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Maïano C, Morin AJS, Tracey D, Hue O, Craven RG. A person-centred investigation of the associations between actual and perceived physical fitness among youth with intellectual disabilities. J Sports Sci 2024:1-15. [PMID: 38976395 DOI: 10.1080/02640414.2024.2370150] [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: 03/23/2023] [Accepted: 06/13/2024] [Indexed: 07/10/2024]
Abstract
The main objective of this person-centred study was to identify profiles of actual and perceived physical fitness among a sample of youth with intellectual disabilities (ID). Participants were 377 youth (60.4% boys) with mild (49.6%) to moderate (50.4%) ID recruited in Australia and Canada. Latent profile analyses revealed five profiles: (1) Underestimation of Average Physical Fitness (5.5% of the sample); (2) Moderate Overestimation of Low Physical Fitness (17.7%), (3) Moderate Underestimation of Average Physical Fitness (31.3%); (4) High Overestimation of Average Physical Fitness (28.3%); and (5) Moderate Underestimation of High Physical Fitness with an Accurate Estimation of Average Flexibility (17.2%). Profiles 1, 2, and 3 relatives to Profiles 4 and 5 included younger participants, more participants with moderate levels of ID, and participants with a higher body mass index. Additionally, profiles 1 and 3 also included a higher proportion of youth pursuing externally-driven motives and less frequently involved in sports outside of the school. In sum, our findings showed that the tendency of youth with ID to rely on upward or downward-lateral social comparisons may have resulted in a depreciation or overestimation of their low levels of physical fitness.
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Affiliation(s)
- Christophe Maïano
- Cyberpsychology Laboratory and Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO,Campus de Saint-Jérôme), Saint-Jérôme, Canada
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
| | - Alexandre J S Morin
- Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
| | - Danielle Tracey
- School of Education, Translational Health Research Institute, Western Sydney University, Sydney, Australia
| | - Olivier Hue
- Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Rhonda G Craven
- Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia
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Maxey M, Beckert TE, Meter D, Landon T. Psychosocial development measures modification for adolescents with intellectual and developmental disabilities. J Adolesc 2024; 96:136-151. [PMID: 37800453 DOI: 10.1002/jad.12262] [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: 07/13/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Although diagnosis and identification of IDD is improving, adolescents with IDD receive limited attention in research, particularly concerning their psychosocial development. Measures developed and normed with typically developing populations may not be appropriate for IDD populations and may result in biased assessment. AIM This study aimed to develop and validate modified psychosocial development assessments for adolescents with intellectual and developmental disabilities (IDD), addressing the absence of such assessments. METHOD It involved two phases: modifying existing instruments and validating the revised versions. Four stakeholder groups participated: adolescents with IDD, parents, and scholars in adolescent developmental and disabilities. Validation included two groups: neurotypical adolescents completing both measures and IDD adolescents completing modified measures. RESULTS Confirmatory factor analyses identified the need to adjust or eliminate scales for better understanding by individuals with IDD. The modified instruments provided suitable measures for assessing psychosocial development in adolescents with IDD. DISCUSSION All the scales allowed for accommodation toward comprehension for those with IDD except for identity formation. Further work is needed to understand the challenges associated with assessing identity formation in adolescents with IDD. The active involvement of and participation from adolescents with IDD and their parents in this research was paramount to understanding their comprehension and needs. CONCLUSION This study highlights the importance of tailored assessments for accurate measurement of IDD individuals' development, benefiting the assessment of all adolescents.
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Affiliation(s)
- Myles Maxey
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Troy E Beckert
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Diana Meter
- Department of Human Development and Family Studies, Utah State University, Logan, Utah, USA
| | - Trenton Landon
- Department of Special Education and Rehabilitation Counseling, Utah State University, Logan, Utah, USA
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Lee HY, Kim SY, Yeob KE, Kim YY, Park JH. Nationwide trends in the prevalence and incidence of depressive disorders and their correlates among adults with disabilities in Korea from 2006 to 2017. Int J Soc Psychiatry 2023; 69:1670-1681. [PMID: 37226935 DOI: 10.1177/00207640231174363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Evidence suggests that people with disabilities are more likely to suffer from depression. Previous studies have focused on depressive disorders in specific disability types or age groups using small-scale cross-sectional samples. We investigated longitudinal trends in the prevalence and incidence of depressive disorders according to disability types and severity levels in the entire Korean adult population. METHODS The age-standardised prevalence and incidence of depressive disorders were investigated using National Health Insurance claims data from 2006 to 2017. The odds of depressive disorders by type and severity were examined using logistic regression after adjusting for sociodemographic characteristics and comorbidities based on merged 2006 to 2017 data. RESULTS Both the incidence and prevalence of depressive disorders were higher among the disabled than the non-disabled, with the prevalence gap being larger than the incidence gap. In regression analyses, adjusting for sociodemographic characteristics and comorbidities considerably reduced the odds ratios, particularly for incidence. The severity of disabilities was inversely associated with the incidence of depressive disorders. Brain injury and disabilities in major internal organs were associated with lower odds of developing depressive disorders than in non-disabled individuals. CONCLUSIONS A significant proportion of depressive disorders in disabled individuals are caused by financial hardships or comorbidities rather than disabilities themselves. We must pay special attention to those who cannot access healthcare services due to severe disabilities and those whose depressive disorders are misdiagnosed as intellectual disabilities. More research is required to elucidate the causal mechanisms underlying depressive disorders in people with various types and severities of disabilities.
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Affiliation(s)
- Hwa-Young Lee
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Republic of Korea
| | - So Young Kim
- Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, Republic of Korea
| | - Kyoung Eun Yeob
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, Republic of Korea
| | - Yeon Yong Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, Republic of Korea
- Drug Evaluation Department, National Institute of Food and Drug Safety Evaluation, Cheongju, Republic of Korea
| | - Jong-Hyock Park
- Institute of Health & Science Convergence, Chungbuk National University, Cheongju, Republic of Korea
- Department of Preventive Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
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Marion A, Bowman K, Thomas G, Harrison AJ. A mixed method examination: how stigma experienced by autistic adults relates to metrics of social identity and social functioning. Front Psychiatry 2023; 14:1243618. [PMID: 37965369 PMCID: PMC10640997 DOI: 10.3389/fpsyt.2023.1243618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
A recent meta-analysis reveals almost half of autistic individuals experience some form of victimization in their lifetime, including bullying and other forms of stigma. Research among caregivers of autistic individuals demonstrates that stigma can have a long-lasting impact on other aspects of a social identity, such as self-esteem, but less research has specifically examined this among autistic adults themselves, in spite of research suggesting these are likely constructs that contribute to the internalization of stigma and subsequent mental health consequences. The current study used a mixed method approach to assess the relation between stigma and several components of social identity and social functioning. More specifically, among 45 autistic young adults, three dimensions of self-reported stigma (discrimination, disclosure, and positive aspects) were examined in relation to self-esteem, self-efficacy, social satisfaction and adaptive social functioning. Quantitative analyses revealed higher reported discriminative and disclosure stigma were significantly associated with lower self-efficacy. Increased experience with all types of stigma were associated with lower social satisfaction. Greater reported disclosure stigma was also associated with lower self-esteem. Qualitative interviewing among eight autistic young adults helped to better understand the nature of stigma and the impact of these experiences. Thematic analysis of the qualitative data revealed that all of the participants experienced stigma in the form of exclusion or isolation and that a majority also experienced verbal bullying. Many of the negative interactions came from educators, peers, and family members. Most participants indicated that these stigmatizing interactions directly contributed to decreased social satisfaction, diminished self-efficacy, and lowered self-esteem. A greater understanding of the negative consequences of stigma can inform efforts to increase awareness and acceptance of autism.
