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Heynen E, Borghuis A, Pat-El R, Moonen X, Stams GJ. Measuring empathy in youth and young adults with mild intellectual disabilities or borderline intelligence in residential care - The validation of an adapted basic empathy scale: The BES-MID. Heliyon 2024; 10:e31050. [PMID: 38813188 PMCID: PMC11133657 DOI: 10.1016/j.heliyon.2024.e31050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
Youths with mild intellectual disability (MID) are assumed to show impaired cognitive and affective empathy. However, the use of linguistic and conceptual complex empathy measures set limits to the valid and reliable assessment of empathy in youth with MID or borderline intelligence (BI). The objective of the present study was to evaluate the validity and reliability of the adapted BES-MID as an instrument for assessing cognitive and affective empathy in youth and young adults (12-24years) with MID/BI. The current study was conducted in a sample of N = 146 youth and young adults with MID or BI Results from Confirmatory Factor Analyses confirm the two-factor structure of affective and cognitive empathy for the BES-MID. While the original BES cannot be used to assess empathy in youth and young adults with MID or borderline intelligence, the BES-MID showed satisfactory validity and reliability in youth and young adults with MID or borderline intelligence. Despite some limitations and the need for further research, the current study has resulted in a valid and reliable empathy scale (BES-MID) for assessing cognitive and empathic abilities in youth and young adults with MID or borderline intelligence, which is important for future empathy research in youth and young adults with MID or borderline intelligence.
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Affiliation(s)
| | | | - Ron Pat-El
- Open University, Heerlen, the Netherlands
| | - Xavier Moonen
- Universiteit van Amsterdam, Amsterdam, the Netherlands
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Wagemaker E, Salemink E, Huizenga HM, Bart HF, Dekkers TJ, Bexkens A. How to support peer resistance in adolescents with mild-to-borderline intellectual disability? Intervention development and feasibility. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13216. [PMID: 38403300 DOI: 10.1111/jar.13216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/16/2024] [Accepted: 02/10/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Adolescents with mild-to-borderline intellectual disability face peer resistance challenges, risking harmful or dangerous situations. METHOD We designed a peer resistance group intervention at school for adolescents with mild-to-borderline intellectual disability, tested its feasibility (N = 4, Mage = 14.1, MIQ = 78.8), adapted it, and tested it again (N = 6, Mage = 15.0, MIQ = 72.8). RESULTS Study 1 demonstrated feasibility in recruitment, resources, and potential benefits on the distal outcome risk taking. However, attendance, obtained knowledge, and potential benefits on peer resistance, peer problems, and prosocial behaviour were suboptimal. Consequently, study 2 contained more learning by doing and individual lessons, resulting in higher attendance and greater personalization. While potential benefits on improved peer resistance measures were not observed, risk taking improved. CONCLUSIONS Despite finding no potential benefits on peer resistance, running a peer resistance intervention for adolescents with mild-to-borderline intellectual disability at school is considered feasible.
