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Benito Arias, Anastasio Ovejero, Raquel Morentin
Love and Emotional Well-being in People with Intellectual Disabilities The Spanish
Journal of Psychology, vol. 12, núm. 1, mayo, 2009, pp. 204-216,
Universidad Complutense de Madrid
España
Available in: http://www.redalyc.org/articulo.oa?id=17213005020
The Spanish Journal of Psychology,
ISSN (Printed Version): 1138-7416
psyjour@sis.ucm.es
Universidad Complutense de Madrid
España
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The Spanish Journal of Psychology
2009, Vol. 12, No. 1, 204-216
Copyright 2009 by The Spanish Journal of Psychology
ISSN 1138-7416
Love and Emotional Well-being in People
with Intellectual Disabilities
Benito Arias, Anastasio Ovejero, and Raquel Morentin
Universidad de Valladolid (Spain)
Love has been a recurrent topic throughout history, and especially, literature. Moreover,
there is generalized agreement about its relevance for health emotional well-being, and
quality of life. This study was carried out with a sample of 376 persons with ID. The
goals of the work were to analyze a theoretical model of love in people with intellectual
disabilities by means of the methodology of structural equations, and to analyze their
perception of love and of amorous relations with regard to other aspects such as amorous
satisfaction, perceived satisfaction, absence of family interference, self-determination, and
emotional well-being. The results revealed that (a) the construct under study has three
factors: Commitment, stability, and idealization, Passion and physiological excitement,
and Intimacy and romanticism; (b) the perception of love in this collective is, in general,
idealized and affected by the context; and (c) self-determination and the lack of family
interference are relevant variables to explain both love and emotional well-being.
Keywords: love, people with intellectual disabilities, emotional well-being, structural
equation models
El amor ha sido un tema de estudio recurrente a través de la historia y, especialmente,
en la literatura. Además, existe un acuerdo generalizado sobre su relevancia para la
salud, el bienestar emocional y la calidad de vida. Este estudio se llevó a cabo con una
muestra de 376 personas con discapacidad intelectual. Los objetivos del trabajo fueron
analizar un modelo teórico del amor en personas con discapacidad intelectual por medio
de la metodología de ecuaciones estructurales, y analizar su percepción del amor y de
las relaciones amorosas en relación con otros aspectos tales como la satisfacción amorosa,
la satisfacción percibida, la ausencia de intromisión familiar, la autodeterminación y el
bienestar emocional. Los resultados pusieron de manifiesto que (a) el constructo estudiado
comprende tres factores: Compromiso, estabilidad e idealización, Pasión y excitación
fisiológica e Intimidad y romanticismo; (b) la percepción del amor en este colectivo está,
en general, idealizado e influenciado por el contexto, y (c) la autodeterminación y la falta
de intromisión familiar son variables relevantes para explicar tanto el amor como el
bienestar emocional.
Palabras clave: amor, personas con discapacidad intelectual, bienestar emocional, modelos
de ecuaciones estructurales
Correspondence concerning this article should be addressed to Benito Arias, Universidad de Valladolid, Paseo de Belén, 1, 47011
Valladolid (SPAIN). E-mail: barias@psi.uva.es
Translation: Virginia Navascués Howard
How to cite the authors of this article: Arias, B., Ovejero, A., Morentin, R.
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LOVE AND EMOTIONAL WELL-BEING
Despite wide-ranging consensus about the fact that
emotions are essential in the life of human beings,
traditionally, they have received relatively little attention
from scientific psychology. Therefore, it is not surprising
that, in his review in the Annual Review of Psychology, Le
Doux (1995, p. 209) concludes that “scientists interested in
human nature have not been capable of reaching an
agreement about what emotion is and what place it should
occupy in a theory of the mind and behavior.” In the last
20 years, a socio-constructivist conception of emotions has
been gaining strength (Averill, 1985; Crespo, 1986; Harré,
1986; Harré & Parrot, 1996; Ovejero, 2000a, 2000b). The
same thing could be said about love, a phenomenon closely
related to emotions, because, although it is a special kind
of interpersonal attraction, it is precisely the emotional aspect
that more clearly differentiates amorous attraction from other
kinds of attraction. And if emotions have traditionally
received little attention, still less have love and amorous
relations. As noted by Berscheid and Walster (1978), this
negligence is probably due to three main causes: (a) the
belief that love has more to do with literature than with
science; (b) the consideration that love—and sexual
behavior—are taboos; and (c) the third and perhaps most
practical reason is simply the difficulty of studying the topic
of love.
It is absolutely unexplainable that this issue has received
so little attention as it is difficult to find a phenomenon that
is more intrinsically interpersonal than love, and at the same
time, more central to the lives of human beings (Fisher,
2006; Ovejero, 1998; Sternberg, 1988; Yela, 2002). This
may be why scientific studies on love have increased since
the 1960s, and especially as of the 1980s (Alberoni, 1990;
Barrón, Martínez-Íñigo, De Paúl, & Yela, 1999; Bauman,
2005; Bloom, 1967; Carreño, 1991; Fisher, 1992; Lampert,
1997; Sangrador, 1993; Sternberg, 1988, 1998; Sternberg
& Barnes, 1988; Sternberg & Grajek, 1984; Sternberg &
Weis, 2006; Yela, 2000, 2006). Something similar occurred
with the studies on the psychology of sexual behavior
(Fernández, Quiroga, & Del Olmo, 2006; Wiseman, 1976),
a behavior that is a fundamental component of love (Critelli,
Myers, & Loos, 1986).