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Affiliation(s)
- Alex Marion
- Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Karrah Bowman
- Department of Educational Psychology, University of Georgia, Athens, GA, United States
| | - Gina Thomas
- Department of Educational Psychology, University of Georgia, Athens, GA, United States
| | - Ashley J. Harrison
- Department of Educational Psychology, University of Georgia, Athens, GA, United States
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Scior K, Patel M, Goldsmith-Sumner A, Hayden N, Lee JY, Lunsky Y, Osborne M, Richardson L, Stewart-Brown S, Hastings RP. Development and initial psychometric properties of the Warwick-Edinburgh Mental Wellbeing Scale-Intellectual Disability version. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:893-900. [PMID: 37129069 DOI: 10.1111/jir.13039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/05/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS; Tennant et al., 2007) is yet to be validated in the intellectual disability (ID) population. The aim of this study was to report the development process and assess the psychometric properties of a newly adapted version of the WEMWBS and the Short WEMWBS for individuals with mild to moderate IDs (WEMWBS-ID/SWEMWBS-ID). METHOD The WEMWBS item wordings and response options were revised by clinicians and researchers expert in the field of ID, and a visual aid was added to the scale. The adapted version was reviewed by 10 individuals with IDs. The measure was administered by researchers online using screenshare, to individuals aged 16+ years with mild to moderate IDs. Data from three UK samples were collated to evaluate the WEMWBS-ID (n = 96). A subsample (n = 22) completed the measure again 1 to 2 weeks later to assess test-retest reliability, and 95 participants additionally completed an adapted version of the adapted Rosenberg Self-Esteem Scale to examine convergent validity. Additional data from a Canadian sample (n = 27) were used to evaluate the SWEMWBS-ID (n = 123). RESULTS The WEMWBS-ID demonstrated good internal consistency (ω = 0.77-0.87), excellent test-retest reliability [intraclass correlation coefficient (ICC) = .88] and good convergent validity with the self-esteem scale (r = .48-.60) across samples. A confirmatory factor analysis for a single factor model demonstrated an adequate fit. The SWEMWBS-ID showed poor to good internal consistency (ω = 0.36-0.74), moderate test-retest reliability (ICC = .67) and good convergent validity (r = .48-.60) across samples, and a confirmatory factor analysis indicated good model fit for a single factor structure. CONCLUSIONS The WEMWBS-ID and short version demonstrated promising psychometric properties, when administered virtually by a researcher. Further exploration of the scales with larger, representative samples is warranted.
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Affiliation(s)
- K Scior
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - M Patel
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - A Goldsmith-Sumner
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - N Hayden
- CEDAR, University of Warwick, Coventry, UK
| | - J Y Lee
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Y Lunsky
- Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - M Osborne
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - L Richardson
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Lee JY, Patel M, Scior K. Self-esteem and its relationship with depression and anxiety in adults with intellectual disabilities: a systematic literature review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:499-518. [PMID: 36855028 DOI: 10.1111/jir.13025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/22/2022] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In the general population, low self-esteem has been linked with poorer mental and physical health. This systematic literature review aimed to summarise and evaluate the findings of studies that examined self-esteem in adults with intellectual disabilities and links with mental health outcomes. METHOD A systematic search of PsycINFO, Web of Science and CINAHL was conducted to identify studies published between 1990 and 2021. The studies were appraised using the QualSyst tool. RESULTS Twenty-six articles were identified of which two studies were removed from the review due to low quality. Studies reported mixed evidence regarding levels of self-esteem compared with the general population. Engagement in activities appeared to be linked with positive self-esteem, and perception of negative interpersonal life events as having a negative impact was associated with lower self-esteem. There was evidence of co-occurrence of low self-esteem and depression, but no studies examined the relationship between self-esteem and anxiety. CONCLUSION Reviewed studies provided mixed evidence on levels of self-esteem in this population, suggesting that factors such as engagement in life were related to higher self-esteem and demonstrating the co-occurrence of low self-esteem and depression. However, clear causal links have yet to be identified, and more research is needed using longitudinal designs to answer questions about trajectory.
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Affiliation(s)
- J Y Lee
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - M Patel
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - K Scior
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Scior K, Richardson L, Osborne M, Randell E, Roche H, Ali A, Bonin EM, Burke C, Crabtree J, Davies K, Gillespie D, Jahoda A, Johnson S, Hastings RP, McNamara R, Wright M. Standing up for Myself (STORM): Adapting and piloting a web-delivered psychosocial group intervention for people with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 137:104496. [PMID: 37094392 DOI: 10.1016/j.ridd.2023.104496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Our STORM intervention was developed for people (16 +) with intellectual disabilities to enhance their capacity to manage and resist stigma. The current study describes the adaptation of STORM for (synchronous) on-line delivery in the context of the Covid-19 pandemic. AIMS To adapt the manualised face-to-face STORM group intervention for delivery via web-based meeting platforms and to conduct an initial pilot study to consider its acceptability and feasibility. METHODS AND PROCEDURES The 5-session STORM intervention was carefully adapted for online delivery. In a pilot study with four community groups (N = 22), outcome, health economics and attendance data were collected, and fidelity of delivery assessed. Focus groups with participants, and interviews with facilitators provided data on acceptability and feasibility. OUTCOMES AND RESULTS The intervention was adapted with minimal changes to the content required. In the pilot study, 95% of participants were retained at follow-up, 91% attended at least three of the five sessions. Outcome measure completion and fidelity were excellent, and facilitators reported implementation to be feasible. The intervention was reported to be acceptable by participants. CONCLUSIONS AND IMPLICATIONS When provided with the necessary resources and support, people with intellectual disabilities participate actively in web-delivered group interventions.
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Affiliation(s)
- Katrina Scior
- Clinical Educational & Health Psychology, University College London, London, UK.
| | - Lisa Richardson
- Clinical Educational & Health Psychology, University College London, London, UK
| | - Michaela Osborne
- Clinical Educational & Health Psychology, University College London, London, UK
| | | | | | - Afia Ali
- Division of Psychiatry, University College London, London, UK
| | | | | | | | - Karuna Davies
- Clinical Educational & Health Psychology, University College London, London, UK
| | | | - Andrew Jahoda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Sean Johnson
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Melissa Wright
- Centre for Trials Research, Cardiff University, Cardiff, UK
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Adapting cognitive behaviour therapy for people with intellectual disabilities: an overview for therapist working in mainstream or specialist services. COGNITIVE BEHAVIOUR THERAPIST 2023. [DOI: 10.1017/s1754470x22000587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Abstract
This paper is an introduction to adaptations to make cognitive behaviour therapy (CBT) more accessible to people with intellectual disabilities. It is intended to inform therapists who may work with people with intellectual disabilities in mainstream services.
The paper describes adaptations that consider neuropsychological processes, such as memory, and executive functions, such as planning, problem solving and self-regulation, and identifies that these factors are not unique to people with intellectual disabilities. We describe adaptations based on a review of literature describing CBT for people with intellectual disabilities (Surley and Dagnan, 2019) and draw on clinical experience to give examples of adaptations where possible. The paper particularly emphasises the generalisability of adaptations used with people with intellectual disabilities to therapy with wider populations and suggests that CBT therapists working in mainstream services will have the skills to be able to adapt therapy for people with intellectual disabilities.
Key learning aims
(1)
To overview the evidence base supporting the use of CBT with people with intellectual disabilities.
(2)
To describe the epidemiology of intellectual disability and discuss its implications for the generalisability of adaptations discussed in this paper.
(3)
To describe a range of adaptations to make CBT more accessible people with intellectual disabilities.
(4)
To consider whether such adaptations are part of the skill set of CBT therapists mainly working with people without intellectual disabilities.