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Affiliation(s)
- Eline Wagemaker
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
| | - Elske Salemink
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Hilde M Huizenga
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Research Priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Han F Bart
- De Viaan, Practical Vocational School, Alkmaar, The Netherlands
- SOVON (Public Secondary Education Foundation), Noord-Holland-Noord, The Netherlands
| | - Tycho J Dekkers
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Levvel, Academic Center of Child and Adolescent Psychiatry and Specialized Youthcare, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
- Accare Child Study Center, Groningen, The Netherlands
| | - Anika Bexkens
- Department of Psychology, Developmental and Educational Psychology, Leiden University, Leiden, The Netherlands
- GGZ Delfland, Delft, The Netherlands
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Restoy D, Oriol-Escudé M, Alonzo-Castillo T, Magán-Maganto M, Canal-Bedia R, Díez-Villoria E, Gisbert-Gustemps L, Setién-Ramos I, Martínez-Ramírez M, Ramos-Quiroga JA, Lugo-Marín J. Emotion regulation and emotion dysregulation in children and adolescents with Autism Spectrum Disorder: A meta-analysis of evaluation and intervention studies. Clin Psychol Rev 2024; 109:102410. [PMID: 38401510 DOI: 10.1016/j.cpr.2024.102410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 01/14/2024] [Accepted: 02/19/2024] [Indexed: 02/26/2024]
Abstract
Children and adolescents with Autism Spectrum Disorder (ASD) often experience challenges in emotion regulation (ER) and emotion dysregulation (ED) which can interfere with their adaptive functioning. This study aimed to systematically review and meta-analyze the evidence on ER/ED in children and/or adolescents with ASD, examining its relationship with the following variables: internalizing and externalizing symptoms, cognitive function and social skills, and the effectiveness of non-pharmacological interventions addressing ER difficulties. Both electronic and manual searches were conducted to identify potential studies. Fifty-five studies were included in the meta-analysis. A statistically significant between-group difference was found, suggesting greater ER/ED challenges in the ASD group. Also, the ASD group showed more maladaptive ER strategies and fewer adaptive ER strategies compared to the non-ASD participants. Additionally, more severe ASD and poorer social skills were associated with greater ED and poorer ER skills, respectivelly. Furthermore, there was a significant correlation between internalizing symptomatology and both adaptive and maladaptive ER strategies. Studies of non-pharmacological interventions showed significant improvement in both ER and ED. These results imply that assessing ER/ED in children and adolescents with ASD should be part of the evaluation process, and it should also be a focal point for intervention in this population.
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Affiliation(s)
- Damián Restoy
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | | | - Teresa Alonzo-Castillo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - María Magán-Maganto
- Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain
| | - Ricardo Canal-Bedia
- Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain
| | - Emiliano Díez-Villoria
- Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain
| | - Laura Gisbert-Gustemps
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Imanol Setién-Ramos
- Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - María Martínez-Ramírez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Jorge Lugo-Marín
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Centro de Atención Integral al Autismo-InFoAutismo. INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca. Salamanca, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
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Zukerman N, Bottone E, Low M, Ogourtsova T. Resilience and adolescence-transition in youth with developmental disabilities and their families: a scoping review. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1341740. [PMID: 38476963 PMCID: PMC10927845 DOI: 10.3389/fresc.2024.1341740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/15/2024] [Indexed: 03/14/2024]
Abstract
Background Children with neurodevelopmental disabilities (NDDs, e.g., cerebral palsy) and their caregivers face lifelong and impactful challenges, particularly during life-transition periods such as adolescence. One's resilience emerges as an essential ability to navigate this vulnerable phase. Resilience is a complex concept that embeds multiple factors on various levels. Little is known about what resilience factors are pivotal in youth with NDDs and their families as they transition into adolescence and how these are addressed as part of existing targeted interventions. Objectives This review explored the concept of resilience in youth with NDDs and their families. Specific aims included describing salient resilience factors in adolescents with NDDs and their families and to describe how resilience is addressed as part of targeted interventions. Methods Using the Arskey and O'Malley framework, six steps were undertaken, including a comprehensive literature search (n = 5 databases), transparent study selection, detailed data extraction with a coding scheme (n = 46 factors), results' collating with numerical and inductive content analysis, and consultation with three key stakeholders. Results The study screened 1,191 publications, selecting fifty-eight (n = 58; n = 52 observational and n = 6 intervention) studies. Findings revealed that resilience in this context is closely linked to more than forty factors across four levels (individual; family; school/peers; and community). Pivotal factors include social and emotional competence, optimism, and family/peer relationships. While existing interventions targeting resilience show promising results, few programs are available and generalizable to different NDDs. Stakeholders highlighted the importance of addressing resilience factors that are not targeted in existing interventions: caregivers' self-efficacy and self-esteem, as well as youth's and caregiver's confidence. Preferences for and advantages of online delivery for support programs and individual/group features also emerged. Conclusion The review emphasizes the need for a holistic approach to support youth with NDDs and their families during adolescence transition. To enhance their resilience, recognizing caregivers' roles, customizing interventions, and exploring new implementation formats are avenues that align with the current evidence and opportunities for practical development in this field.