This growing interest in the study of love has also
promoted the development of instruments to assess it
(especially Likert-type probabilistic scales, frequently
validated through the responses of university students), among
which the following are noteworthy: (a) the Love Scale
(Rubin, 1970), (b) the Love Attitudes Scale (LAS; Hendrick
& Hendrick, 1986, 1989; Hendrick, Hendrick, & Dicke,
1998), (c) the Triangular Love Scale (Sternberg, 1988, 1997),
and, in Spain, (d) the “Escala Tetrangular del Amor” (The
Tetrangular Love Scale; Yela, 1995, 1996, 2006).
However, this progressive and incipient interest in love
has not extended to include the context of disabled people,
and still less to people with intellectual disabilities (hereafter
ID). The studies carried out with this population have
205
focused on issues related to sexuality, such as the analysis
of the frequency of certain sexual behaviors (Gust, Wang,
Grot, Ransom, & Levine, 2003; Servais et al., 2002), the
description of myths and attitudinal barriers (Amor, 1997;
Campo, 2003; Fierro, 2000; López, 2002), the assessment
of knowledge, attitudes, and experience of people with ID
(Galea, Butler, Iacono, & Leighton, 2004; McCabe, 1999;
Szollos & McCabe, 1995), or the proposal of guidelines for
the development of educational affective-sexual programs
(Alcedo, Aguado, & Arias, 2006; Löfgren-Martenson, 2004;
López, 2002, 2006; McCabe, 1999; Morentin, 2005;
Morentin, Arias, Rodríguez Mayoral, & Aguado, 2006;
Rodríguez Mayoral, López, Morentin, & Arias, 2006). With
rare exceptions (Arias, Morentin, Verdugo, & Rodríguez,
2006; Knox & Hickson, 2001), practically no studies of the
theoretical models underlying love among people with ID
have been developed, nor have new assessment scales been
designed nor existing ones adapted. In any case, the
limitations these people may encounter, such as restrictions
of access to normalized environments (people with ID are
often more in strictly “attended” environments), the negative
effect of over protective family attitudes on the establishment
of normalized interpersonal relations (García, 2005; LöfgrenMartenson, 2004; López, 2002), or unrealistic expectations
and beliefs (biased towards an idealized conception) derived
from not having positive models in the immediate
environment (Arias et al., 2006; Gordon, Tschopp, &
Feldman, 2004; Howland & Rintala, 2001; Knox & Hickson,
2001; Lesseliers & Van Hove, 2002; López, 2002) have
often been noted.
Proof of this “selective attention” in the study of love
in people with ID is the fact that, after performing a search
in the ERIC, Medlin, and PsycInfo databases from 1987 till
2007, we found 10 references when crossing the terms
love/loving and mental retard* / intellectual disabilit* /
learning disabilit*. These publications are specifically about
couple love, but they focus on aspects more closely related
to sexuality (sexual health, barriers or affective-sexual
education) than to love.
The quantity of investigation on love in people with ID
carried out to date is considered insufficient for two reasons:
On the one hand, the consideration of love as an important
phenomenon for people without ID, as well as its
consequences on health, well-being, happiness, satisfaction,
and quality of life (Chiappo, 2002; King, 2004; Ovejero,
1998; Sangrador, 1993; Yela, 2002) and, on the other hand,
the current importance of the study of quality of life in the
collective of people with ID which has led to various
theoretical models (Cummins, 1997; Felce & Perry, 1996;
Schalock & Verdugo, 2002). Despite the fact that these
models include a dimension related to emotional well-being,
the relevant role of couple relations and love-related
emotions has not received sufficient attention. The studies
carried out on quality of life (in persons both with and
without ID) usually report positive subjective appraisals,
206
ARIAS, OVEJERO, AND MORENTIN
despite the adverse conditions that can be found (Cummins,
1995, 2003; Felce, 2006; Hensel, Rose, Stenfert-Kroese, &
Banks-Smith, 2002). The homeostatic theory of subjective
quality of life made an attempt to explain this aspect
(Cummins, 2003, 2005; Cummins & Nistico, 2002).
Summing up, there have been very few studies that have
analyzed the relation between quality of life or well-being
and aspects related to amorous satisfaction and love.
Moreover, most of these investigations have focused on
physical disability (Kedde & Van Berlo, 2006; McCabe,
Cummins, & Deeks, 2000; McCabe, Taleporos, & Dip, 2003;
Taleporos & McCabe, 2002), paying special attention to the
relation between psychological adjustment or self-esteem
and well-being and sexual satisfaction (instead of to love
or amorous satisfaction).
In view of this situation, the goal of this study is to
contribute to the analysis and understanding of couple relations
and the perception of love in adults with ID, as well as its
relation with emotional well-being. With this general goal,
we propose the following hypotheses: Firstly, the appraisals
and perceptions of love in adults with ID will be negatively
skewed, in accordance with the results of a pilot study we
shall present below. Secondly, we expect the perception of
love of people who have a partner at the time of the study
(who respond as a function of their current relation) will be
different from that of people who do not have a partner at
that time, but who had have some previous experience in
stable intimate relations (who respond as a function of the
“ideal”). Thirdly, the scores obtained in emotional well-being
will be high, in accordance with the results of other studies
on quality of life. Fourthly, in agreement with findings in
population without ID, we expect to find a relation between
the perception of love and emotional well-being experienced
by the population with ID; however, in view of the relevance
of the family in this population, we expect to find some
moderation of the family variables in this relation.