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Xu E, Nicosia FM, Zamora K, Barrientos M, Spar MJ, Reyes-Farias D, Karliner LS, Potter MB, Brown RT. When Functional Impairment Develops Early: Perspectives from Middle-Aged Adults. J Gen Intern Med 2023; 38:90-97. [PMID: 35391621 PMCID: PMC9849615 DOI: 10.1007/s11606-022-07541-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/29/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Difficulty performing basic daily activities such as bathing and dressing ("functional impairment") affects more than 15% of middle-aged people, and this proportion is increasing. Little is known about the experiences and needs of individuals who develop functional impairment in middle age. OBJECTIVE To examine the experiences and needs of adults who developed functional impairment in middle age. DESIGN Qualitative study using semi-structured interviews. PARTICIPANTS Forty patients aged 50-64 years who developed functional impairment in middle age, recruited from four primary care clinics in San Francisco. APPROACH Interviews included open-ended questions about participants' daily life, ability to perform activities of daily living (ADLs), and needs related to functional impairment. We analyzed interviews using qualitative thematic analysis. KEY RESULTS Interviews revealed several themes related to the psychosocial and physical impacts of developing functional impairment in middle age. Participants noted that losses associated with functional impairment, such as loss of independence, control, and social roles, caused conflict in their sense of identity. To cope with these losses, participants used strategies including acceptance, social comparison, adjusting standards, and engaging in valued life activities. Participants reflected on the intersection of their functional impairment with the aging process, noting that their impairments seemed premature compared to the more "natural" aging process in older adults. In terms of physical impacts, participants described how a lack of accommodations in the built environment exacerbated their impairments. While participants used behavioral strategies to overcome these challenges, unmet needs remained, resulting in downstream physical and psychological impacts including safety risks, falls, frustration, and fear. CONCLUSIONS Unmet psychosocial and physical needs were common among middle-aged adults with functional impairment and led to negative downstream effects. Eliciting and addressing unmet needs may help mitigate downstream health consequences for this growing population, optimizing function and quality of life.
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Affiliation(s)
- Edison Xu
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
- Geriatrics, Palliative, and Extended Care, San Francisco VA Health Care System, San Francisco, CA, USA.
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA.
| | - Francesca M Nicosia
- Geriatrics, Palliative, and Extended Care, San Francisco VA Health Care System, San Francisco, CA, USA
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kara Zamora
- Geriatrics, Palliative, and Extended Care, San Francisco VA Health Care System, San Francisco, CA, USA
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Maureen Barrientos
- Geriatrics, Palliative, and Extended Care, San Francisco VA Health Care System, San Francisco, CA, USA
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Malena J Spar
- Geriatrics, Palliative, and Extended Care, San Francisco VA Health Care System, San Francisco, CA, USA
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - David Reyes-Farias
- Division of Geriatric Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Leah S Karliner
- Division of General Internal Medicine, Multiethnic Health Equity Research Center, University of California, San Francisco, San Francisco, CA, USA
| | - Michael B Potter
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Rebecca T Brown
- Division of Geriatric Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
- Geriatrics and Extended Care Program, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
- Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
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Collins J, Langdon PE, Barnoux M. The Adapted Firesetting Assessment Scale: reliability and validity. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:642-654. [PMID: 35621252 PMCID: PMC9323425 DOI: 10.1111/jir.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/04/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Adapted Firesetting Assessment Scale was developed for use with adults with developmental disabilities targeting fire-related factors thought to be associated with deliberate firesetting behaviour (i.e. attitudes towards fire, fire interest, fire normalisation, identification with fire and fire safety awareness). However, the psychometric properties of the scale are yet to be evaluated. METHOD The reliability, validity, comprehensibility, relevance and comprehensiveness of the Adapted Firesetting Assessment Scale were evaluated. Fifty-nine adults with developmental disabilities, some of whom had a history of firesetting, completed the Adapted Firesetting Assessment Scale on two occasions. Feedback about the questionnaire was sought from both participants and professionals. RESULTS The AFAS has acceptable internal consistency and excellent test-retest reliability. The attitudes towards fire, fire normalisation, poor fire safety subscales and total scores discriminated firesetters from non-firesetters. Content analysis of feedback indicated items of the AFAS were understood, relevant, accessible and comprehensible. CONCLUSION A larger study is needed to examine the factor structure of the AFAS.
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Affiliation(s)
- J. Collins
- Tizard CentreUniversity of KentCanterburyUK
| | - P. E. Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR)The University of WarwickCoventryUK
- Coventry and Warwickshire Partnership NHS TrustCoventryUK
| | - M. Barnoux
- Tizard CentreUniversity of KentCanterburyUK
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Thalen M, Volkers KM, van Oorsouw WMWJ, Embregts PJCM. Psychosocial interventions for older people with intellectual disabilities and the role of support staff: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:312-337. [PMID: 34783418 PMCID: PMC9298902 DOI: 10.1111/jar.12953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/02/2021] [Accepted: 09/24/2021] [Indexed: 12/02/2022]
Abstract
Background The life expectancy of people with intellectual disabilities has increased. The implications of ageing have resulted in changes in their support needs and challenges to support staff. Access to evidence based strategies for support staff providing care to elderly with intellectual disabilities remains scarce. A systematic review was conducted to provide an overview of available psychosocial interventions. Methods Four databases were searched and assessed according to the PRISMA guidelines. A narrative, integrative method of analysis was conducted to synthesise quantitative and qualitative data. Results The 36 studies included in the review reported on interventions aimed at either identifying and meeting the needs or perceptions of older individuals or at improving their behaviour and skills. Furthermore, the role of support staff in the implementation of interventions was either active, assisting or undefined. Conclusions This overview of studies could contribute to the existing body of knowledge and help to optimise psychosocial support for a growing population.
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Affiliation(s)
- Marloes Thalen
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands.,Philadelphia Care Foundation, Amersfoort, The Netherlands
| | | | - Wietske M W J van Oorsouw
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands
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12
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Ali A, McKenzie E, Hassiotis A, Priebe S, Lloyd‐Evans B, Jones R, Panca M, Omar R, Finning S, Moore S, Roe C, King M. A pilot randomised controlled trial of befriending by volunteers in people with intellectual disability and depressive symptoms. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:1010-1019. [PMID: 34570405 PMCID: PMC9291894 DOI: 10.1111/jir.12886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/13/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are more likely to experience chronic depression compared with the general population, which may be compounded by loneliness and lower levels of social support. Befriending aims to provide social support and promote engagement in community activities. No randomised controlled trials have examined whether befriending improves symptoms of depression and social outcomes in people with ID. The aim of this pilot trial was to assess the feasibility and acceptability of a future larger trial of one-to-one befriending by volunteers in people with ID and depressive symptoms. METHODS Participants were adults with mild or moderate ID with a score of 5 or more on the Glasgow Depression Scale for People with Learning Disabilities (GDS-LD). They were randomised to the intervention arm (matched to a volunteer befriender for 6 months) or the control arm (usual care). Volunteers received training and supervision provided by two community befriending schemes. The main outcomes were feasibility of recruitment (minimum target n = 35), retention rate of participants, adherence (minimum 10 meetings), acceptability of the intervention, changes in depressive symptoms (assessed at baseline and 6 months) and feasibility of collecting data for a health economic analysis. RESULTS Recruitment was challenging, and only 16 participants with ID and 10 volunteers were recruited. Six participants were matched with a volunteer and no participants dropped out (except for two volunteers). Four participants completed 10 meetings (mean 11.8). Befriending was thought to be acceptable, but modifications were suggested. An exploratory analysis suggested that GDS-LD score was lower in the intervention group compared with the control group after adjusting for baseline scores, but not significant (adjusted mean difference: -4.0; 95% confidence interval: -11.2 to 3.2). CONCLUSIONS A large trial would not be feasible based on the recruitment strategies employed in this study. A further feasibility study addressing these challenges or the use of other study designs should be considered.
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Affiliation(s)
- A. Ali
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - E. McKenzie
- Research and Development OfficeGoodmayes Hospital, North East London NHS Foundation TrustLondonUK
| | - A. Hassiotis
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - S. Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services DevelopmentQueen Mary University of LondonLondonUK
| | - B. Lloyd‐Evans
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - R. Jones
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - M. Panca
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - R. Omar
- Department of Statistical ScienceUniversity College LondonLondonUK
| | - S. Finning
- Outward HousingOutward, Newlon HouseLondonUK
| | - S. Moore
- The Befriending SchemeSudburySuffolkUK
| | - C. Roe
- The Befriending SchemeSudburySuffolkUK
| | - M. King
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
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Ali A, Mckenzie E, Rasoul Z, Hassiotis A, Priebe S, Lloyd-Evans B, Jones R, Panca M, Omar R, Finning S, Moore S, Roe C, King M. One-to-one volunteer befriending to reduce symptoms of depression in people with intellectual disability: a feasibility RCT. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Little is known about the effectiveness of befriending for people with intellectual disability and whether or not befriending improves depressive symptoms and social outcomes.
