Exploring Psychological Distress Among Individuals with Specific Learning Disabilities: The Impact of Age, Gender, and Disability Type

Abstract

Background: Extensive research indicates that individuals with learning disabilities are more prone to experiencing heightened levels of emotional difficulties and distress. Objective: This study aimed to investigate the relationships between specific learning disabilities (SLDs) and psychological distress (PD), particularly focusing on the predictive power of difficulties in reading, writing, and arithmetic on PD, while also considering the effects of gender and age. Methods: The sample consisted of 133 participants (73 male) aged 23–44 years (M = 34.41, SD = 9.69), with 56 officially diagnosed with an SLD. The participants completed an online survey comprising a demographics questionnaire, a self-report SLD questionnaire, and psychological distress assessment using the K6 scale. Results: The participants with SLDs reported higher PD levels than the general population, with significant correlations between difficulties in reading, writing, and arithmetic and PD. Reading and writing difficulties were stronger predictors of PD than arithmetic difficulties. Additionally, the women and younger adults reported more PD, with the SLD severity significantly impacting PD beyond these variables. Conclusion: These findings highlight the strong link between SLDs and PD, particularly emphasizing the role of reading and writing difficulties in contributing to psychological distress. Moreover, the subjective severity of the SLD predicted PD beyond gender and age within the SLD group.

1. Introduction

Learning disabilities and their emotional effects extend beyond school age, influencing individuals throughout their lives. Studies have long explored the emotional challenges faced by individuals diagnosed with learning disabilities, aiming to better understand the psychological experiences within this population. Previous research has shown differences in psychological distress related to gender and age, which this study examines within the learning-disabled population. In addition, this study examines whether distinct types of specific learning disabilities (SLDs)—namely, reading, writing, and arithmetic—result in differential levels of psychological distress among adults officially diagnosed with these conditions. The following literature review presents the challenges encountered by individuals with SLDs, their increased vulnerability to psychological distress, and emphasizes that each SLD presents unique challenges.

1.1. Psychological Distress

Distress is a natural psychological response to stressful life events, where an individual’s psychological functioning remains within normal levels despite becoming and remaining distressed [1]. Psychological distress (PD) refers to the emotional suffering that results from exposure to a stressful event threatening one’s physical or mental health and the inability to effectively cope with this stressor [2]. PD is widely used as an indicator of mental health in public health, population surveys, and epidemiological studies. It also serves as an outcome measure in clinical trials and intervention studies. However, PD is rarely defined as a distinct concept and is often discussed within the broader context of stress, tension, and distress [3]. The term “Psychological Distress” encompasses a broad spectrum of symptoms, including depression, general anxiety, personality traits, functional disabilities, and behavioral problems [4]. PD may also be accompanied by somatic symptoms [5] or a range of chronic conditions [6]. High levels of PD can indicate common mental disorders such as depressive and anxiety disorders [7,8]. Risk factors for PD include stress-related and sociodemographic factors as well as inadequate internal and external resources [9].

1.2. Psychological Distress and Specific Learning Disabilities

The diagnosis of learning disabilities is conducted in accordance with the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders [10], as specified by the Ministry of Education. This standardized approach ensures that evaluations are consistent with international practices and are based on widely accepted diagnostic criteria. The American Psychiatric Association defines specific learning disabilities (SLDs) as neurodevelopmental disorders that impair the ability to learn or use basic academic skills such as reading, writing, or arithmetic [11]. To be considered to have an SLD, academic difficulties must persist despite good teaching opportunities and not result from intellectual disability, hearing or vision impairments, poor instruction, sociocultural deprivation, or acquired conditions [12].

Compared to the general population, individuals with SLDs are at a higher risk of developing significant mental health issues such as anxiety and depression [13]. Ample evidence demonstrates that individuals with learning disabilities experience significantly more emotional difficulties compared to those without learning disabilities [14,15,16]. For instance, children and adolescents diagnosed with SLDs report lower levels of mental well-being and higher levels of anxiety and depression than their peers in the general population (e.g., [17,18,19,20,21]). These emotional challenges manifest through crying, worrying, physical distress, avoidant behavior [22], and higher levels of helplessness [23,24,25].

The relationship between SLDs and mental health is multifaceted, with several theoretical models offering insights into this connection. The stress-vulnerability model [26] suggests that individuals with SLDs are more susceptible to psychological distress due to chronic stressors, such as academic challenges and social difficulties. The cognitive behavioral model [27] highlights that repeated experiences of failure can lead to negative thought patterns and low self-esteem, which in turn impact mental health. Additionally, the biopsychosocial model [28] emphasizes the interplay between biological factors (e.g., neurological differences), psychological processes (e.g., coping strategies), and social influences (e.g., support systems) in determining mental health outcomes. Recent research builds on these frameworks by emphasizing the role of self-compassion as a buffer against the PD associated with SLDs [29]. Furthermore, the integration of ecological systems theory highlights the influence of family, school, and societal factors in shaping mental health outcomes for individuals with SLDs [30]. These perspectives highlight the complex relationship between SLDs and mental health, offering insights into the heightened risks of anxiety, depression, and low self-esteem in this population.

People with SLDs often experience a lower sense of competence, reduced self-esteem, less positive mood, more negative mood, diminished hope, and increased loneliness compared to their peers [31]. The social and psychological impacts of SLDs in childhood can persist into adulthood, as evidenced by studies on adult SLD participants [32,33,34,35,36,37]. Raskind et al. [38] found that learning-related stress in individuals with SLDs surpasses stress from other sources, significantly affecting their lives. This stress is prolonged and extreme, often experienced daily throughout school years and beyond [34,39]. Additionally, studies have reported higher levels of distress [40,41] and psychological distress [42,43,44] among individuals with learning disabilities compared to the general population.

Hence, the literature review indicates that individuals with SLDs are at a heightened risk of experiencing increased PD.