Method
Participants
A total of 411 people with ID were selected incidentally
from the main associations and organizations that work with
this population in four provinces of the Autonomous
Community of Castilla and León (Burgos, Palencia,
Salamanca, and Valladolid). After processing the initial data
(i.e., eliminating cases with more than 25% of missing
responses by means of the listwise procedure, elimination
of subjects with extremely systematic responses), the final
number of participants was reduced to 376.
The participants met the following criteria: (a) being 18
years of age or older, (b) having a medium-high functioning
level of ID, (c) currently having a partner or, otherwise,
having some kind of experience or interest in intimate
interpersonal relations and (d) having accepted voluntarily
to participate in the study.
The main sociodemographic characteristics of the
participants were:
1. Province and association to which each participant
belonged: from a total of 12 associations of people
with ID, 47.61% belonged to Valladolid, followed by
Burgos (22.07%), Palencia (19.68%), and Salamanca
(10.64%);
2. Age: range between 18 and 71 years, mean age 34.58
(SD = 9.47); 50% of the sample was between 28 and
40 years of age;
3. Sex: 187 participants were male (49.73%) and 189
were female (50.27%);
4. Housing: 55.85% lived in the family home, 20.21%
in supervised flats, 19.68% in residences, and only
3.99% lived in their own flat;
5. Geographic setting: 72.34% lived in an urban setting
and 26.60% in a rural setting:
6. Program or service: 66.23% attended an Occupational
Center, 22.87% a Special Employment Center (SEC),
5.85% went to a Day Care Center, 3.72% studied a
Social Guarantee program, and 1.33% attended some
other kind of specific programs;
7. Employment: 23.67% worked in a SEC and the rest
(76.33%) were unemployed;
8. Level of functioning: 87.58% obtained an Inventory
for Client and Agency Planning score (ICAP; see
Montero, 1999) between 7 and 9; 84.82% was
classified by professionals in the centers in the category
of intermittent or limited need of support; and lastly,
47.41% and 43.35%, respectively, had mild or moderate
retardation according to the diagnostic criteria of the
Diagnostic and Statistical Manual of Mental Disorders4th edition (American Psychiatric Association, 2000);
9. Intimate relations: 72.9% currently had a partner at
the time of the study; the mean duration of the current
relation was 4 years and 8 months, with a total range
of 1 to 288 months; 91.61% did not live with their
partner; 98.40% were single; 97.07% reported being
homosexual; 65.16% said they had not had any
previous stable intimate relationship. Four of the
participants interviewed (0.97%) had not had any kind
of experience in intimate relations with other people.
Instrument
Above, we mentioned the lack of specific instruments
(or adaptations of existing ones) to assess love in people
with ID, so we had to construct a specific scale for this
purpose. In the following paragraphs, we describe the process
followed and the main psychometric characteristics of the
scale.
The starting point was the review of four scales targeting
population without disability. (a) the Love Scale (Rubin,
LOVE AND EMOTIONAL WELL-BEING
1970), (b) the Love Attitudes Scale (LAS; Hendrick &
Hendrick, 1986, 1989; Hendrick et al., 1998), (c) the
Triangular Love Scale (Sternberg, 1988, 1997), and (d) the
“Escala Tetrangular del Amor” (The Tetrangular Love Scale;
Yela, 1995, 1996, 2006). From these scales, we extracted
the items that made up the initial database. This review was
carried out on the Current Contents, ERIC, ISOC, Medline,
PsycInfo, Psicodoc, and TESEO databases, and we also
consulted three authorities in this field by electronic means
(R. J. Sternberg, personal communication, November 12,
2005; C. Yela, personal communication, October 24, 2005;
M. McCabe, personal communication, November 10, 2005).
As the instruments reviewed focused on population
without disability, in order to adapt them to the population
of interest, we elaborated a guideline of questions with the
content of these instruments and we organized a focus group
with 11 adults with ID. The results indicated that, initially,
the items with similar content to the studies of people
without disability could be used for population with ID,
taking into account that, in general, the comprehension of
the phenomenon of love was very similar in both
populations. The necessary adaptations refer to the inclusion
of family-related aspects and to drafting new items so they
would include phrases or common terms in the habitual
vocabulary of this population.
From this information, we elaborated an initial set of 131
items—whose drafting matched the conclusions of the
discussion group—that were evaluated by 15 independent
experts. These experts assessed (a) the extent to which each
item was appropriate to assess love, (b) the intensity with
which it assessed it, and (c) in which theoretical dimension it
could be included, in addition to noting any other observations
or suggestions. The results were satisfactory, both in adequacy
(Bangdiwala’s BN = .82) and in intensity (Bangdiwala’s BWN
= .64) (Bangdiwala, 1987). Discrepancies were observed in
the theoretical dimension (Krippendorff, 2004) in which the
judges placed each one of the items (Krippendorff’s α = .45).
Following the judges’ suggestions, 75 items were eliminated
(either because they were inadequate, redundant, overlapping,
ambiguous, or there were marked discrepancies among the
judges), so that the pilot scale had 56 items.