Objective
This pilot trial aimed to assess the feasibility and acceptability of conducting a future full-scale randomised controlled trial of one-to-one befriending for people with intellectual disability who had depressive symptoms.
Design
This was a parallel-group, two-armed randomised controlled trial incorporating an exploratory economic analysis and a mixed-methods process evaluation. Outcome assessments were conducted at baseline and at 6 months post randomisation by a research assistant who was blind to allocation. We aimed to approach 50 participants, with a view to recruiting 40.
Setting
Participants with intellectual disability were recruited from one NHS trust and from referrals to two community befriending services. The intervention was delivered by community befriending services.
Participants
Adults with mild or moderate intellectual disability with a score on the Glasgow Depression Scale for people with a Learning Disability of ≥ 5 were included. Those attending a day service/college for ≥ 3 days a week were excluded. Volunteers were aged ≥ 18 years and had no history of prior convictions.
Intervention
Participants in the intervention group were matched with a volunteer befriender and were expected to meet once per week for 1 hour, over 6 months. Volunteers recorded activities in a logbook. Volunteers received training and regular supervision. Both groups received usual care and a resource booklet of local activities.
Main outcome measures
The feasibility outcomes and progression criteria were recruitment of at least 70% of participants approached; matching of at least 70% of participants in the intervention group to a volunteer; a dropout rate of < 30% of participants and volunteers; adherence to the intervention (10 meetings between pairs); acceptability of the intervention; and feasibility of collecting data on costs and resource use for an economic evaluation. Changes in depressive symptoms (primary clinical outcome: Glasgow Depression Scale) and self-esteem, quality of life, social participation, social support, health-related quality of life and service use were recorded at 6 months. Outcomes in volunteers were also assessed.
Results
We recruited only 16 participants with intellectual disability (40% of target) and 10 volunteers. Six of the eight (75%) participants in the intervention group were matched with a befriender and there was good adherence (mean number of meetings attended 11.8; range 1–21 meetings). Going to a cafe/restaurant and having a conversation were the most frequent activities. All participants were retained at follow-up, but two volunteers dropped out. Trial procedures and the intervention might be acceptable, but modifications were suggested. Data on costs and resource use were obtained, but there were discrepancies in the health-related quality-of-life data.
Limitations
Delays to the study prevented the use of alternative recruitment strategies and the planned 12-month follow-up could not be completed.
Conclusions
Recruitment was not feasible, but other feasibility outcomes were more positive.
Future work
Evaluating befriending for people with intellectual disability could be explored through alternative study designs, such as observational studies.
Trial registration
Current Controlled Trials ISRCTN63779614.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 10. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Afia Ali
- Division of Psychiatry, University College London, London, UK
| | - Emma Mckenzie
- Research and Development Office, Goodmayes Hospital, North East London NHS Foundation Trust, London, UK
| | - Zara Rasoul
- Division of Psychiatry, University College London, London, UK
| | | | - Stefan Priebe
- Unit for Social and Community Psychiatry (World Health Organization Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | | | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
| | - Monica Panca
- Priment Clinical Trials Unit, University College London, London, UK
| | - Rumana Omar
- UK Department of Statistical Science, University College London, London, UK
| | | | | | | | - Michael King
- Division of Psychiatry, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
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Lally P, Beeken RJ, Wilson R, Omar R, Hunter R, Fovargue S, Anderson D, King M, Hassiotis A, Croker H. A manualised weight management programme for adults with mild-moderate intellectual disabilities affected by excess weight: A randomised controlled feasibility trial (Shape Up-LD). JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:112-122. [PMID: 34297441 DOI: 10.1111/jar.12922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim was to pilot an adapted manualised weight management programme for persons with mild-moderate intellectual disabilities affected by overweight or obesity ('Shape Up-LD'). METHOD Adults with intellectual disabilities were enrolled in a 6-month trial (3-month active intervention and 3-month follow-up) and were individually randomised to Shape Up-LD or a usual care control. Feasibility outcomes included recruitment, retention, initial effectiveness and cost. RESULTS Fifty people were enrolled. Follow-up rates were 78% at 3 months and 74% at 6 months. At 3 and 6 months, controlling for baseline weight, no difference was observed between groups (3 months: β: -0.34, 95% confidence interval [CI]: -2.38, 1.69, 6 months: β: -0.55, 95%CI -4.34, 3.24). CONCLUSION It may be possible to carry out a trial of Shape Up-LD, although barriers to recruitment, carer engagement and questionnaire completion need to be addressed, alongside refinements to the intervention.
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Affiliation(s)
- Phillippa Lally
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rebecca J Beeken
- Department of Behavioural Science and Health, University College London, London, UK.,Leeds Institute of Health Sciences, London, UK
| | - Rose Wilson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Rumana Omar
- Department of Statistical Science, University College London, London, UK
| | - Rachael Hunter
- Department of Primary Care & Population Health, University College London, London, UK.,Priment Clinical Trials Unit, London, UK
| | | | | | - Michael King
- Division of Psychiatry, University College London, London, UK
| | | | - Helen Croker
- Department of Behavioural Science and Health, University College London, London, UK
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Syropoulou A, Vernadakis N, Papastergiou M, Kourtessis T. Psychometric evaluation of the Rosenberg Self-Esteem Scale in primary school students with mild intellectual disability: First evidence. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103964. [PMID: 34020410 DOI: 10.1016/j.ridd.2021.103964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 04/03/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although the Rosenberg Self-Esteem Scale (RSES) is the most widely used measure of self-esteem, the evidential basis to confirm the RSES factor validity and reliability in children with intellectual disabilities (ID) has not been previously addressed. The purpose of this study was to evaluate the psychometric properties of the Greek version of the RSES into a sample consisting of primary school students with mild ID, bearing in mind the aspect of multidimensionality. In addition, gender differences were also investigated. METHODS The participants were 103 primary school students with mild ID aged 9-12 years old. Fifty-four (52.4 %) of the participants were boys and forty-nine were girls (47.6 %). Using the LISREL software, six different models of factor structure were estimated. The psychometric properties of the RSES, including internal consistency, content validity, convergent and discriminant validity as well as confirmatory factor analysis, were assessed. RESULTS The findings of this study provide some preliminary support to the robustness of the bifactor model, with a general self-esteem factor and two method effect factors that capture the direction of positive and negative item wording. CONCLUSIONS Although it is inappropriate to conclude that the results will be extended to all other populations and cultures, it can be assumed that bifactor models, which specify method effects due to wording, fit better than strictly unidimensional or two factor models.