1.3. Gender, Age, SLDs, and Psychological Distress

There is substantial evidence linking PD with various factors [45,46]. The literature has pointed out two distinctive features of PD—the widespread gender difference and the variation over the life span [9,47]. The role of gender in PD is widely documented, with women consistently reported to experience higher levels of PD than men [9,48,49,50,51,52,53], across almost all regions of the world [47]. The significance of gender differences in PD is further illustrated by findings that female students exhibit higher rates of suicidal tendencies compared to their male counterparts [51,54]. Chown et al. [42] found that learning disabilities were linked to clinically relevant PD in males but not in females, which was unexpected given prior research showing a stronger association between learning disabilities and mental health issues in females. However, the relationship between gender, learning disabilities and internalizing disorders remains inconsistent and has not been consistently examined across studies [32,42,55].

Regarding age, the prevalence of PD generally decreases over the lifespan, starting in late adolescence [4,56]. The concept of “emerging adulthood,” introduced by Arnett [57], spans ages 18 to 29 and is marked by transitions in living arrangements, relationships, education, and employment [57,58]. This period is characterized by instability, with frequent job changes and romantic relationships [51,59]. Individuals with learning disabilities face added challenges in later life, including lower educational attainment, higher unemployment, loss of support systems, and increased reliance on sickness benefits and psychoactive medication [42,60]. Chown et al. [42] also found that younger emerging adults (15–19 years) with learning disabilities experienced lower levels of PD compared to older emerging adults (25–29 years), possibly due to school-based support in younger years and greater challenges during transitions to adulthood. Given these factors, examining PD across emerging adulthood and beyond for individuals with SLDs is crucial, as most studies have focused on younger populations, such as school-aged students (e.g., [20,21,61]).

1.4. Specific Learning Disability Types and Emotional Aspects

Individuals with SLDs focused on reading difficulties have difficulties with accurate and/or fluent word recognition and spelling despite adequate instruction and intelligence and intact sensory abilities [62]. Reading difficulties have been associated with poor outcomes in academic, social, emotional, occupational, and economic domains [63]. In addition, reading difficulties were associated with depression, anxiety, lower self-esteem, attention deficits, and, often, behavioral problems (e.g., [63,64,65,66,67]). McNulty [68] interviewed 12 adults with reading difficulties and found that all struggled through school, experienced failures, and perceived school as traumatic. They all had self-esteem problems. Similar anxiety problems were also reported by university students who were diagnosed with dyslexia [66], indicating that the anxiety issues of individuals with reading difficulties could become permanent in adulthood [69]. Given the importance and prevalence of reading in everyday life, it is not surprising that the literature on reading difficulties and their emotional consequences is extensive.

Developmental SLD with writing difficulties is characterized by an impairment in the acquisition of writing skills [70], presenting impaired spelling accuracy, grammar clarity, or organization of written expression [71]. It was recently estimated that 7–15% of school-aged children exhibit some form of developmental writing deficit [72]. For many people with writing difficulties, any writing assignment is an ordeal. The struggle to spell words correctly or produce legible handwriting is immensely frustrating and diverts attention away from the more substantive aspects of the assignment [73,74]. Students with writing difficulties are also vulnerable to cumulative emotional and behavioral problems [15], which are often left unattended [75]. Adults with significant developmental writing deficits may face limitations in career choice or advancement, as well as facing difficulty with everyday tasks that draw upon writing skills [70]. Similarly to reading difficulties, writing is also a relatively common activity on a daily basis, and therefore, the emotional difficulty that accompanies it is understandable and expected.

Arithmetic difficulties refer to a persistent difficulty in the learning or understanding of number concepts, counting principles, or arithmetic. These difficulties are often called a mathematical disability [76]. It is estimated that 5–8% exhibit forms of this disability [77,78]. Research literature does address the social–emotional consequences of arithmetic difficulties. As in other learning disabilities, emotional and behavioral problems are prevalent in children with arithmetic difficulties [79], which is often associated with mental disorders [80,81,82] like depression and anxiety [83]. According to a review about arithmetic difficulties, “low numeracy in learners is a cause of distress, low self-esteem, stigmatization, and disruptive behavior in class” [84]. It has been suggested that the association between math anxiety and arithmetic problem-solving is stronger among people with arithmetic difficulties than in the general population [85]. In today’s information age, mathematical skills are becoming as important for everyday life and employment as literacy [86]. This may relate to findings that adults with poor numeracy are prone to unemployment and are likely to be depressed [84]. Similarly, desirable professions such as those in high-tech industries also require good mathematical abilities, so it is understandable why a significant difficulty in this skill can cause distress. However, much fewer studies have been published about arithmetic difficulties and psychological problems.

The high prevalence and significant impact of comorbidities among SLD subtypes warrant particular attention, as they often exacerbate academic, emotional, and functional difficulties beyond those observed in single-diagnosis cases. Research consistently highlights the high prevalence of comorbidity among SLD subtypes, indicating that most individuals with SLDs experience difficulties in more than one domain. For instance, it is common for individuals with dyscalculia to also exhibit deficits in writing and reading skills, as well as associated externalizing behavior disorders and hyperactivity [87]. This overlap complicates diagnosis and intervention strategies. The cognitive profiles of such comorbid cases suggest additive effects of distinct deficits, as seen in dyslexia (phonological deficits) and dyscalculia (numerical magnitude deficits), where their combined presence exacerbates the challenges faced by individuals [87]. Comorbidities often intensify emotional and behavioral problems, with studies linking them to increased rates of anxiety, depression, and social difficulties [88,89]. For example, Willcutt et al. [89] found that nearly 40% of individuals with reading difficulties also have math difficulties, leading to greater academic and psychological distress. Moreover, comorbid SLDs have been associated with heightened risks of unemployment and lower educational attainment compared to single-diagnosis cases [90]. According to an understanding that emotional problems are secondary to the learning difficulties, comorbidities may result in more emotional problems. These findings highlight the necessity to consider the interplay of multiple deficits when addressing the PD and functional challenges in this population.

