appreciation for the contribution of normal personality characteristics to behavior, in both its adaptive and not-so-adaptive manifestations. Research is needed to examine the consistency of these findings with other samples of adults with LD (i.e., noncaucasians, females, and a wider range of ages).

Further, LD research from the perspective of trying to understand normal personality holds promise for improving our understanding and ability to work with clients who have LD. Additional research should also focus on the relation of normal personality characteristics to such variables as learning styles and personal-social adjustment which has implications for improving the provision of rehabilitation services. This model of normal personality holds promise for all rehabilitation clients if interpreted relative to their unique personalities. However, while a nonpsychopathological personality approach holds promise as a useful tool for other rehabilitation populations, its use is particularly relevant for individuals with LD. The LD literature in the area of personality and socio-emotional functioning suggests a prevalent risk in over-emphasizing pathology when assessing the functioning of learning disabled populations.

References

Ackerman, P. T., McGrew, J. M., & Dykman, R. A. (1987). A profile of male and female applicants for a special college program for learning-disabled students. Journal of Clinical Psychology, 43, 67-78.

Angelone, E. O., & Kunce, J. T. (1990). Personal Styles Inventory test-retest correlations. Unpublished manuscript, University of Missouri-Columbia.

Bigler, E. D. (1989). On the neuropsychology of suicide. Journal of Learning Disabilities, 22, 180-185.

Cope, C. S., Kunce, J. T., & Roland, M. M. (1990). Dimensions of normal personality. Unpublished manuscript, University of Missouri-Columbia.

Cox, S. (1977). The learning-disabled adult. Academic Therapy, 13, 79-86.

Fafard, M. B., & Haubrich, P. A. (1981). Vocational and social adjustment of learning disabled young adults: A follow up study. Learning Disability Quarterly, 4, 122-130.

Geist, C. S., & McGrath, C. (1983). Psychosocial aspects of the adult learning disabled person in the world of work: A vocational rehabilitation perspective. Rehabilitation Literature, 44, 210-213.

Glass, G. Y. & Stanley, J. C. (1970). Statistical Methods in Education and Psychology. Englewood Cliffs, NJ: Prentice Hall.

Glosser, G., & Koppell, S. (1987). Emotional behavioral patterns in children with learning disabilities: Laterilized hemispheric differences. Journal of Learning Disabilities, 20, 365-368.

Hinkebein, J. H. (1990). Personality, adjustment, and neuropsychological correlates among learning disabled adults: A comparison of subgrouping approaches. Unpublished doctoral dissertation, University of Missouri-Columbia.

Krauskopf, C., & Davis, K. (1969). Studies of the normal personality. University of Missouri-Columbia, Testing and Counseling Service.

Kunce, J. T. (1979). MMPI scores and adaptive behavior. In C. S. Newmark (Ed.), MMPI clinical and research trends New York: Praeger.

Kunce, J. T., & Anderson, W. P. (1976). Normalizing the MMPI. Journal of Clinical Psychology, 32, 776-780.

Kunce, J. T., & Anderson, W. P. (1984). Perspectives on uses of the MMPI in nonpsychiatric settings. In P. McReynolds & G. J. Chelune (Eds.), Advances in psychological assessment. San Francisco: Jossey-Bass.

Kunce, J. T., & Cope, C. S. (1987). Personal styles analysis. In N. C. Gysber & E. J. Moore (Eds.), Career counseling: Skills and techniques for practitioners (pp. 100-130). Englewood Cliffs, NJ: Prentice Hall.

Kunce, J. T., & Cope, C. S., & Newton, R. M. (1986). Personal styles inventory: Manual for counselors and clinicians. Columbia, MO: Educational and Psychological Consultants.

Kunce J. T., Cope, C. S., & Newton, R. M. (1991). Personal Styles Inventory. Journal of Counseling and Development, 70, 334-341.

Kunce, J. T., & Newton, R. M. (1989). Normal and psychopathological personality characteristics of individuals in alcohol rehabilitation. Journal of Counseling Psychology, 36, 308-315.

Kunce, J. T., & Tamkin, A. S. (1981). Rorschach movement and color responses and MMPI social extraversion and thinking introversion personality types. Journal of Personality Assessment, 45, 5-10.

Leary, T. (1957). Interpersonal diagnosis of personality: A function theory and methodology for personality evaluation. New York: Ronald Press.

Livingston, R. (1985). Depressive illness and learning disabilities: Research needs and practical implications Journal of Learning Disabilities, 18, 518-520.

National Joint Committee on Learning Disabilities (1987). Adults with learning disabilities: A call to action. Journal of Learning Disabilities, 20, 172-175.

Patton, J. R., & Polloway, E. A. (1982). The learning disabled: The adult years. Topics in Learning and Learning Disabilities, 2, 79-88.

Polloway, E. A., Smith, J. D., & Patton, J. R. (1984). Learning disabilities: An adult developmental perspective. Learning Disabilities Quarterly, 7, 179-186.

Porter, J. E., & Rourke, B. E. (1985). Socio-emotional functioning of learning-disabled children: A subtypal analysis of personality patterns. In B. E. Rourke (Ed.), Neuropsychology of Learning Disabilities. New York: Guilford Press.

Quinn, D. (1984). Perspective from the other side: A message of hope for learning disability teachers and students. Learning Disability Quarterly, 7, 295-298.

Rehabilitation Services Administration (1990). Program assistance circular. RSA-PAC-90-7.

Rourke, B. P., Young, G. C., & Leenars, A. A. (1989). A childhood learning disability that predisposes those afflicted to adolescent and adult depression and suicide risk. Journal of Learning Disabilities, 22, 169-175.

Spreen, O. (1988). Learning disabled children growing up. London: Oxford University Press.

Spreen, O. (1987). Learning disabled children growing up: A follow-up into adulthood. Victoria, Canada: Swets & Zeitlinger B. V./Lisse.

Weintraub, S., & Mesulam, M. M. (1983). Developmental learning disabilities of the Right Hemisphere: Emotional, interpersonal, and cognitive components. Archives of Neurology, 40, 463-468.