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Affiliation(s)
- Angeliki Syropoulou
- Democritus University of Thrace, Department of Physical Education and Sport Sciences, University Campus, 69100 Komotini, Greece
| | - Nikolaos Vernadakis
- Democritus University of Thrace, Department of Physical Education and Sport Sciences, University Campus, 69100 Komotini, Greece.
| | - Marina Papastergiou
- University of Thessaly, Department of Physical Education and Sport Science, 42100 Trikala, Greece
| | - Thomas Kourtessis
- Democritus University of Thrace, Department of Physical Education and Sport Sciences, University Campus, 69100 Komotini, Greece
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Richard S, Hennekam S. Constructing a positive identity as a disabled worker through social comparison: The role of stigma and disability characteristics. JOURNAL OF VOCATIONAL BEHAVIOR 2021. [DOI: 10.1016/j.jvb.2020.103528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Kengne Kamga K, Munung NS, Nguefack S, Wonkam A, De Vries J. Negotiating political power and stigma around fragile X Syndrome in a rural village in Cameroon: A tale of a royal family and a community. Mol Genet Genomic Med 2021; 9:e1615. [PMID: 33544459 PMCID: PMC8104168 DOI: 10.1002/mgg3.1615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fragile X Syndrome (FXS) is a neurogenetic condition that significantly impacts the lives of affected individuals and their families due to its association with intellectual disability (ID) and stigma. METHOD In this paper, we present the findings of an ethnographic study in the community of a patient who received a genetic diagnosis for FXS in Cameroon. This study builds on data from 28 participants of a royal family and 58 from the community who participated in 20 in-depth interviews and nine focus group discussions. RESULTS We identified two types of stigma in this community: public stigma directed towards the royal family and associative stigma experienced by royal family members. We outline the stereotyping labels used for the family and its children with Fragile X Syndrome and describe the stigma-power dynamic between the community members and the royal family. First, most villagers use less stigmatizing terms to addressing FXS children from the chieftaincy because of their position in society. Secondly, due to their social position, the royal family uses their status to negotiate marriages with community members. From these observations, we can suggest that the primary role of stigma in this community is to keep people away from FXS and keep them down through domination and exploitation. CONCLUSION We advocate that other researchers examine if the same pattern exists in other inheritable forms of ID and conduct more qualitative research on FXS in Africa.
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Affiliation(s)
- Karen Kengne Kamga
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nchangwi Syntia Munung
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Séraphin Nguefack
- Department of Pediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Ambroise Wonkam
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Institute of Infectious Disease and Molecular Medicine (IDM, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jantina De Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Davies L, Randle-Phillips C, Russell A, Delaney C. The relationship between adverse interpersonal experiences and self-esteem in people with intellectual disabilities: The role of shame, self-compassion and social support. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:1037-1047. [PMID: 33305501 DOI: 10.1111/jar.12844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/29/2020] [Accepted: 11/17/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with intellectual disabilities are reported to have low self-esteem and to experience high rates of adverse interpersonal experiences (AIEs). This study aimed to investigate whether shame and self-compassion mediate the relationship between AIEs and self-esteem for people with intellectual disabilities and whether perceived social support moderates this relationship. METHOD This study employed a cross-sectional design, involving between-group comparisons. Forty-seven people with intellectual disabilities and 50 people without intellectual disabilities completed self-report questionnaires measuring shame, self-compassion, self-esteem, early AIEs and social support. RESULTS Shame and self-compassion were found to mediate the relationship between AIEs and self-esteem for people with intellectual disabilities. There was no evidence for a moderating effect of social support and no difference between groups in shame or self-compassion. CONCLUSIONS The findings suggest shame and self-compassion are important concepts for people with intellectual disabilities. Clinical and research implications are discussed.
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Affiliation(s)
- Lauren Davies
- Child and Family Psychology and Therapies Service, Aneurin Bevan University Health Board, Newport, UK
| | | | - Ailsa Russell
- Department of Psychology, University of Bath, Bath, UK
| | - Claire Delaney
- Learning Disabilities Service, 2Gether NHS Foundation Trust, Gloucester, UK
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Brougham L, Pert C, Jahoda A. Exploring the ability of individuals with an intellectual disability to generate and use a compassionate image. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1296-1306. [PMID: 32430986 DOI: 10.1111/jar.12749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/10/2020] [Accepted: 04/19/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a growing interest in adapting third-wave therapies such as mindfulness for people who have intellectual disabilities. This study explored their ability to generate and use a compassionate image. METHOD Nineteen people with an intellectual disability and twenty people without were recruited from further education colleges. A compassion-focused therapy technique was adapted to help participants generate their own compassionate image, and examine whether they could use their images in potentially distressing situations. RESULTS With appropriate support, participants with intellectual disabilities were just as able as those without disabilities to generate their own compassionate image. They were also able to generate self-soothing statements. CONCLUSIONS The participants' success in generating compassionate images suggests this approach may have clinical utility with people who have intellectual disabilities. The next question is whether this client group can use this technique to deal with personally salient stressors.
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Affiliation(s)
- Laura Brougham
- Institute of Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, Glasgow, Scotland
| | - Carol Pert
- Institute of Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, Glasgow, Scotland
| | - Andrew Jahoda
- Institute of Health & Wellbeing, Academic Centre, Gartnavel Royal Hospital, University of Glasgow, Glasgow, Scotland
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Ali A, Mckenzie E, Hassiotis A, Priebe S, Lloyd-Evans B, Omar R, Jones R, Panca M, Fernandez V, Finning S, Moore S, O'Connor D, Roe C, King M. One-to-one befriending for people with intellectual disability and symptoms of depression: protocol for a pilot randomised controlled trial. BMJ Open 2020; 10:e033989. [PMID: 32565450 PMCID: PMC7311030 DOI: 10.1136/bmjopen-2019-033989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION People with intellectual disability (ID) are more likely to experience loneliness and have smaller social networks, which increases vulnerability to depression. Befriending may reduce depressive symptoms in other populations, but randomised controlled trials (RCTs) have not been carried out in this population. This pilot study aims to assess the acceptability and feasibility of carrying out a full RCT of one-to-one befriending by volunteers for people with ID, compared with an active control group. METHODS AND ANALYSIS The trial aims to recruit 40 participants with ID. Participants in the intervention arm will receive weekly visits from a volunteer over 6 months. Community befriending schemes will recruit, train, supervise volunteers and match them to individuals with ID. Both groups will receive a booklet about local activities and have access to usual care. Health and social outcomes will be measured at the end of the intervention and 6 months' follow-up. The following outcomes will be assessed: (1) recruitment and retention of individuals with ID and volunteers in the trial, (2) adverse events related to the intervention, (3) the acceptability of the intervention, (4) whether the intervention is delivered as intended, (5) changes in health and social outcomes and (6) the feasibility of carrying out a cost-effectiveness analysis in a full trial. Qualitative data from participants, volunteers, staff and carers will identify barriers and facilitators of a future full trial. ETHICS AND DISSEMINATION The study has been approved by the London City and East Research Ethics Committee (reference 18/LO/2188). The findings will be presented at conferences and published in a peer-reviewed journal and in the National Institute of Health Research journals library. A public engagement seminar will be held at the end of the study aimed at key stakeholders. TRIAL REGISTRATION NUMBER ISRCTN63779614.
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Affiliation(s)
- Afia Ali
- Division of Psychiatry, University College London, London, UK
| | - Emma Mckenzie
- Research and Development, North East London NHS Foundation Trust Goodmayes Hospital, Ilford, Essex, UK
| | | | - Stefan Priebe
- Unit of Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, University of London, London, UK
| | | | - Rumana Omar
- Department of Statistical Science, University College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
| | - Monica Panca
- Primary Care and Population Health, University College London, London, UK
| | | | - Sally Finning
- Hackney Volunteer and Befriending Scheme, Outward, London, UK
| | | | | | | | - Michael King
- Division of Psychiatry, University College London, London, UK
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Park JY, Park EY. The Rasch Analysis of Rosenberg Self-Esteem Scale in Individuals With Intellectual Disabilities. Front Psychol 2019; 10:1992. [PMID: 31572254 PMCID: PMC6751397 DOI: 10.3389/fpsyg.2019.01992] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 08/14/2019] [Indexed: 01/20/2023] Open
Abstract
Background The purpose of this study was to examine the psychometric properties of the Rosenberg Self-Esteem Scale for individuals with intellectual disabilities (ID) using the Rasch model and to determine whether the scale is valid and reliable for use with this population. Methods Rasch analysis was carried out on data from 223 respondents to the 8th Panel Survey on Employment for the Disabled conducted by the Korea Employment Agency for the Disabled. The validity and reliability of scale items were verified through analyses of item fit, item difficulties, the rating scale, and separation indices. Results Item infit mean square values were found to range between 0.71 and 1.25, and item outfit mean square values between 0.71 and 1.26. Additionally, item difficulties were appropriate; Item 4 was the most difficult item, while Item 10 was the easiest item. The 4-point rating scale was appropriate, and the separation indices were at an acceptable level. Conclusion Based on these results, the validity and reliability of the Rosenberg Self-Esteem Scale for use with individuals with ID were verified. Thus, this scale can be regarded as a useful tool for evaluating the level of self-esteem of individuals with ID.