It seems that all three SLD types have emotional consequences related to impaired functioning. In addition to examining the difference in the level of PD between people with SLDs and without SLDs, in this study, we are exploring differences in the associations between PD and each of the different SLD types. In many cases, there is a comorbidity of the different types [89], meaning that persons with SLDs experience difficulties in more than just reading or writing or numbers and calculating. In their systematic review and meta-analysis on learning disabilities and internalizing problems (e.g., anxiety and depression), Vieira et al. [91] examined empirical studies comparing different types of learning difficulties, which yielded mixed results. For instance, Martínez and Semrud-Clikeman [92] found no significant differences in internalizing problems among groups with reading difficulties, arithmetic difficulties, or a combination of both. Contrarily, Scarborough and Parker [93] reported that individuals with arithmetic difficulties experienced more internalizing and externalizing problems than those with reading difficulties. Similarly, a study by Aro et al. [55] on adults found that math difficulties were linked to higher levels of antidepressant use and unemployment compared to reading difficulties. Moreover, Donolato et al. [94] did not find significant differences between children with reading difficulties and those with arithmetic difficulties. Vieira et al. [91] concluded in their meta-analysis that reading difficulties are associated with internalizing problems to a similar extent as arithmetic difficulties.

1.5. Current Research

Given the well-documented role of stress in PD [50,95,96,97], our study aims to explore whether different types of SLDs differentially affect subjective stress and its implications for PD. We seek to understand how the unique challenges and stressors associated with each type of disability contribute to variations in psychological outcomes.

According to the reviewed literature, women, younger adults, and individuals with SLDs tend to be more vulnerable to emotional difficulties and are more exposed to risk factors for PD compared to men, older adults, and people without SLDs. Given the lack of clear findings on mental health differences among the various types of SLDs, there is substantial room for further research in this area. Gender differences have been inconsistently examined in individuals with learning disabilities [55], and most research examining age-related differences has focused on non-adult populations. Additionally, previous studies comparing types of SLDs often overlooked writing difficulties, which this study specifically examines. Finally, unlike previous studies, which relied solely on self-reported questionnaires, in the current study, we validated the self-report with a formal diagnosis report. Therefore, our hypotheses are as follows:

H1:

The first hypothesis posits that the participants with SLDs will report higher PD scores compared to the participants without SLDs (control group).

H2:

Consistent with previous research, females will report higher levels of PD than males, and PD will decrease with age. Additionally, it is anticipated that PD associated with SLDs will remain significant even after accounting for the effects of gender and age.

H3:

Given that previous findings do not indicate an unequivocal direction regarding the differences between types of SLDs and their relationship to various aspects of mental health, and considering that most studies focus on the relationship between reading difficulties and potential PD, we hypothesize that there are differences in the PD levels among the distinct types of SLDs (reading, writing, and arithmetic). However, we do not specify the direction of these differences.

2. Methods

2.1. Participants and Procedure

The study staff recruited volunteers by advertising the study in centers for students with learning disabilities in various academic institutions and by publishing the study in various student groups representing a variety of academic institutions on the social network. A sample comprising 133 adults (73 males and 60 females, aged 23–44, average age = 34.41, SD = 9.69) responded to an online questionnaire (7 participants were excluded from the analysis because they did not correctly answer embedded test items). Within this sample, 56 (41.3%) reported that they have been officially diagnosed with an SLD. The diagnoses of 39 participants were validated through the presentation to the first author of a valid diagnosis conducted in accordance with the criteria set by the Israeli Ministry of Education. Upon verification, each participant was assigned a serial number to ensure anonymity. Subsequently, they received a link to an online questionnaire, which included a self-reported learning disability assessment and additional questionnaires. The remaining 78 participants (59%) who reported that they had no SLD constituted the control group. Questionnaires began with a short statement assuring confidentiality and participants’ their rights to skip questions and/or refuse to participate entirely. All methods were performed in accordance with the relevant guidelines and regulations and were approved by the Social Science Faculty Review Board at Ariel University. Respondents indicated informed consent for participating according to the review board’s approval.

2.2. Measures

Each participant completed the following four questionnaires in the following order:

(1)

Self-report SLDs. In addition to verifying a valid diagnosis, participants were asked to respond about the presence of learning disabilities, the severity of the disabilities, and their type (reading, writing, or arithmetic). In this questionnaire, participants read a paragraph describing what SLDs are [98]. Based on this paragraph, participants responded whether they have an SLD or are not sure if they do, or they do not have one. In addition, participants rated one item indicating how much they were disturbed by the general issue of SLDs (SLD severity) and items indicating how much the SLD issues corresponding to SLD types (reading, writing, and arithmetic) disturbed them. These items were rated on a Likert scale ranging from 1 (never) to 4 (often) and a higher score on these questionnaires indicated a higher severity of difficulties of each SLD type. The reliability of this aggregated variable was good, α = 0.91. The reliability for reading, writing, and arithmetic parts were α = 0.88, α = 0.64, and α = 0.89, correspondingly.

(2)

Psychological distress. We used Psychological Distress Scale—K6 [99]. This questionnaire measures the level of distress experienced in the present over the past 30 days. It consists of six items in which the subject should rate the frequency of emotions related to psychological distress: (1) nervous; (2) hopeless; (3) restless or fidgety (restless); (4) so depressed that nothing could cheer them up (depressed); (5) that everything was an effort (effort); and (6) worthless. The six items are rated on a Likert scale ranging from 1 (not at all) to 5 (all the time). The reliability of this questionnaire was good, at α = 0.92.

(3)

Personal details and health status. Questions regarding gender (male, female, or other), age, details about the diagnosis of an SLD (when and by which professional), and perception of health status.

2.3. Data Analysis

Data were analyzed using SPSS software version 27. The level of significance defined for all statistical analyses was 0.05.