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Affiliation(s)
- Naomi Zukerman
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Emily Bottone
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Maya Low
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Tatiana Ogourtsova
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
- The Research Center of the Jewish Rehabilitation Hospital, Centre Intégré de Santé et de Services Sociaux de Laval, Laval, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC, Canada
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Dubé C, Morin AJS, Tóth-Király I, Olivier E, Tracey D, McCune VS, Craven RG, Maïano C. Social Interaction Profiles Among Youth with Intellectual Disabilities: Associations with Indicators of Psychosocial Adjustment. J Autism Dev Disord 2024; 54:458-476. [PMID: 36342629 DOI: 10.1007/s10803-022-05783-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 11/09/2022]
Abstract
This study investigates the nature of the social interaction profiles observed among youth with intellectual disabilities (ID), defined while considering their relationships with their parents, peers, and teachers, as well as the implication of these profiles for self-esteem, aggressive behaviors, and prosocial behaviors. A sample of 393 youth with mild (48.2%) to moderate (51.8%) levels of ID, aged between 11 and 22 (M = 15.70), was recruited in Canada (n = 141) and Australia (n = 253). Our results revealed four profiles, corresponding to Socially Isolated (23.24%), Socially Integrated (39.83%), Socially Rejected (28.37%) and Socially Connected (8.57%) youth with ID. The socially integrated and connected profiles both presented higher self-esteem, more prosocial behaviors, and less aggressive behaviors than the socially isolated and rejected profiles.
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Affiliation(s)
- Céleste Dubé
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, H4B 1R6, Montreal, QC, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, H4B 1R6, Montreal, QC, Canada.
| | - István Tóth-Király
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, H4B 1R6, Montreal, QC, Canada
| | - Elizabeth Olivier
- Département de psychopédagogie et d'andragogie, Université de Montréal, Montréal, Canada
| | - Danielle Tracey
- School of Education, Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Victoria Smodis McCune
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, 7141 Sherbrooke W, H4B 1R6, Montreal, QC, Canada
| | - Rhonda G Craven
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | - Christophe Maïano
- Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO|Campus de Saint-Jérôme), Saint-Jérome, Canada
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Samson AC, Sokhn N, Van Herwegen J, Dukes D. An exploratory study on emotion regulation strategy use in individuals with Williams syndrome, autism spectrum disorder and intellectual disability. Front Psychiatry 2022; 13:940872. [PMID: 36506439 PMCID: PMC9726902 DOI: 10.3389/fpsyt.2022.940872] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/31/2022] [Indexed: 11/24/2022] Open
Abstract
Background Individuals with neurodevelopmental disorders often have atypical emotion profiles, but little is known about how they regulate their emotions. While several studies have examined emotion regulation strategy use in autism spectrum disorder (ASD), only a few have included individuals with intellectual disability (ID) or focused on specific syndromes such as Williams syndrome (WS). Methods A parent-reported survey launched during the first months of the COVID-19 pandemic allowed to exploratorily study emotion regulation strategy use and its link to anxiety in individuals with ASD with (N=785) and without ID (N=596), WS (N=261), and Intellectual Disability not otherwise specified (N=649). Results Using multilevel analyses, besides revealing specific group differences in emotion regulation strategy use, a variety of strategies (e.g., rumination, avoiding information, repetitive behaviors) were found to be linked to elevated levels of anxiety, while focusing on the positive was linked to lower anxiety levels in all groups. Moreover, only autistic people without ID used humor more frequently while experiencing lower anxiety levels. Conclusion This study sheds light on an underexplored area of emotion regulation strategy use in different neurodevelopmental disorders. It also paves the way to further examine emotion regulation in more rigorous ways to better understand emotion regulation in different neurodevelopmental disorders as well as the impact on outcome measures such as anxiety. This exploratory study may help to develop and validate adequate measures to study a broad array of ER strategies used by individuals with neurodevelopmental disorders.