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Affiliation(s)
- Ju-Young Park
- Department of Rehabilitation, College of Medical Sciences, Jeonju University, Jeonju, South Korea
| | - Eun-Young Park
- Department of Secondary Special Education, College of Education, Jeonju University, Jeonju, South Korea
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Clapton NE, Williams J, Griffith GM, Jones RS. 'Finding the person you really are … on the inside': Compassion focused therapy for adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2018; 22:135-153. [PMID: 28105897 DOI: 10.1177/1744629516688581] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study utilized a mixed methods approach to examine the feasibility and acceptability of group compassion focused therapy for adults with intellectual disabilities (CFT-ID). Six participants with mild ID participated in six sessions of group CFT, specifically adapted for adults with ID. Session-by-session feasibility and acceptability measures suggested that participants understood the group content and process and experienced group sessions and experiential practices as helpful and enjoyable. Thematic analysis of focus groups identified three themes relating to (1) direct experiences of the group, (2) initial difficulties in being self-compassionate and (3) positive emotional changes. Pre- and post-group outcome measures indicated significant reductions in both self-criticism and unfavourable social comparisons. Results suggest that CFT can be adapted for individuals with ID and provide preliminary evidence that people with ID and psychological difficulties may experience a number of benefits from this group intervention.
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Hedley D, Young R. Social comparison processes and depressive symptoms in children and adolescents with Asperger syndrome. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 10:139-53. [PMID: 16613864 DOI: 10.1177/1362361306062020] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study investigated the relationship between social comparison processes and depressive symptoms in 36 participants (34 males and two females) aged 10 to 16 years with Asperger syndrome. Participants completed the Social Comparison Scale and the Children’s Depression Inventory. Depressive symptoms were significantly correlated with the SCS ( r = 0.52, p = 0.001), specifically perceived group membership ( r = 0.56, p < 0.001). A regression analysis revealed that perceived group membership significantly and independently predicted depression scores (β= 0.56, p = 0.002). It is suggested social comparison is a salient factor related to depressive symptoms in this group, and interventions involving adolescents with AS should therefore address this factor.
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Affiliation(s)
- Darren Hedley
- School of Psychology, Flinders University, Adelaide, SA 5001, Australia
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Phillips BN, Smedema SM, Fleming AR, Sung C, Allen MG. Mediators of disability and hope for people with spinal cord injury. Disabil Rehabil 2015; 38:1672-83. [DOI: 10.3109/09638288.2015.1107639] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Clarke R, Camilleri K, Goding L. What's in it for me? The meaning of involvement in a self-advocacy group for six people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2015; 19:230-250. [PMID: 25688140 DOI: 10.1177/1744629515571646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND This article explores the experiences of six people with intellectual disabilities in the context of a self-advocacy group, identifying the benefits and difficulties of being part of the group. MATERIALS AND METHODS Six adults with intellectual disabilities were interviewed about their experiences. Each individual took part in two individual and two group interviews. The transcripts were analysed using thematic analysis. RESULTS Analysis revealed four themes, namely, being part of the group, self-esteem, self-determination and empowerment. CONCLUSION Being part of the group is central to the experience of self-esteem, self-development and empowerment. Responses allow the exploration of the interrelationship between individual, group and community. Consideration is given to models of disability and the evidence base in relation to personal and political outcomes of self-advocacy. Links are made with developing a sense of self, self-determination, interpersonal learning and building resilience. Implications for practice are discussed.
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McGillivray JA, Kershaw M. Do we need both cognitive and behavioural components in interventions for depressed mood in people with mild intellectual disability? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:105-115. [PMID: 24372867 DOI: 10.1111/jir.12110] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/25/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND A growing literature suggests that people with mild intellectual disability (ID) who have depressed mood may benefit from cognitive-behavioural interventions. There has been some speculation regarding the relative merit of the components of this approach. The aim of this study was to compare (i) cognitive strategies; (ii) behavioural strategies; and (iii) combined cognitive-behavioural (CB) strategies on depressed mood among a sample of 70 individuals with mild ID. METHODS Staff from three participating agencies received training in how to screen individuals with mild ID for depressive symptoms and risk factors for depression. Depressive symptoms and negative automatic thoughts were assessed prior to and at the conclusion of the intervention, and at 6-month follow-up. The interventions were run in groups by the same therapist. RESULTS A post-intervention reduction in depression scores was evident in participants of all three interventions, with no significant difference between groups. A significant reduction in negative automatic thoughts post-intervention was evident in the CB combination group and was maintained at follow-up. Examination of clinical effectiveness suggests some advantage of the CB combination in terms of improvement and highlights the possible short term impact of behavioural strategies in comparison with the longer-term potential of cognitive strategies. CONCLUSIONS The findings support the use of group cognitive-behavioural interventions for addressing symptoms of depression among people with ID. Further research is necessary to determine the effectiveness of components.
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Affiliation(s)
- J A McGillivray
- School of Psychology, Deakin University, Burwood, Vic., Australia
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27
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Spassiani NA, Friedman C. Stigma: Barriers to Culture and Identity for People With Intellectual Disability. ACTA ACUST UNITED AC 2014. [DOI: 10.1352/2326-6988-2.4.329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Abstract
This exploratory article examines disability culture and identity for people with intellectual disability. In doing so, we argue that the stigma around intellectual disability severely affects people with intellectual disability's sense of culture and identity. This stigma causes internalized ableism and leads to people with intellectual disability disassociating from other people with intellectual disability in an attempt to cope with this stigma. True community inclusion for people with intellectual disability can only occur when this stigma is removed. Fortunately, as we argue, the self-advocacy movement is making great strides in doing so. The self-advocacy movement must be supported to achieve true inclusion and a sense of culture and identity for people with intellectual disability.
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Affiliation(s)
- Natasha A. Spassiani
- Natasha A. Spassiani, doctoral candidate; and Carli Friedman, doctoral candidate, Disability and Human Development, University of Illinois, Chicago
| | - Carli Friedman
- Natasha A. Spassiani, doctoral candidate; and Carli Friedman, doctoral candidate, Disability and Human Development, University of Illinois, Chicago
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Cuskelly M, Moni K, Lloyd J, Jobling A. Reliability of a method for establishing the capacity of individuals with an intellectual disability to respond to Likert scales. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2013; 38:318-324. [PMID: 24279784 DOI: 10.3109/13668250.2013.832734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The study reported here was an examination of the reliability of a method for determining acquiescent responding and the capacity to respond to items using a Likert scale response format by adults with an intellectual disability. METHOD Reliability of the outcomes of these procedures was investigated using a test-retest design. Associations with receptive vocabulary were examined. RESULTS The majority of the participants did not demonstrate acquiescent responding. Individuals' responses to the Likert-type discrimination tasks were consistent, although this varied somewhat depending upon the abstractness of the task. There was some association between receptive language age equivalence scores and respondent performance. CONCLUSION It is recommended that the pretest protocol (a) be modified to improve its reliability, and (b) this modified version be used with study participants who have an intellectual disability to ascertain the appropriate level of choice to be used for items that use a Likert response format.