These 56 items were administered to 232 students of the
Faculty of Education and Social Work of the University of
Valladolid. Although it would have been desirable to administer
the pilot scale to people with ID, this was not possible because
we had no access to the sample at that time. However, we
consider that this sample met the required conditions to achieve
the goal of the pilot test, which was to assess the behavior of
the items and to refine the scale as much as possible. The
indexes provided by the data analysis were satisfactory, both
reliability (α = .953) and validity (exploratory factor analysis
with principal components, oblimin rotation, yielded a threefactor solution that accounted for 62.30% of the variance:
Commitment, stability, and idealization; Intimacy and
romanticism; and Passion and recurrent thoughts).
207
Four items with low values in the corrected
homogeneity index were eliminated, so the final scale,
called the Specific Scale to Assess Love in People with
Intellectual Disabilities was made up of 52 items. This
scale was administered to 376 people with ID, and, after
preliminary analysis, 3 items were eliminated because they
were not very homogeneous, and 2 items whose loadings
did not reach the threshold of .30 in any of the factors.
Summing up, the definite instrument was a probabilistic
scale of summatory estimations made up of 47 items, rated
on a 4-point Likert-type scale, ranging from 1 (totally
disagree) to 4 (totally agree), to avoid central tendency
response bias.
Global internal consistency was high (Cronbach’s α =
.926). The factor structure obtained by means of principal
components and oblimin rotation accounted for 51.54% of
the common variance, yielding three factors:
The first factor (23 items) explained 32.35% of the
variance. Its items refer to the establishment of future plans
in the relationship (e.g., “If I could, I would like to live with
_______ by ourselves in our home”), the desire and decision
to continue the relation at long term (e.g., “I want _______
and me to be fiancées forever”), faithfulness (e.g., “I trust
that _______ only goes out with me”) and, lastly, the
idealization of the partner which, in fact, promotes the
stability and duration of the relation (e.g., “No other person
would make me as happy as _______“). Therefore, we called
it Commitment and idealization.
The second factor (7 items) explained 11.81% of the
variance and its content is related to physical excitement or
passion (e.g., “I like to see _______ naked,” “I get excited
when _______ and I caress and touch each other”).
Therefore, we called it Passion and physiological excitement.
Lastly the third factor (17 items) explained 7.38% of
the variance. Its content refers to support and mutual help
(e.g., “_______ and I are concerned about each other’s wellbeing”), communication and understanding within the couple
(“_______ and I tell each other very personal and intimate
things”), trust (e.g., “_______ and I trust each other a lot”),
respect (“_______ and I respect each other’s decisions”),
empathy (“Between _______ and me, there is good
chemistry”), affection (“_______ and I give each other a
lot of affection”), and some romanticism (“Mi relation with
_______ is very beautiful and romantic”). We called this
factor Intimacy and romanticism.
Two complementary sections were included in the
Specific Scale to Assess Love in Persons with ID:
1. The section we called “related aspects” (11 items),
which includes: the person’s own global appraisal
(“How much do you love_______?”) and perceived
appraisal (“How much do you think _______loves
you?”), general satisfaction (“If my relationship is
alright, in general, I feel happy and content”), amorous
(“I am satisfied, happy with my relation with
_______.”), and sexual (“I am content, satisfied with
208
ARIAS, OVEJERO, AND MORENTIN
our sexual life.”); family involvement and selfdetermination (“I wish my family would let me decide
when and how to be alone with ________,” “I would
not let my family interfere in my relation with
_________,” “Although we’d like want to, sometimes
we cannot go out because one of the families is
against it,” “If my family did not want me go to out
with _________, I would break off with my partner,”
and “My family is happy and supports my relation
with ___________.”); and lastly, status and
acknowledgement (“I feel more valued by my
coworkers and friends when I have a partner.”).
2. A section about emotional well-being, made up of 7
items extracted from Verdugo and colleagues’
(Verdugo, Gómez, Arias & Schalock, 2009) “Escala
de Evaluación de la Calidad de Vida en Personas con
Discapacidad Intelectual” (Scale of Assessment of
Quality of Life in People with Intellectual
Disabilities): (“I often feel like crying,” “I feel happy,”
“I don’t feel like doing anything,” “I am happy with
my body’s aspect,” “I am content about myself,” “I
would like to enjoy life more,” and “I am content
with my life.”).
The following information was also presented with the
instrument: (a) instructions on how to complete it, (b)
sociodemographic data, (c) data of the institution to which
participants belonged, and (d) data of the interviewer and
administration date.
Lastly, we elaborated a protocol to explain the items, in
which a brief explanation of each scale item was included.
The inclusion of explanations and paraphrases of the items,
along with not using more than 4 degrees of agreement, are
valid and reliable ways to use this kind of scale with people
with mild or borderline ID (Hartley & MacLean, 2006).
Procedure
After we had elaborated the final scale, we contacted
main associations and organizations that work with people
with ID in provinces of Burgos, Palencia, Salamanca, and
Valladolid. After they had agreed to collaborate, we planned
a schedule for the two (previously trained) interviewers to
administer the scales at the diverse centers. The instruments
were administered, by means of an individual interview that
lasted between 20 and 40 minutes (depending on the
characteristics of each case), between the months of February
and April of 2006. Later, the sociodemographic data was
completed and checked by the professionals of the center.
Data Analysis
We performed descriptive analyses (score distribution,
central tendency and dispersion measures, ranges, etc.),
comparative analyses (to determine the existence of
differences as a function of independent variables or the
respondent collective), reductional analyses (principal
components analysis, discriminant analysis, etc.), and we
elaborated and validated the models (structural equations).