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Affiliation(s)
- Andrea C. Samson
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Faculty of Psychology, UniDistance Suisse, Brig, Switzerland
| | - Nayla Sokhn
- Faculty of Psychology, UniDistance Suisse, Brig, Switzerland
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
- Eye and Brain Mapping Laboratory (iBMLab), Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Jo Van Herwegen
- Department of Psychology and Human Development, UCL Institute of Education, London, United Kingdom
| | - Daniel Dukes
- Institute of Special Education, University of Fribourg, Fribourg, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
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Treatment Approach and Sequence Effects in Cognitive Behavioral Therapy Targeting Emotion Regulation Among Adolescents with Externalizing Problems and Intellectual Disabilities. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10261-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Abstract
Background
Over the past years, it has become clear that adapted cognitive behavior therapy can be effective for adolescents with externalizing problems and mild intellectual disabilities or borderline intellectual functioning (MID–BIF). Most adapted treatment protocols consist, however, of a combined cognitive and behavioral approach, even though it is actually unclear which approach is most suitable for these adolescents. This experimental study aimed to examine which treatment approach (cognitive versus behavioral) and which treatment sequence (cognitive–behavioral versus behavioral–cognitive) is most effective.
Methods
Participating adolescents (N = 42, 50% boys, Mage = 15.52, SD = 1.43) consecutively received a cognitive and behavioral emotion regulation training module, but were randomly assigned to a different module sequence condition. Emotion regulation and externalizing problems were measured before and after the modules, and with continuing weekly assessments.
Results
Results indicated that the cognitive module, by itself, was more effective than the behavioral module. In addition, the results indicated that it is most effective to include behavioral exercises after (rather than before) cognitive training.
Conclusions
These findings highlight the importance of cognitive treatment approaches for adolescents with MID–BIF, and show that treatment approaches may have different effects, depending on the order in which they are presented.
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Te Brinke LW, Menting ATA, Schuiringa HD, Deković M, Weisz JR, de Castro BO. Emotion regulation training as a treatment element for externalizing problems in adolescence: A randomized controlled micro-trial. Behav Res Ther 2021; 143:103889. [PMID: 34111699 DOI: 10.1016/j.brat.2021.103889] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 04/20/2021] [Accepted: 05/14/2021] [Indexed: 11/25/2022]
Abstract
Improving interventions for externalizing problems in adolescence may require determining which treatment elements actually produce change. In this micro-trial, we tested a treatment element addressing one widely-hypothesized mechanism underlying externalizing problems: emotion regulation. We tested whether emotion regulation could be improved via training, whether adolescents who received such training would subsequently show reduced externalizing problems, and which training approach and sequence was most effective. We randomized 108 adolescents with elevated externalizing problems (71.3% boys, Mage = 13.66, SD = 1.10) to a control condition or an experimental condition teaching emotion regulation through either a cognitive or behavioral approach, in alternated sequences. Effects of the modules were assessed before and after the modules, and with weekly assessments. The results showed a positive effect of the experimental training on self-reported use of adaptive emotion regulation strategies. However, self-reported externalizing problems decreased more in the control condition than in the experimental condition. No mediation, approach (cognitive versus behavioral) or sequence (cognitive-behavioral versus behavioral-cognitive sequence) effects were found. These findings illustrate that change in a proposed mechanism may not be accompanied by change in targeted problems; this highlights the importance of testing the hypothesized impact of specific treatment elements on targeted mental health problems. TRIAL REGISTRATION: This trial was registered in the Dutch Trial Register (NTR7334, July 10th, 2018) and the study protocol was published (te Brinke, Schuiringa, Menting, Deković, & de Castro, 2018).
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Affiliation(s)
- Lysanne W Te Brinke
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands.
| | - Ankie T A Menting
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands.
| | - Hilde D Schuiringa
- Department of Developmental Psychology, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands.
| | - Maja Deković
- Department of Clinical Child and Family Studies, Utrecht University, Heidelberglaan 1, 3584, CS, Utrecht, the Netherlands.
| | - John R Weisz
- Department of Psychology, Harvard University, 33 Kirkland Street Cambridge, MA, 02138, United States.
| | - Bram O de Castro
- Department of Developmental Psychology, Utrecht University, 80125, 3508, TC, Utrecht, the Netherlands.
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