We began by conducting descriptive statistics of the main research variables: gender, age, SLD status, general self-reported SLD severity, self-reported SLD severity concerning reading, writing, and arithmetic, and psychological distress (PD). This provided a foundation for understanding the distribution and relationships among these variables. Next, we conducted a Pearson correlation analysis to explore the relationships among the key research variables: gender, age, SLD status, self-reported SLD severity, SLD types, and PD. Following this, we employed several statistical techniques to examine the relationship between SLD status (SLD/non-SLD) and PD. First, an initial 3 × 3 ANOVA with repeated measures analysis and t-test for independent samples to test our initial hypothesis regarding differences in PD between participants with SLDs (verified and non-verified) and without SLDs. A further post hoc analysis using Bonferroni correction was performed to examine the differences identified. Following the merger of SLD groups, independent t-tests were conducted to compare the severity of self-reported difficulties in reading, writing, and arithmetic between the merged SLD group and the non-SLD group. Next, an independent samples t-test was conducted to compare PD levels between the consolidated SLD group and the non-SLD group, testing the first hypothesis. We also used a χ² test to assess differences in significantly elevated levels of PD between these groups. To test our second hypothesis, we conducted t-tests for independent samples to examine the relationship between PD and gender, as well as between PD and age. Additionally, an independent samples t-test was performed to further assess gender differences in PD. Subsequently, hierarchical regression models were employed to assess the predictive power of gender, age, and self-reported SLD severity on PD, specifically within the SLD group (n = 56). This approach allowed us to examine whether the severity of the SLD contributes to PD, beyond the effects of age and gender, within the SLD group. This targeted analysis was necessary to isolate the unique impact of disability severity on distress, providing insights that might be obscured in a broader sample. For our primary hypothesis, we analyzed the entire sample (n = 133) to examine the effects of different SLD types on PD. Hierarchical regression models were applied to evaluate the predictive power of background variables, SLD status, and specific SLD-related difficulties on PD, providing a comprehensive understanding of the factors correlating PD. This approach offers insights into the interplay between these variables and PD across the sample.

3. Results

3.1. Variable Handling and Descriptive Statistics

The PD variable was calculated based on the sum of scores from the Psychological Distress Scale [99]. In addition, a Psychological Distress variable categorized participants into serious PD and non-distressed groups using a dichotomous classification based on the elevated levels threshold established for the K6 scale. Specifically, participants scoring 13 or higher were classified as experiencing serious psychological distress—a threshold widely recognized in the literature as indicative of a high level of distress that warrants further clinical attention [100]. Participants with scores below 13 were categorized as non-distressed.

Two “learning disability” variables were generated. The first was based on the direct self-report of being diagnosed with a specific learning disability (SLD) in the demographic questionnaire. The second was based on the presentation of a valid diagnosis, serving as a verification of the self-reported SLD. For the first research hypothesis, participants were initially handled according to the three groups: (1) those who reported not having an SLD and had no record of diagnosis, (2) those who reported having an SLD but lacked a validated record, and (3) those who reported having an SLD and provided a validated record of the diagnosis.

Participants presented official diagnoses of SLDs to the study conductors to confirm their eligibility. However, due to ethical considerations, no direct association was established between the individual participants and the specific type of diagnosed disability. Instead, the participants’ self-reported assessments of their difficulties were utilized as the primary criteria for identifying specific areas of learning challenges. The participants were classified as having acute reading difficulties if their reported difficulty scores were greater than one standard deviation above the average score for reading difficulties among the non-SLD participants. Acute writing and arithmetic difficulties were identified using the same method. The comorbidity of learning difficulties was assessed by counting positive classifications across these three variables.

Table 1. Prevalence of learning difficulty domains in people with and without specific learning disabilities (SLDs).

Acute Difficulties	SLD	Non-SLD
No acute difficulties	9	52
Acute reading difficulties	9	1
Acute writing difficulties	0	10
Acute arithmetic difficulties	7	5
Acute reading and writing difficulties	19	2
Acute reading and arithmetic difficulties	4	3
Acute writing and arithmetic difficulties	0	1
Acute reading, writing and arithmetic difficulties	8	3

Note. Acute difficulties were defined as scores exceeding one standard deviation above the average score of non-SLD participants in the respective domain. The table displays frequencies of participants reporting no acute difficulties, single-domain acute difficulties, and multi-domain acute difficulties across SLD (n = 56) and non-SLD groups (n = 77).

presents the number of participants classified as having acute difficulties in reading, writing, and arithmetic. The table also shows the prevalence of participants reporting acute difficulties in more than one domain. While this study acknowledges the critical role of comorbidities in exacerbating challenges for individuals with SLDs, the current analysis focused on reported difficulties rather than classification groups due to limitations in subgroup sizes for comorbid entities.

The gender and age data were retrieved from the personal details and health status questionnaire. To examine age differences, participants were categorized into two groups: “emerging adults” (18–29 years) and “adults beyond emerging adulthood” (30 years and older), based on Arnett’s [57] concept of “emerging adulthood”. We also created a variable for “self-reported SLD severity” by calculating the average responses regarding the level of difficulties in reading, writing, and arithmetic due to learning disabilities. This approach, when calculated separately for reading, writing, and arithmetic, also enabled assigning the level of difficulty each participant endured in each domain, which was essential for testing the third research hypothesis. Descriptive statistics for PD, age, gender, and learning disability variables are presented in

Table 2. Descriptive statistics for gender, age, SLD variables, and psychological distress.

Variable	n	Mean	SD	%
Gender
Male	60	-	-	44.7
Female	73	-	-	55.3
Age
Emerging adults (18–29 years)	52	-	-	39.1
Adults beyond emerging adulthood (≥ 30)	81	-	-	60.9
SLD Status
Self-reported SLD severity	133	1.8	0.53
Non-SLD	77	-	-	57.9
Self-reported SLD, no valid diagnosis	17	-	-	12.7
Self-reported SLD with valid diagnosis	39	-	-	29.4
Psychological Distress
Continuous PD variable	133	2.07	0.9
Non-distressed (K6 < 13)	98	-	-	73.7
Significantly elevated distress (K6 ≥ 13)	35	-	-	26.3

Note. Table 2 displays the descriptive statistics for the study variables. Gender distribution is provided for male and female participants. Age groups are divided into emerging adults (18–29 years) and adults beyond emerging adulthood (30 years and above). The SLD status includes three categories: no SLD, self-reported SLD with no valid diagnosis, and self-reported SLD with a valid diagnosis. The self-reported SLD severity is presented as mean severity scores in reading, writing, and arithmetic difficulties. The continuous psychological distress (PD) variable includes the mean and standard deviation of PD scores. Participants are categorized into non-distressed (K6 < 13) and significantly elevated distress (K6 ≥ 13), based on the K6 scale.