We used the following programs: SAS, version 9.3 (The
SAS Institute, 2006), SPSS, version 14.0 (SPSS, 2006),
LISREL, version 8.8. (Scientific Software International,
2006a) and PRELIS, version 2.3 (Scientific Software
International, 2006b).
Results
Love in People with Intellectual Disabilities
The data obtained in the total score of the Specific Scale
to Assess Love in People with ID (47 items) were negatively
skewed, with a mean of 168.04 (SD = 15.14), which
considerably exceeds the theoretical mid-point of the scale
(117.5) This skewed distribution was also observed in the
factors of the scale (skewness values were –2.07 for the first
factor, –1.46 for the second, and –1.51 for the third).
Therefore, the data revealed that the global perception
of people with ID of their couple relations is very positive,
which supports our first hypothesis.
The contrast of the scores as a function of whether or
not the participants had a partner was performed with MannWhitney’s U test. No significant differences were found,
either in the total score of the specific scale or in any of the
three factors (see Table 1).
These results initially led us to reject our second hypothesis,
as the differences between the responses of those who had a
partner and those who did not (who presumably responded as
a function of the ideal partner) were not significant.
Table 1
Scores on the Specific Scale as a Function of the Variable Current Partner (Mann-Whitney’s U)
Mean range
Factor 1
Factor 2
Factor 3
Total
Contrast
Yes (n = 274)
No (n = 102)
U
p
189.51
184.53
182.26
186.03
185.78
199.18
205.27
195.12
13697.00
12885.00
12263.00
13298
.767
.242
.067
.471
209
LOVE AND EMOTIONAL WELL-BEING
Related Aspects
As mentioned above, we included in this study a section
that took into account aspects related to intimate relations,
that is: global appraisal of love (one’s own and perceived),
satisfaction (general, amorous, and sexual), status and
acknowledgement, the role of the family, and selfdetermination.
Regarding the global appraisal of love, the responses were
very positive (Md = 4), both in the person’s own global appraisal
(“How much do you love_______?”) and in the perceived
appraisal (“How much do you think _______ loves you?”).
The results regarding satisfaction were also extremely
positive (Md = 4) both in general satisfaction (“When I get
on well with my partner, I feel happier and more content
in general.”), amorous satisfaction (“I am satisfied, happy
with my relation with _______.”), and sexual satisfaction
(“I am content, satisfied with our sexual life.”).
Regarding status and acknowledgement, assessed by means
of the item “I feel more valued by my coworkers and friends
when I have a partner,” 78.2% of the participants responded
“disagree” or “totally disagree” to this item. This indicates that
social acknowledgement for having a partner is not perceived
among the participants as an element of contextual pressure.
Lastly, the role of the family was assessed with 5 items,
grouped into two blocks: attitude and family involvement
(2 items: “Although we’d like to, sometimes we cannot go
out because one of the families is against it” and “My family
is happy and supports my relation with _______.”) and selfdetermination desired or expressed by the person (3 items:
“I wish my family would let me decide when and how to
meet _______ alone,” “I would not let my family interfere
in my relation with _______,” and “If my family didn’t want
me to go out with _______, I would break off with
him/her.”). The global distribution in this section was also
negatively skewed, with a median of 4 (the items with
negative valence were inversed) in all the items except one
(“Although we’d like to, sometimes we cannot go out because
one of the families is against it”), whose median was 3.
We then analyzed the relation of the scores in the aspects
related to the total score obtained in the Specific Scale to
Assess Love in People with ID (Table 2).
High scores in the scale correlated positively with higher
global appraisal (own and perceived), higher satisfaction
(amorous and sexual), less family interference, and higher
self-determination of the person with ID.
Emotional Well-being
In order to analyze emotional well-being of people with
ID, we included the 7 items mentioned above, which were
used in various stages of the elaboration and validation of
the Scale for the Assessment of Quality of Life of People
with Intellectual Disabilities (Verdugo et al., in press).
As stated in our third hypothesis, the descriptive results
were negatively skewed, indicating (according to
Kolmogorov-Smirnov’s Z test) that the data do not have a
normal distribution (Z = 1.988, p = .001). The mean was
22.75 (SD = 3.01) and the median was 23, and the theoretical
mid-point of this factor was 17.5.
Relation between Love and Emotional well-being
We analyzed the relation between the scores on the Specific
Scale for the Assessment of Love in People with ID, and those
obtained in emotional well-being by means of Kruskal-Wallis’
H test. For this purpose, we divided the participants into three
groups as a function of the score in the total scale (quartiles
1 and 3 were the cut-off points to differentiate between low,
medium, and high scores). The result was significant, χ2(2 )=
11.152, p = .004; thus, higher scores in the total scale
corresponded to higher scores in emotional well-being.
However, regarding the related factors (Table 3), we found
a significant relation (but not high) between emotional wellbeing and perceived global appraisal, but not with the person’s
own global appraisal. Therefore, high levels of emotional wellbeing may be more closely related to what people “perceive
they receive” than with what they “perceive they give.”