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Affiliation(s)
- Monica Cuskelly
- The University of Queensland, School of Education , Brisbane , Australia
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Rose J, Willner P, Shead J, Jahoda A, Gillespie D, Townson J, Lammie C, Woodgate C, Stenfert Kroese B, Felce D, MacMahon P, Rose N, Stimpson A, Nuttall J, Hood K. Different Factors Influence Self-Reports and Third-Party Reports of Anger by Adults with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 26:410-9. [DOI: 10.1111/jar.12037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 11/29/2022]
Affiliation(s)
- John Rose
- School of Psychology; University of Birmingham; Birmingham UK
- Black Country Foundation Partnership Trust; Stourbridge UK
| | - Paul Willner
- Psychology Department; College of Human and Health Sciences; Swansea University; Swansea UK
- Directorate of Learning Disability Services; Abertawe Bro Morgannwg University Health Board; Neath UK
| | - Jennifer Shead
- Black Country Foundation Partnership Trust; Stourbridge UK
| | - Andrew Jahoda
- Institute of Health and Wellbeing; College of Medical, Veterinary and Life Sciences; University of Glasgow; Glasgow UK
| | - David Gillespie
- South East Wales Trials Unit; Institute of Primary Care & Public Health; School of Medicine; Cardiff University; Cardiff UK
| | - Julia Townson
- South East Wales Trials Unit; Institute of Primary Care & Public Health; School of Medicine; Cardiff University; Cardiff UK
| | - Claire Lammie
- Institute of Health and Wellbeing; College of Medical, Veterinary and Life Sciences; University of Glasgow; Glasgow UK
| | - Christopher Woodgate
- Directorate of Learning Disability Services; Abertawe Bro Morgannwg University Health Board; Neath UK
| | | | - David Felce
- Psychological Medicine and Neurology; School of Medicine; Cardiff University; Cardiff UK
| | - Pamela MacMahon
- Institute of Health and Wellbeing; College of Medical, Veterinary and Life Sciences; University of Glasgow; Glasgow UK
| | - Nikki Rose
- Black Country Foundation Partnership Trust; Stourbridge UK
| | - Aimee Stimpson
- Directorate of Learning Disability Services; Abertawe Bro Morgannwg University Health Board; Neath UK
| | - Jacqueline Nuttall
- South East Wales Trials Unit; Institute of Primary Care & Public Health; School of Medicine; Cardiff University; Cardiff UK
| | - Kerenza Hood
- South East Wales Trials Unit; Institute of Primary Care & Public Health; School of Medicine; Cardiff University; Cardiff UK
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Wilson S, McKenzie K, Quayle E, Murray GC. The postnatal support needs of mothers with an intellectual disability. Midwifery 2013; 29:592-8. [DOI: 10.1016/j.midw.2012.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 05/10/2012] [Accepted: 05/12/2012] [Indexed: 11/17/2022]
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Dagnan D, Hull A, McDonnell A. The controllability beliefs scale used with carers of people with intellectual disabilities: psychometric properties. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:422-428. [PMID: 22471440 DOI: 10.1111/j.1365-2788.2012.01554.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Beliefs about the controllability of behaviour have been consistently shown to be important in understanding the responses of carers to the challenging behaviour of people with intellectual disabilities (IDs). This paper reports the reliability and validity of the controllability beliefs scale (CBS), a 15-item measure of beliefs regarding the controllability of challenging behaviour when used with carers of people with IDs. METHODS Two hundred and sixty-four carers of people with IDs completed the CBS, 74 people also completed the modified attributional style questionnaire and the self-injury behavioural understanding questionnaire scale to determine concurrent and convergent validity and 34 people completed the scale twice within a 2- to 4-week period to determine test-retest reliability. RESULTS The scale has a two-factor structure and has adequate internal reliable. The scale is significantly correlated with the controllability, internality and stability items from the Modified Attributional Style Questionnaire, showed expected associations with behavioural and internal emotional understanding items from the self-injury behavioural understanding questionnaire. The scale has good test-retest reliability. CONCLUSIONS The data support use of the CBS in clinical practice and research to assess carers' beliefs regarding challenging behaviour of people with IDs.
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Affiliation(s)
- D Dagnan
- Cumbria Partnership NHS Trust, Community Learning Disabilities Service, Workington, Cumbria, UK.
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Erol S, Ergun A. Hopelessness and social comparison in Turkish adolescent with visual impairment. J Psychiatr Ment Health Nurs 2013; 20:222-7. [PMID: 22070767 DOI: 10.1111/j.1365-2850.2011.01805.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to determine visually impaired adolescents' level of hopelessness and how they perceive of themselves socially compared to other individuals. Another purpose of this study was to look for relationships between hopelessness and social comparison in adolescents with visual impairment. The research population was comprised of 130 students at a secondary school for the visually impaired in Istanbul, Turkey. Our study demonstrated a weak relationship between social comparison and hopelessness (r=-0.46, P < 0.000). The mean hopelessness score for the adolescents with visual impairment was 4.59 ± 3.12 (girls: 4.23 ± 3.10; boys: 4.83 ± 3.11) and social comparison score was 87.50 ± 11.19 (girls: 88.67 ± 11.62; boys: 86.60 ± 10.85). Hopelessness and social comparison were not affected by being blind from birth compared to later or from being a full-time boarding student compared to being a day student. The hopeless (Beck Hopelessness Scale score ≥ 9) adolescents' social comparison scores were found lower than hopeful ones' scores (P < 000). Factors affecting hopelessness and social comparison were feelings about their father, teacher and school.
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Affiliation(s)
- S Erol
- Community Health Nursing Department, Nursing Division, Faculty of Health Science, Marmara University, Uskudar, Istanbul, Turkey
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Beeken RJ, Spanos D, Fovargue S, Hunter R, Omar R, Hassiotis A, King M, Wardle J, Croker H. Piloting a manualised weight management programme (Shape Up-LD) for overweight and obese persons with mild-moderate learning disabilities: study protocol for a pilot randomised controlled trial. Trials 2013; 14:71. [PMID: 23497560 PMCID: PMC3605362 DOI: 10.1186/1745-6215-14-71] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 02/26/2013] [Indexed: 01/22/2023] Open
Abstract
Background National obesity rates have dramatically risen over the last decade. Being obese significantly reduces life expectancy, increases the risk of a range of diseases, and compromises quality of life. Costs to both the National Health Service and society are high. An increased prevalence of obesity in people with learning disabilities has been demonstrated. The consequences of obesity are particularly relevant to people with learning disabilities who are already confronted by health and social inequalities. In order to provide healthcare for all, and ensure equality of treatment for people with learning disabilities, services must be developed specifically with this population in mind. The aim of this project is to pilot the evaluation of a manualised weight management programme for overweight and obese persons with mild-moderate learning disabilities (Shape Up-LD). Methods/Design An individually randomised, controlled pilot trial in 60 overweight and obese (body mass index ≥ 25) adults (age ≥ 18) with mild-moderate learning disabilities and their carers will be carried out, comparing “Shape Up-LD” with usual care. The manualised Shape Up-LD intervention will involve 12 weekly sessions, which include healthy eating messages, advice on physical activity and use of behaviour change techniques to help people manage their weight. Assessments of participants will be conducted at baseline, 12 weeks and 6 months. Service users and their carers and service providers will also give their perspectives on the experience of Shape Up-LD in qualitative interviews at 12 weeks. Feasibility outcomes will include recruitment rates, loss to follow-up, compliance rates, completion rates, collection of information for a cost-effectiveness analysis and an estimation of the treatment effect on weight. Discussion The findings from this study will inform our preparation for a definitive randomised controlled trial to test the efficacy of the programme with respect to weight loss and maintenance in this population. Weight loss through Shape Up-LD could lead to improvements in health and quality of life. Costs to the National Health Service might be reduced through decreased overall service use because of improved health. The programme would also ensure a more equitable service for overweight service users with learning disabilities and fill the current gap in weight management services for this population. Trial registration International Standard Randomised Controlled Trial No ISRCTN39605930
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Affiliation(s)
- Rebecca J Beeken
- Department of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
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Johnson P. The prevalence of low self-esteem in an intellectually disabled forensic population. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2012; 56:317-325. [PMID: 21726326 DOI: 10.1111/j.1365-2788.2011.01447.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND This was a quantitative study to measure the prevalence low self-esteem in an intellectually disabled forensic population. The dependent variables used were the adapted six-item Rosenberg Self-Esteem Scale and the adapted Evaluative Beliefs Scale. It had a repeated measures design with independent variables including consideration of differences between the low and medium secure parts of the service, the influences of types of offences and the effects of disrupted childhood attachments. METHODS Forty-four male clients, with mild to borderline intellectual disabilities, were recruited. Data were collected by one key researcher during individual research interviews using the two structured instruments to measure self-esteem. Further data were then obtained from routinely recorded clinical information held on the hospital computer system. RESULTS Unexpectedly, the majority of clients scored as having moderate or high self-esteem on both self-esteem measures. There was a statistically significant positive correlation between the two scales. In all, 64% of the population studied had committed either sexual offences or fire setting offences. Contrary to expectation, those who had evidence of disrupted attachments had slightly higher self-esteem than those who had not experienced disrupted attachments. CONCLUSIONS Self-esteem is a complex personal concept with many influencing factors. Cognitive behaviour therapy has a unique role in realising and overcoming negative core beliefs and feelings of low self-worth. The offence types concurred with previously noted patterns of offending within the intellectually disabled forensic population.