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3.2. Correlations Among Main Study Variables

Pearson’s correlations were calculated to study the relationship between the main variables in order to test the research hypotheses regarding these relationships. Correlations between the variables in the study are indicated in

Table 3. Pearson’s correlations between the main research variables.

N = 133	1	2	3	4	5	6	7	8
1-Gender	1	−0.01	0.12	0.16	0.07	−0.15	0.33 **	0.25 **
2-Age		1	−0.13	−0.22 *	−0.29 **	−0.25 **	−0.22 **	−0.37 **
3-SLD status			1	−0.60 **	−0.58 **	−0.41 **	−0.33 **	0.32 **
4-Self-reported SLD				1	0.74 **	0.55 **	0.51 **	0.54 **
5-Reading difficulties					1	0.64 **	0.40 **	0.57 **
6-Writing difficulties						1	0.26 **	0.47 **
7-Arithmetic difficulties							1	0.40 **
8-PD								1

Note. * indicates p < 0.05. ** indicates p < 0.01. Coefficients between gender (male = 1, female = 2), age, SLD status (yes = 1, no = 2), self-reported SLD severity, reading difficulties, writing difficulties, arithmetic difficulties, and psychological distress (PD).

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Pearson’s correlations among the study variables revealed significant relationships between the gender, age, and PD. As expected, being female was associated with higher levels of PD, while an increase in age was linked to lower PD levels. A negative correlation was observed between the age and self-reported SLD severity, indicating that the younger individuals reported greater severity of learning disabilities. Additionally, significant positive correlations were found between the SLD status and self-reported SLD severity, as well as between these variables and PD. Specifically, all of the types of SLD were positively related to PD, with the strongest correlation observed for reading difficulties. Moreover, a distinct positive relationship was found between gender and difficulties in arithmetic, with women reporting more difficulties in this area.

3.3. SLD Status and Psychological Distress

An initial 3 × 3 (SLD status × difficulties in SLD domains) ANOVA with repeated measures analysis of PD yielded significant main effects for differences between the three groups of participants: those who reported having an SLD with a valid diagnosis, those who reported having an SLD without a valid diagnosis, and those who reported not having an SLD (F (2, 130) = 29.81, p < 0.001), and between the evaluations of difficulties in the three SLD domains: reading, writing, and arithmetic (F (2, 129) = 49.74, p < 0.001). The interaction effect was also significant (F (4, 258) = 6.68, p < 0.001). Further post hoc analysis showed no significant differences between the participants who reported having an SLD, whether or not they could present diagnosis papers (p > 0.05, Bonferroni-corrected). However, significant differences were found between these two groups and the group of participants who reported not having an SLD (p’s < 0.001). This outcome validated the self-reports of our participants regarding their SLD status, even if some participants could not confirm their SLD with a valid diagnosis. Consequently, we merged the SLD groups into a single group, regardless of the ability to present diagnosis papers.

Following this merger, we conducted independent t-tests to compare self-reported difficulties in specific learning domains—reading, writing, and arithmetic—between the merged SLD group and the non-SLD group. As expected, the SLD group reported significantly higher severity levels across all three domains, as shown in

Table 4. Averages (standard deviations) of self-reported difficulties in reading, writing, and arithmetic for participants with and without SLDs.

	Reading	Writing	Arithmetic
Non SLD (n = 77)	1.52 (0.45)	1.31 (0.35)	1.76 (0.73)
SLD (n = 56)	2.29 (0.57)	1.76 (0.66)	2.29 (0.74)
t(131)	8.17 *	4.67 *	4.15 *

Note. * indicates p < 0.001.

. The differences between the SLD and non-SLD groups were statistically significant for reading, writing, and arithmetic (all p < 0.001), demonstrating measurable distinctions between the two groups.

To test the first hypothesis, an independent samples t-test was conducted comparing the consolidated SLD group with the non-SLD group. The scores of and differences in the PD (K6), along with the means and standard deviations, are presented in

Table 5. Averages (standard deviations) of self-reported psychological distress (PD) within the specific learning disability (SLD) and non-SLD groups.

	PD
Non SLD (n = 77)	10.90 (4.48)
SLD (n = 56)	14.52 (6.02)
t(131)	3.80 *

Note. * indicates p < 0.001.

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Together with the results of the ANOVA, these results suggest that the participants with SLDs reported significantly higher levels of PD compared to their non-SLD counterparts, indicating that the presence of an SLD is associated with increased PD.

For learning about the significance of this association, using a cutoff point of 13 for elevated levels of PD [99], reconfirmed that the participants in the SLD group were significantly (X²₍₁₎ = 9.49, p < 0.01) more likely to be in the significantly elevated PD range (54%) than the non-SLD participants (27%). A cutoff point of 17 yielded similar results. These results are presented in

Table 6. SLD status × significantly elevated psychological distress threshold crosstabulation among SLD and non-SLD groups.

SLD Status		Elevated Psychological Distress		X2(df)
		No	Yes
Non-SLD	Count	56	21	9.49(1) **
	%	73%	27%
SLD	Count	26	30
	%	46%	54%
Total	Count	82	51
	%	61%	39%

Note. ** p < 0.001. The table displays the distribution of participants who meet or do not meet the elevated psychological distress threshold, categorized by their SLD status (SLD vs. non-SLD).

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In summary, the results confirm our first hypothesis that individuals with SLDs would report higher levels of PD compared to those without SLDs.

3.4. Gender, Age, SLDs, and Psychological Distress

As suggested in the correlations shown in Table 3, an independent samples t-test further confirmed the associations of gender and age with PD. As of the significant effect of gender on PD, t (130) = −2.92, p = 0.04, women (M = 2.28, SD = 0.94) reported higher levels of PD compared to men (M = 1.83, SD = 0.79). Similarly, the ANOVA results confirmed a significant gender difference in the PD levels, with women reporting higher PD than men, F (1, 130) = 8.580, p = 0.004. Regarding the age differences, another t-test for the independent samples revealed a significant effect of age on PD: t (131) = −2.92, p < 0.01. The younger individuals (“emerging adults”) under 30 years of age (M = 2.40, SD = 1.07) reported significantly higher PD compared to those over 30 years (“adults beyond emerging adulthood”) (M = 1.84, SD = 0.77).