Table 2
Correlation between the Total Score on the Specific Scale
and Related Aspects (Spearman’s Rho)
Table 3
Correlation between Emotional Well-being and Related
Aspects (Spearman’s Rho)
Emotional well-being
Emotional well-being
Related Aspects
Own global appraisal
Perceived global appraisal
General satisfaction
Amorous satisfaction
Sexual satisfaction
Status and acknowledgement
Family interference
Self-determination
ρ
p
.392
.309
.109
.538
.356
.053
.202
.384
.000
.000
.035
.000
.000
.334
.000
.000
Related Aspects
Own global appraisal
Perceived global appraisal
General satisfaction
Amorous satisfaction
Sexual satisfaction
Status and acknowledgement
Family interference
Self-determination
ρ
.072
.161
–.029
.163
.111
–.039
.144
.127
p
.166
.002
.574
.002
.031
.448
.005
.014
210
ARIAS, OVEJERO, AND MORENTIN
Regarding satisfaction, the correlation (Spearman’s Rho),
although low, was significant in sexual satisfaction and
especially amorous satisfaction. However, there was no
correlation with the responses about general satisfaction.
Nor did we find a significant relation between the belief
about status and acknowledgement and emotional well-being.
Lastly, although also low, the correlations with less
family interference and more self-determination of people
with ID were also positive.
On the basis of these results, we proposed a model that
relates emotional well-being with love and related aspects.
For this purpose, we used the variables that had a significant
relation with emotional well-being in the previous analyses,
and we established a theoretical model that we then
contrasted. At this point, we would like to justify our going
from the descriptive level used till now to the explanatory
level (as we will propose a structural equation model). In
the introduction, we alluded several times to the lack of
studies that relate love and emotional well-being in people
with ID. Therefore, there are no theoretical models that are
sufficiently consolidated in previous research that could
guide our analysis of the structural relations among the
variables of interest and any other variables (family, in our
case) that could contribute to the explanatory power of the
model and support it from a theoretical viewpoint. The use
of SEM methodology, in addition to a considerable amount
of empirical data, requires sufficient conceptual clarity,
especially when used for confirmatory purposes. However,
it would not be adequate to identify all the cases of SEM
models as confirmatory methodology. Jöreskog (1993)
established a formal distinction between SEM applications
that are (a) strictly confirmatory, (b) alternative, and (c) used
to generate new models (i.e., exploratory). Many authorities
on this topic (e.g., Arbuckle, 2000; Cribbie, 2007; Hancock,
1999; Loehlin, 2004) have studied in depth the conception
of SEM models as merely exploratory in cases—like ours—
where there are no clearly established prior models, and the
theory is not sufficiently solid. The model we propose should
therefore be understood as an initial attempt to explore the
relations of interdependence and mutual influence among
the variables of interest—love, emotional well-being,
mediating family variables—in people with ID. In view of
this approach to the knowledge of such relations, it could
be argued that it would be more appropriate to use more
“exploratory” methods, for example simple regression. We
rejected this option because of the unfeasibility of using this
methodology to analyze conjointly the relations among the
variables involved.
The observed variables were the subjects’ responses to
the following items: (a) regarding emotional well-being, we
considered the items with a higher degree of consistency in
the analyses: Items 65 (“I feel happy”), 68 (“I am content
about myself”), and 70 (“I am content with my life”); (b)
regarding love and couple relations, the total score obtained
in the Specific Scale, perceived appraisal (“How much do
you think ________ loves you?”), and amorous satisfaction
(“I am satisfied, happy with my relation with _______”); (c)
the factor of family and self-determination was divided into
two components: family interference (score of the items:
“Although we’d like to, sometimes we cannot go out because
one of the families is against it” and “My family is happy
and supports my relation with _______”) and selfdetermination (score obtained from the items: “I wish my
family would let me decide when and how to meet ________
alone,” “I would not let my family interfere in my relation
with _______,” and “If my family didn’t want me to go out
with _________, I would break off with him/her”).
Thus, the model includes family variables (family
interference and self-determination) as the exogenous latent
variable, and emotional well-being and love as endogenous
latent variables.
In view of the nature of our entered variables (i.e.,
combination of ordinal and continuous variables assessed at
different levels of measurement, absence of multivariate
normality, as contrasted by means of Mardia’s (1974) statistic:
skewness = 562.90, p < .0001, kurtosis = 6.55, p < .0001,
Henze-Zirkler’s T = 58.54, p < .0001), the model was
validated using the polychoric covariance and asymptotic
covariance matrices calculated with the PRELIS 2.3 program
(Jöreskog & Sörbom, 1996c; Scientific Software International,
2006b), and parameters were estimated with the robust
maximum likelihood method (DuToit & DuToit, 2001;
Jöreskog & Sörbom, 1996a, 1996b).
Fit of the Measurement Model
The fit of the measurement model with two endogenous
latent variables (love and emotional well-being) was fully
satisfactory: S-Bχ2(8) = 14.557, p = .0684; root mean square
error of approximation (RMSEA) = .0468, PCLOSE = .503,
normed fit index (NFI) = .985, nonnormed fit index (NNFI)
= .987, comparative fit index (CFI) = .993, and goodnessof-fit index (GFI) = .935.
Fit of the Structural Model
The global fit was satisfactory, S-Bχ2(15) = 22.75, p =
.089, and clearly indicated the correspondence of the model
with the data, so we accepted the hypothesis that the
specified restrictions of the model were correct. The global
fit was supported by the remaining indexes: RMSEA = .037,
PCLOSE = .735, with a 90% confidence interval between
.000 and .0663, NFI = .981, NNFI = .987, CFI = .993, and
GFI = .943.
As can be seen in Figure 1, all the loadings (except for
e γ11, in which the t-value of Wald’s contrast did not reach
statistical significance) were significantly different from
zero. The determination coefficients were reasonably high
in most of the observed variables, which indicates sufficient
quality of the measurement.
LOVE AND EMOTIONAL WELL-BEING
211
Figure 1. Structural equation model with standardized estimations.
