Dissertation
Hidden but heard: navigating the disclosure decision-making process for people with invisible disabilities in close relationships
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Spring 2025
DOI: 10.25820/etd.007998
Abstract
In this dissertation, I investigated the disclosure decision-making process that people with invisible disabilities (PWID) navigate when disclosing their disabilities, using a mixed-methods approach. Of the mixed methods designs, I employed sequential exploratory design using two phases. I began my investigation with a rigorous review of the historical underpinnings and previous conceptualizations of disability. Following this review, I conducted the first phase (qualitative), which informed the development of the second phase (quantitative; Creswell & Plano, 2017). In Study 1, I employed cognitive interviews to assess widely used disclosure-related survey measures. During my analysis, I identified a range of response errors related to comprehension, recall, judgment, response process, and accessibility. These findings demonstrated how impairments shaped cognitive processes when completing surveys and underscored the need to refine measurement tools for disability-related research.
In Study 2, I tested a hypothesized model based on Greene’s (2009) Disclosure Decision-Making Model (DD-MM) using structural equation modeling (SEM). I examined the relationships among information assessment, receiver assessment, disclosure efficacy, and disclosure outcomes. While some theorized relationships held, other relationships, such as the second-order structure of information assessment and anticipated outcomes, demonstrated weak reliability and failed to meet model fit criteria. Notably, stigma emerged as a strong and consistent predictor of disclosure perceptions, while relational quality unexpectedly showed a negative association with disclosure efficacy.
Overall, I advanced theoretical, methodological, and practical understandings of how PWID disclosed their disabilities in interpersonal contexts. My findings challenged and extended existing communication theory by demonstrating that disability-related disclosure was a distinct process requiring further theoretical refinement. Methodologically, I offered a more valid and accessible measurement approach and emphasized the importance of accessibility in survey-based research. Practically, my results informed policy development, intervention strategies, and support programs aimed at improving disclosure experiences for PWID. Ultimately, I provided a foundation for inclusive, evidence-based interpersonal communication research that positioned disability as a core site of inquiry.
Details
- Title: Subtitle
- Hidden but heard: navigating the disclosure decision-making process for people with invisible disabilities in close relationships
- Creators
- Erin C Slattery
- Contributors
- Kate Magsamen-Conrad (Advisor)Helen M Lillie (Committee Member)Rachel M McLaren (Committee Member)Sylvia L Mikucki-Enyart (Committee Member)Elizabeth A Williams (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Communication Studies
- Date degree season
- Spring 2025
- DOI
- 10.25820/etd.007998
- Publisher
- University of Iowa
- Number of pages
- x, 226 pages
- Copyright
- Copyright 2025 Erin C Slattery
- Language
- English
- Date submitted
- 04/29/2025
- Description illustrations
- illustrations
- Description bibliographic
- Includes bibliographical references (page 164-185).
- Public Abstract (ETD)
Many people live with disabilities that are not immediately visible to others. These individuals often face difficult decisions about whether or not to disclose their disability, especially in close relationships. In this dissertation, I explored how people with invisible disabilities make those disclosure decisions and what influences their choices.
I used a two-part study to better understand this process. First, I interviewed people with invisible disabilities to improve how researchers ask questions about disability disclosure on surveys. My findings from these interviews revealed that common survey questions are often unclear or not accessible to everyone especially people with certain impairments. Then I revised the questions to be more inclusive and easier to understand.
Next, I used a survey to test Greene’s (2009) Disclosure Decision-Making Model (DD-MM). I analyzed how factors like stigma, relationship quality, and confidence talking about your disability affect whether someone decides to disclose their disability. My findings showed that stigma plays a major role in people not wanting to share their disability. Surprisingly, I also found that even strong relationships can sometimes make people hesitate to disclose.
This research helps improve how we study disability and communication and suggests ways to make surveys more accessible. It also offers insights that could guide new policies, public education efforts, and support programs for people with invisible disabilities. Overall, my research goal is to make communication research more inclusive and approachable to the real experiences of people with disabilities.
- Academic Unit
- Communication Studies
- Record Identifier
- 9984831229002771
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