Within the subgroup of individuals with SLDs, we obtained that the severity of difficulties encountered due to learning disabilities significantly contributed to PD even after accounting for gender and age. To this end, a hierarchical regression analysis was conducted. In the initial model, gender and age explained a significant portion of the variance in PD F (2, 53) = 5.49, p = 0.007. Within this group, gender was not a significant predictor (β = 0.127, p = 0.320), while age did achieve a significant prediction of PD (β = −0.317, p = 0.005). Most importantly, in the second step, the self-reported general SLD severity significantly improved the model’s explanatory power, F (3, 52) = 14.14, p < 0.001. Gender remained non-significant (β = 0.152, p = 0.151.), age continued to be a significant predictor (β = −0.290, p = 0.008), and the self-reported SLD severity emerged as a significant predictor of PD (β = 0.534, p < 0.001), demonstrating that greater self-reported SLD severity is associated with higher levels of PD. The calculated Cohen’s f² = 0.597 indicates a large effect size. This hierarchical regression analysis is summarized in

Table 7. Hierarchical regression analysis summary for the SLD group—ΔR² and Beta coefficients.

Variable	Standardized Beta Coefficient	p
Model 1
ΔR2 = 0.155; p < 0.001
Gender	0.12	n.s.
Age	−0.31	0.005
Model 2
ΔR2 = 0.278; p < 0.001
Gender	0.15	n.s.
Age	−0.29	0.008
Self-report SLD Severity	0.53	<0.001

Note. Dependent variable: PD (psychological distress). Predictor variables: gender, age, and self-reported SLD severity. Analysis was conducted specifically within the SLD group (n = 56). n.s. (non-significant). VIF as a measure of multicollinearity of all variables was <2.3.

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These results align with our second hypothesis: while women and younger adults with SLDs report higher levels of PD, the distress associated with their perceived difficulties due to SLDs remains significant even after accounting for the effects of gender and age.

3.5. SLD Type and Psychological Distress

Finally, to evaluate the unique contribution of each of the SLD types on PD, a hierarchical regression was calculated. We conducted a hierarchical regression model with three steps in which the background variables were entered in the first step, the SLD diagnosis status was added in the second step, and the levels of difficulty in each SLD type were added in the third step. As expected, the results indicate that the predicting power of the three SLD types on PD differs between the three SLD domains. These results are presented in

Table 8. Summary of hierarchical linear regression analysis. ΔR² for each step and Beta coefficients for variables entered in the various steps.

Variable	Standardized Beta Coefficient	p
Model 1
ΔR2 = 0.161; p < 0.001
Gender	0.24	0.003
Age	−0.31	<0.001
Model 2
ΔR2 = 0.030; p < 0.05
Gender	0.21	0.009
Age	−0.23	0.009
SLD Status	−0.19	0.031
Model 3
ΔR2 = 0.251; p < 0.001
Gender	0.20	0.04
Age	−0.19	0.012
SLD Status	0.15	n.s
Reading	0.40	<0.001
Writing	0.19	0.035
Arithmetic	0.14	n.s

Note. Dependent variable: PD (psychological distress). Predictor variables: gender, age, SLD diagnosis status, levels of difficulty encountered with reading, writing, and arithmetic. n.s. (non-significant; however, both p values were >0.1). VIF as a measure of multicollinearity of all variables was <2.3.

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Two important findings emerge from the data in Table 8. According to this analysis, women and younger people and having a diagnosis of an SLD are related to more PD. However, when the levels of difficulty encountered due to reading, writing, and arithmetic difficulties are entered in the third step, the SLD status ceases to contribute to the PD variability any further. In addition, among the three SLD domains, reading and writing, but not arithmetic problems, contribute to the variance in PD. It should be noted that in the last step, the SLD diagnosis status and arithmetic were in the range of p < 0.1.

These results align with the third main research hypothesis, demonstrating that differences in the types of SLDs do indeed affect psychological distress.

4. Discussion

The primary objective of this study was to investigate the variations in PD among individuals with different types of SLDs, specifically focusing on reading, writing, and arithmetic disabilities. One of the novelties of this study is our emphasis on a formal diagnosis of SLDs, rather than relying solely on functional history or self-filled questionnaires, as commonly seen in prior research. Our findings aligned with this hypothesis, revealing significant differences in PD levels across these disabilities. Notably, the individuals with reading disabilities exhibited the highest relatedness with PD levels, followed by those with writing and arithmetic disabilities. Furthermore, as expected, individuals diagnosed with SLDs experienced significantly higher levels of PD compared to their non-diagnosed counterparts.

Consistent with previous research, women reported higher levels of PD compared to men [9,48,49,50,51,52,53] and the PD levels tended to decrease with age [4,56,101,102]. However, within the SLD group, the severity of the learning disability emerged as a significant predictor of PD, surpassing the influence of both age and gender. These findings underscore the nuanced relationship between SLDs and psychological well-being, highlighting the need for targeted support and interventions, as detailed in the research implications.

4.1. SLD Status and PD Relations

The findings support an association between the SLD status and elevated PD levels, as the participants with SLDs reported greater difficulties with reading, writing, and arithmetic tasks and had higher PD levels than the non-SLD group. Individuals with learning disabilities are particularly vulnerable to mental health challenges [66,103,104], with numerous studies showing that students with learning disabilities exhibit more symptoms of anxiety and depression compared to the general population [20,61,66,105,106]. The current findings align with this body of research, showing elevated PD levels among the participants with SLDs (e.g., [42,43,107]). Several factors may contribute to this increased psychological distress. Academic struggles are more pronounced in individuals with SLDs, leading to a greater risk of academic failure, school maladjustment, and even dropping out [61,106,108]. These challenges may originate from atypical central nervous system development, which results in functional deviations [109], or they may stem from the emotional toll of chronic academic failure [110]. A combination of academic and emotional difficulties could also be at play [92,108]. Given the long-lasting impact of learning disabilities throughout one’s educational journey, it is reasonable to expect sustained distress and emotional challenges. This study supports that notion, showing that these symptoms persist into adulthood. Wilson et al. [41] found that adults with SLDs report higher rates of suicidal thoughts, depression, and distress compared to individuals with SLDs in earlier life stages, suggesting that emotional difficulties may accumulate over time, leading to ongoing psychological distress in adulthood.