However, the 28 standardized residuals ranged from 1.951 to 1,224, with a median of 0.039. Thus, no absolute
values higher than |1.96| were observed. The eight indicators
selected to measure the three latent variables of interest in
the model are accepted as valid, in accordance with the
above arguments.
Regarding the effects of the model, as expected, the
conjoint effect of associated family factors and love factors
on emotional well-being was positive and significant,
although the percentage of variance explained by the conjoint
influence of these factors was not high (34.0%). The direct
standardized effect of family factors on love was also
positive and significant, and explained 23.9% of the variance.
Moreover, the direct standardized effects of associated family
factors on love were greater than their effects on emotional
well-being ((γ12 = .49 and γ11 = .36, respectively).
The total effect of family factors on emotional wellbeing reached the value of .51, and the indirect effect (via
Table 4
Results of the Multigroup Analysis as a Function of having
a Partner
Hypothesis
Equal groups (H0)
Different groups (H1)
Difference
χ2
df
p
1.15
0.94
0.21
52
45
7
1.000
love) was lower (0.15). The direct effect of love on
emotional well-being was moderate (β21 = .31), although
statistically significant.
Thus, according to the model, self-determination and
family interference affect amorous behavior, and approximately
one third of this effect is transmitted to emotional well-being,
a result that supports the last two hypotheses.
Lastly, we conducted multigroup analysis to determine
whether the estimated parameters were identical in the
participants depending on whether or not they had a partner
at the time of the study. It was assumed that having a partner
would have great impact on the two endogenous variables of
the model. The null hypothesis therefore states that the
estimated parameters will be invariant in both groups. Upon
dividing the participants into two groups, a new analysis with
the weighted least squares estimation method was carried out.
The results (Table 4) showed that the estimated
parameters in each group were not significantly different,
so we accept the null hypothesis. As occurred in the bivariate
analyses explained above, there were no differences
depending on whether the participants had a partner, which
leads us to reject the second hypothesis.
Discussion and Conclusions
The purpose of this study was to contribute to the
understanding of the perception of people with ID of couple
212
ARIAS, OVEJERO, AND MORENTIN
relations and love (merely an approximation, given the lack
of consolidated theories in this field of study), and to analyze
the relation of these variables with emotional well-being.
For this purpose, given the small amount of specific
bibliography, we decided to base our work on the existing
studies and instruments to assess love in populations with
no disability (Hendrick & Hendrick, 1986; Rubin, 1970;
Sternberg, 1988; Yela, 1995). We elaborated out instrument
on this basis, underscoring the need to adapt its content to
the concrete reality of people with ID.
As our first conclusion, we can state that the
configuration of love in people with ID is, in general, similar
to that found in the people without disability who
participated in the pilot study, as seen from the examination
of the factor loading matrixes of both groups. It is noted
that the items about “recurrent thoughts” in the sample of
university students were eliminated from the factor structure
in disabled people so that, in this group, the second factor
is only made up of items about passion and physiological
excitement.
Regarding the five hypotheses proposed in our study,
four were corroborated and one was rejected:
1. The perception of love and couple relations in the
participants was extremely positive, in fact, idealized,
both in the Specific Scale to Assess Love in People
with ID and in the related aspects (specifically, global
appraisal and satisfaction). This idealization
corroborates the findings of other studies (Arias et
al., 2006; Knox & Hickson, 2001), and may be
explained, at least partially, by the lack of positive
models and the lack of access to realistic information
(Gordon et al., 2004; Howland & Rintala, 2001;
Lesseliers & Van Hove, 2002; López, 2002).
2. We did not find significant differences between the
participants with a partner and those who did not have
one. We expected that the people without a partner
would tend more towards idealization in their
responses than those who had a partner (who respond
as a function of their current relation). However, this
did not occur: the perceptions of both groups were
similar, which suggests that the participants’ intimate
relations are judged as highly satisfactory and that,
in support of the previous hypothesis, they tend
towards idealization. Therefore, the results of both
groups can be considered conjointly in the structural
model, as there were no differences between them.
3. The distribution found in emotional well-being is also
characterized by negative skewness. These results are
similar to those found in other studies on quality of
life (Cummins, 1995, 2003; Felce, 2006; Hensel et
al., 2002), about which the homeostatic theory of
subjective quality of life (Cummins, 2003, 2005;
Cummins & Nistico, 2002) can offer an explanation.
4. As stated in our hypothesis, positive intimate relations
in people with ID affect emotional well-being, so that
high scores in the Specific Scale of Assessment of
Love in People with ID correlate with highs scores
in emotional well-being. There is also a positive and
significant correlation between emotional well-being
and perceived global appraisal, as also between
amorous satisfaction and sexual satisfaction.
Therefore, as with the population without disability,
positive intimate relations affect not only physical
well-being and health, but also psychological wellbeing, happiness, and quality of life (Chiappo, 2002;
King, 2004; Ovejero, 1998; Sangrador, 1993; Yela,
2002).
5. Lastly, the data support the hypothesis of the relevance
of family variables in people with ID, underscoring
their moderating role in the relation between love and
emotional well-being. Thus, high scores in love (total
score in the Specific Scale to Assess Love in People
with ID) on the one hand and high scores in emotional
well-being on the other correlate significantly with
less family interference and a higher capacity of selfdetermination in people with ID. Likewise, the
structural model proposed of the three latent variables
(emotional well-being, love, and family variables)
emphasizes this moderating relevance of the family,
and supports the relation between love and emotional
well-being. At this point, it should not be forgotten
that the family frequently decides what people with
ID can or cannot do (García, 2005; LöfgrenMartenson, 2004; López, 2002), a factor of great
relevance to differentiate couple relations in
populations with and without disability.