It must be noted that the data presented in Table 4 indicate that people report some levels of difficulties associated with reading, writing, and arithmetic despite having no formal diagnosis and no self-perception of having an SLD. This may reflect the fact that some people are not aware of having learning problems or that, as is known about many other variables, learning difficulties are on a continuum rather than on a dichotomous scale. This illustrates the obvious, that some people encounter difficulties with reading, writing, or arithmetic although they do not have an SLD. In other words, people without SLDs do find it difficult, to some extent, to read, write, and deal with numerical tasks.

4.2. Gender, Age, SLDs, and PD Relations

In our study, we examined the secondary relationship between gender, age, and PD among individuals with SLDs. The results provide valuable insights into how these factors influence PD in this population. Initially, gender did not significantly predict PD, suggesting that gender differences may not substantially influence PD in this context. These findings align with those of previous studies, which have either not reported results by gender or have not found significant gender differences in behavioral–emotional problems among people with SLDs [20,111]. Additionally, Aro et al. [55] similarly found a lack of gender-specific or SLD-type-specific differences. However, Chown et al. [42] presented an unexpected finding in their study, where females with SLDs reported more PD than males. They suggest that this result could possibly be a function of the study methods used, as the inclusion of a large number of potential confounding factors in the regression models might have contributed to these findings. Age was found to be a significant predictor of PD, with emerging adults with SLDs experiencing higher levels of PD. This age group faces the dual challenge of managing SLDs alongside the typical academic, social, and career-related demands of this developmental stage. Individuals with SLDs may experience an additional layer of distress during this stage of life [42]. The combination of these factors likely contributes to the increased PD observed among emerging adults with SLDs compared to their older peers with SLDs. Research supports this, with emerging adults with learning disabilities often encountering greater challenges than their peers without learning disabilities, including difficulties in academic performance, social integration, and transitioning to adulthood [42,112,113]. Additionally, research on emerging adulthood has highlighted the impact of factors like problematic behaviors [114] and perfectionism [29] on psychological distress, suggesting that this developmental stage is particularly vulnerable to increased stress levels. However, there is still room to explore these specific challenges in more detail to better understand how the pressures of this life stage uniquely affect individuals with SLD.

The most notable result emerged when the self-reported SLD severity was included in the analysis. This variable was significantly associated with higher levels of PD, predicting PD beyond gender and age. This suggests that the impact of SLDs on psychological well-being is closely tied to the subjective perception of SLD severity rather than the mere existence of the disability itself. The results highlight this factor, as it appears to be crucial in understanding and mitigating their distress.

4.3. SLD Type and PD Relations

In addition to the differences observed between the SLD and non-SLD groups, we found preliminary evidence suggesting the unique contributions of SLD subtypes to PD, which was our primary focus. The reading–distress association was the strongest. Compliantly, a review of the research literature indicates a profound impact of reading on the individual, and it has been associated with depression, anxiety, lower self-esteem (e.g., [64,65,66,67]), and more. Despite the extensive literature on reading, the reasons behind the relationship between emotional difficulties and reading have not been clarified. After reviewing many studies concerning the impact of reading, Klassen and colleagues [32] suggested that mental health, especially internalizing problems, like the actual learning difficulties, are associated with deficits in executive functioning. Another explanation, according to Livingston et al. [63], suggests that the stigma caused by others noticing performance being different is the primary result of reading. The stigma leads to secondary negative emotional, social, and behavioral outcomes. According to this interpretation, the emotional, social, and behavioral problems may actually be a secondary result of the state which also presents itself as SLDs.

Writing difficulties also predict the PD levels, but not as much as reading. In today’s technologically advanced world, writing remains a vital means of self-expression [115,116]. Struggles with writing can be emotionally exhausting and limiting, creating significant stress for those affected [117]. A systematic review by Miller et al. [118] highlights that such challenges can negatively influence students’ self-esteem, behavior in school, and academic performance. Additionally, research has linked specific learning disorders, including difficulties with handwriting, to substantial impacts on social–emotional well-being and behavior (e.g., [119]). Children with these challenges often face stigmatizing labels such as “lazy” or “unmotivated to learn” [117,120]. Such negative perceptions and academic pressures can lead to frustration and anxiety, further hindering their learning processes [117]. Due to inefficient pencil grips and visual–motor deficits, students with writing difficulties often expend significant effort on letter formation, leaving little capacity for organizing and processing their thoughts [115]. Over time, the combination of these struggles may contribute to emotional and behavioral challenges, as students become increasingly frustrated by their difficulties with self-expression [121]. However, there is a notable gap in the literature exploring the emotional challenges associated with writing impairments [116]. This study seeks to address this gap by shedding light on the emotional aspects of writing difficulties.

In contrast to reading and writing, the data analysis pointed out that, while simply correlated with PD, upon controlling for the other predicting variables, arithmetic difficulties did not significantly predict PD. Our results do not match the results of a study by Aro et al. [55], who found an overall higher use of psychiatric drugs to reduce anxiety and depression and higher levels of unemployment in subjects with an arithmetic disability compared to subjects with a reading disability. However, the subgroup comparisons showed that reimbursements for antidepressants were markedly more common among females with both reading and math disability, while among males, contrary proportions were detected, showing a higher percentage among males with reading disabilities (18%) than among those with both reading and math disability (12%) [55]. The lack of uniformity within the results of this study and with the current study indicates that more research is needed in this field. The fact that Aro et al. [55] collected data concerning people with reading problems in Finland may have significance importance here. As Aro and colleagues state, Finnish is an orthographically transparent language. As such, the relative level of difficulty experienced by Finnish adults with an SLD centered on reading may be different than that of adults in other countries. Thus, the discrepancy between their results and the results presented here may reflect this difference.

Many affected children acquire a negative attitude toward counting and arithmetic, which, in turn, often develops into a specific mathematics anxiety or even generalized school phobia [122]. Unless specifically treated, it can lastingly impair personality development, schooling, and occupational training. Arithmetic can also create an economic burden, as adults with poor arithmetic skills suffer a major disadvantage in the job market [80]. Other studies found negative correlations between low mathematics achievement and later high mathematics anxiety [85,123] and positive correlations between arithmetic and math anxiety [85]. Although arithmetic anxiety is more common in people with arithmetic difficulties, it is also common in people with arithmetic difficulties who are not functioning at the level of impairment (e.g., [83]). Thus, it appears that despite reports of negative emotional consequences in a similar way to other types of SLDs, this impairment expressed in arithmetic skills may not be as important for day-to-day functions as reading and writing. People with arithmetic disability/difficulties confront their impairment less frequently and, thus, may be less preoccupied with it and suffer less PD based on this specific disability.

In our society, adults with reading difficulties are often perceived as unusual and are frequently associated with low intelligence. Nicolson and Fawcett [124] suggest that “Impaired performance on reading might well lead not only to reading-related stress but also to the more general (and equally toxic) feeling of shame, and shame will attach to the more general school environment”. In contrast, math difficulties are often seen as a normal variation in personal aptitudes [91]. This perception might explain differences in emotional responses to arithmetic difficulties between children and adults, with the latter, including our participants, potentially feeling that their math-related challenges are behind them. Alternatively, the small sample size of participants with arithmetic difficulties in this study may account for the lack of significant predictive power. The patterns observed in reading, writing, and arithmetic highlight the possibility that the emotional and social issues linked to SLDs may be secondary to academic failures. However, another explanation is that these difficulties—academic, emotional, and social—are all consequences of the same atypical central nervous system development. If this is the case, reading, writing, and arithmetic impairments would be expected to correlate similarly with psychological distress unless they stem from distinct forms of brain development.

4.3.1. Implications

The findings of this study have several important implications for both research and practice. First, the differential impact of various types of SLDs on PD underscores the necessity for tailored interventions. Specifically, individuals with reading difficulties who exhibit the highest levels of PD should be prioritized for support services. This targeted approach can enhance the effectiveness of interventions by addressing the specific needs associated with different types of SLDs. Furthermore, the overall higher levels of PD reported by individuals with any learning disability highlight the urgent need for comprehensive mental health support within this population. Educational institutions and mental health professionals should collaborate to develop and implement strategies that mitigate the psychological burden experienced by these individuals.

Additionally, we hope that our study will inspire further research into these aspects, particularly exploring the differences in learning-based distress levels between men and women with SLDs, as well as how these levels vary across different age groups. The age-related vulnerability suggests that the transition into adulthood, marked by increased independence and responsibility, may exacerbate the challenges faced by those with SLDs. Therefore, it may be necessary to develop age-specific support systems that not only address the immediate academic and social demands but also foster long-term resilience. Such research could provide deeper insights into the specific challenges faced by different subgroups, leading to more nuanced and effective interventions that consider age-related factors in the experience of distress among adults with SLDs.

4.3.2. Limitations and Future Research

The main limitation of the study is the reliance on self-reported data collection tools, which may have introduced bias, as participants might provide socially desirable responses. Another limitation concerns the data collection process itself—our participants were not asked to indicate whether their diagnosis involved reading, writing, or arithmetic difficulties, or any combination of the three. Providing this classification could help in identifying more differences between these entities. This emphasizes the need for more rigorous research to understand the distinct psychological impacts of each type of SLD. Additionally, with only 56 subjects in the SLD group, the small sample size may have impacted the robustness of statistical inferences, particularly in the hierarchical regression analysis. Another limitation concerns the potential comorbidity among the participants. While participants were asked to assess their difficulty levels in reading, writing, and arithmetic, they did not specify whether their diagnosis pertained to reading, writing, or arithmetic difficulties, or a combination of these. Thus, our results describe the relationship between subjective experiences in each domain, reflecting the extent to which participants encountered minor or significant difficulties in each area. However, we used the reported difficulty levels to calculate a measure of acute difficulty, providing a descriptive measure of the participants. Another potential limitation of this study is that the participants with reading disabilities may have faced challenges in fully comprehending the questionnaire items. A potential limitation of this study is that participants with reading disabilities may have faced challenges in fully comprehending the questionnaire items. Although the questionnaires were designed to be as clear as possible, no additional support (e.g., audio narration or direct assistance) was provided during data collection. However, it is worth noting that the participants were university students, which likely reduced concerns about their ability to understand the written items. Additionally, there was no time pressure during the completion of the questionnaires, which may have further mitigated potential comprehension difficulties. Finally, while the study relied on the K6 threshold for interpreting severity levels of psychological distress (PD), it is important to note that no specific Israeli norms exist for this measure. This limitation highlights the need for caution in generalizing findings and suggests that future research should validate these thresholds within an Israeli context.

Follow-up studies on mental health among people with SLDs should explore more deeply the risk factors and investigate the origins of those PD symptoms. It is interesting to examine whether the source of the emotional difficulties stems from the same structural irregularity as the cognitive functions that characterize SLDs or whether the emotional difficulties are secondary to their learning experiences. Follow-up studies can further investigate the differences in the emotional consequences of each type of SLD more extensively. It is possible that, as technology advances, the need for learning and practicing reading, writing, and arithmetic will see some changes. Pupils with SLDs may then be less challenged by frustration due to their inability to meet expectations regarding class tasks and assignments. This way or the other, a similar comparison of the relative relations between reading, writing, and arithmetic problems and PD among school children will be needed. As mentioned, while for an adult, the need for using mathematic skills may be of less importance, school children are still taking mathematics lessons and exams, which may make them feel it is important for their life. If PD related to having SLDs is indeed a secondary result of schooling experiences, these people may see a better future ahead.

5. Conclusions

In conclusion, this study found that difficulties related to reading and writing were stronger predictors of PD than those related to arithmetic among individuals with SLDs. Notably, the self-reported SLD severity, rather than the mere presence of an SLD, was closely associated with higher levels of PD. Additionally, age was a key factor, with emerging adults being particularly vulnerable. The revealed disparity between reading, writing, and arithmetic difficulties suggests that the emotional challenges faced by individuals with SLDs are likely secondary to their academic difficulties.