No doubt, more research is needed to contribute to the
comprehension of intimate relations in people with ID. This
is a difficult task if we consider the habitual difficulties of
research in the field of intellectual disability, especially
access to subjects, the cognitive limitations inherent to ID,
and the heterogeneity of the samples. As almost all the data
about psychology of love were obtained with samples of
people without disability, it is not surprising that we still do
not know whether such knowledge and findings can be
applied to the population with ID; if so, we should ask to
what extent, because these people’s socialization process is
very different from that of people without disability. We
trust that future research will clarify these doubts and light
up this still obscure field.
In concluding, we would like to mention some of the
difficulties we encountered to carry out this work. Firstly,
the use of this kind of scales with population with ID has
been questioned because of the possible cognitive and
linguistic limitations, and the emergence of some response
biases (Finlay & Lyons, 2002). In this study, we administered
an array of measures (Hartley & MacLean, 2006) to
contribute to reliability and validity of the use of Likerttype scales in people with ID (e.g., medium-high level of
functioning, no more than 4 points in the scale,
LOVE AND EMOTIONAL WELL-BEING
administration by means of individual interview, including
explanation and paraphrasis of the items—using a protocol
to minimize the systematic secondary variance).
However, the topic of study (love) entails asking
questions about people’s personal, intimate, and private life.
This leads to obvious limitations related to the lack of
sincerity in the responses, which is generally avoided (at
least partially) by offering guaranties about confidentiality
and anonymity to the respondents. However, when the study
is carried out with people with ID and the self-administered
format of the scale turns into a structured interview, then
anonymity, strictly speaking, disappears (Finlay & Lyons,
2001) even if confidentiality is stressed.
Another limitation of the study is related to the extreme
tendency response bias we noted in the collective of interest.
Despite the fact that the measurement scale had only a 4point range, people with ID tended to respond with extreme
options and it was difficult for them to qualify their response
and choose intermediate values. We tried to attenuate this
bias by having the interviewers make sure that the interviewee
considered all the options before choosing a response.
Finally, another limitation has to do with the family
variables that, in our hypothesis, are directly or indirectly
related to emotional well-being. In addition to the ones we
selected (family interference, self-determination), it is likely
that there are others such as emotional support, trust, or
information, that could affect the intimate relations of people
with ID and, through them, their emotional well-being and
quality of life.
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Received May 12, 2007
Revision received July 22, 2008
Accepted September 4, 2008
216
ARIAS, OVEJERO, AND MORENTIN
APPENDIX
Items of the Specific Scale to Assess Love in People with Intellectual Disabilities
Item nº
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
20
22
23
24
25
27
28
30
32
35
36
37
39
41
42
43
44
45
46
47
48
49
50
51
52
53
55
56
57
58
60
61
62
63
Item text
_____ knows what I like and what I don’t like.
If I could, I’d like to live with _______ by ourselves in our home.
I think about ______ often during the day.
If I could, I’d like to have children with _________.
My relation with _______ is very beautiful and romantic.
_____ and I are concerned about each other’s well-being
I am capable of forgiving _______ his/her small faults.
I want to take care of my relation with _____.
_______and I respect each other’s decisions.
Between _______and me, there is good chemistry.
I feel very close to ________.
_____ is my ideal partner.
I would like to go out with _____ and at the same time with more boyfriends /girlfriends.
I feel that I’m very important for ______.
No other person would make me as happy as ______.
_____ and I tell each other very personal and intimate things.
I am sure of my love for _______.
I feel that I need ______.
If _______ is faithful to me, we will always be together.
When I see love movies, I think about _______.
_______ and I give each other a lot of affection.
When I’m near ______ I notice my heart beats faster.
_______ and I trust each other a lot.
It would bother me if ______ were dating another person at the same time as me.
I would do anything to maintain my relation with ______.
I like to see _____ naked.
What I feel for _____ is more special than what I feel for any other friend.
I think that ______ is a perfect and marvelous person.
I think my relation with ______ is solid (serious).
I get excited when _____and I caress and touch each other.
I think that ______ is very handsome and attractive.
I trust that ______ is only going with me (is not being unfaithful with another person).
I like to make love to _______.
When I’m with ______ I’m very happy.
If I couldn’t be with _____, I’d feel very sad.
_______ and I really understand each other.
I like to give romantic presents to ______.
I’d do anything for ______.
I don’t think anyone can be happier than I am with ______.
I wouldn’t let anyone interfere in my relation with ______.
I think my relation with ______ is stable (it will last).
I think that _____ is a very important person in my life.
Although we sometimes argue, I want to go on dating _______.
______ and I communicate very well with each other.
I like to kiss _______ passionately.
Faithfulness if very important in our couple relation.
I like to give ______ big hugs.
_____ and I are sincere with each other.
It is difficult for me to imagine my life without _____.
I want _____ and me to be fiancées forever.
If I could, I would like to marry _____.
______ and I support and help each other.
Note. Initially, the scale was made up of 52 items. The 47 items that make up the final version of the scale—after eliminating three
items through the analysis of internal consistency (Items 1, 13, and 27) and two items through the analysis of the factor structure
(Items 7 and 53)—are in boldface.