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Affiliation(s)
- P Johnson
- Research & Development, Calderstones Partnership NHS Foundation Trust, Lancashire, UK.
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Werner S, Corrigan P, Ditchman N, Sokol K. Stigma and intellectual disability: a review of related measures and future directions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:748-765. [PMID: 22115915 DOI: 10.1016/j.ridd.2011.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 10/07/2011] [Accepted: 10/07/2011] [Indexed: 05/31/2023]
Abstract
The theoretical construct of stigma has received much attention in psychiatric disability research, leading to the development of widely used measures. Such measures have had real world impact in that they allow for the assessment of stigma change efforts. The study of stigma has not received the same level of attention for persons with intellectual disabilities. In this manuscript we evaluate existing measures of intellectual disability stigma through a systematic review of the literature. Twenty-four scales were reviewed and evaluated. Findings indicate a paucity of stigma measures based on theoretical conceptualizations pointing to a need for further development of measures to pursue the study of public, self, and family stigma as related to intellectual disability.
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Affiliation(s)
- Shirli Werner
- The Paul Baerwald School of Social Work and Social Welfare Hebrew University of Jerusalem Mount Scopus, Jerusalem 91905, Israel.
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36
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Anderson G, Kazantzis N. Social Problem-Solving Skills Training for Adults With Mild Intellectual Disability: A Multiple Case Study. BEHAVIOUR CHANGE 2012. [DOI: 10.1375/bech.25.2.97] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractSocial problem-solving training has been successful in improving maladaptive behaviour and problem-solving skills for individuals with intellectual disability. However, in contrast to individuals without intellectual disability there has been only one study that has examined whether social problem-solving training can improve psychological distress in individuals with intellectual disability and a psychiatric diagnosis. Three participants from a vocational community centre with mild intellectual disability, comorbid mental illness, and challenging behaviour, participated in 15 individually delivered sessions of social problem-solving training. Social problem-solving skill, behaviour, and psychological distress measures were used to assess outcome. All three participants showed improvement in social problem-solving skills, and two participants showed improvement in depression. Improvement was maintained at 4-week follow-up. The results provide preliminary evidence that social problem-solving training could be an effective intervention tool for the treatment of psychological distress in individuals with mild intellectual disability.
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Paterson L, McKenzie K, Lindsay B. Stigma, Social Comparison and Self-Esteem in Adults with an Intellectual Disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011; 25:166-76. [DOI: 10.1111/j.1468-3148.2011.00651.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Varsamis P, Agaliotis I. Profiles of self-concept, goal orientation, and self-regulation in students with physical, intellectual, and multiple disabilities: Implications for instructional support. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:1548-55. [PMID: 21377324 DOI: 10.1016/j.ridd.2011.01.054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 01/27/2011] [Indexed: 05/25/2023]
Abstract
The present study explored physical self-concept, goal orientation in sport, and self-regulation in regard to a motor task, in 75 secondary students with physical, intellectual, and multiple disabilities, who were educated in the same special education units. It was found that students with intellectual disabilities generally presented a positive profile in all three psychosocial constructs, whereas students with physical disabilities presented low scores in most measures. Students with multiple disabilities did not differ essentially from students with intellectual disability in regard to physical self-concept and goal orientation; however, they compared unfavorably to them regarding self-regulation. The delineation of a distinct and defendable profile of self-concept, goal orientation, and self-regulation for each disability group allows the formulation of proposals for the implementation of appropriate instructional programs for students belonging to the above mentioned categories.
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Affiliation(s)
- Panagiotis Varsamis
- Aristotle University of Thessaloniki, Primary Teachers' In-Service Training School, 29, Arcaiologikou Mouseiou, 54640 Thessaloniki, Greece.
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39
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Kock E, Molteno C, Mfiki N, Kidd M, Ali A, King M, Strydom A. Cross-Cultural Validation of a Measure of Felt Stigma in People with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011; 25:11-9. [DOI: 10.1111/j.1468-3148.2011.00644.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kilbane AL, Jahoda A. Therapy Expectations: Preliminary Exploration and Measurement in Adults with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1468-3148.2011.00630.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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41
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Willner P, Jahoda A, Rose J, Stenfert-Kroese B, Hood K, Townson JK, Nuttall J, Gillespie D, Felce D. Anger management for people with mild to moderate learning disabilities: study protocol for a multi-centre cluster randomized controlled trial of a manualized intervention delivered by day-service staff. Trials 2011; 12:36. [PMID: 21306624 PMCID: PMC3045902 DOI: 10.1186/1745-6215-12-36] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 02/09/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive behaviour therapy (CBT) is the treatment of choice for common mental health problems, but this approach has only recently been adapted for people with learning disabilities, and there is a limited evidence base for the use of CBT with this client group. Anger treatment is the one area where there exists a reasonable number of small controlled trials. This study will evaluate the effectiveness of a manualized 12-week CBT intervention for anger. The intervention will be delivered by staff working in the day services that the participants attend, following training to act as 'lay therapists' by a Clinical Psychologist, who will also provide supervision. METHODS/DESIGN This is a multi-centre cluster randomized controlled trial of a group intervention versus a 'support as usual' waiting-list control group, with randomization at the level of the group. Outcomes will be assessed at the end of the intervention and again 6-months later. After completion of the 6-month follow-up assessments, the intervention will also be delivered to the waiting-list groups. The study will include a range of anger/aggression and mental health measures, some of which will be completed by service users and also by their day service key-workers and by home carers. Qualitative data will be collected to assess the impact of the intervention on participants, lay therapists, and services, and the study will also include a service-utilization cost and consequences analysis. DISCUSSION This will be the first trial to investigate formally how effectively staff working in services providing day activities for people with learning disabilities are able to use a therapy manual to deliver a CBT based anger management intervention, following brief training by a Clinical Psychologist. The demonstration that service staff can successfully deliver anger management to people with learning disabilities, by widening the pool of potential therapists, would have very significant benefits in relation to the current policy of improving access to psychological therapies, in addition to addressing more effectively an important and often unmet need of this vulnerable client group. The economic analysis will identify the direct and indirect costs (and/or savings) of the intervention and consider these in relation to the range of observed effects. The qualitative analyses will enhance the interpretation of the quantitative data, and if the study shows positive results, will inform the roll-out of the intervention to the wider community. TRIAL REGISTRATION ISRCTN: ISRCTN37509773.
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Affiliation(s)
- Paul Willner
- Directorate of Learning Disability Services, Abertawe Bro Morgannwg University Health Board, and Dept of Psychology, Swansea University, UK.
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Forte M, Jahoda A, Dagnan D. An anxious time? Exploring the nature of worries experienced by young people with a mild to moderate intellectual disability as they make the transition to adulthood. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2011; 50:398-411. [DOI: 10.1111/j.2044-8260.2010.02002.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jahoda A, Dagnan D, Stenfert Kroese B, Pert C, Trower P. Cognitive behavioural therapy: from face to face interaction to a broader contextual understanding of change. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2009; 53:759-771. [PMID: 19627425 DOI: 10.1111/j.1365-2788.2009.01189.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Cognitive behavioural therapy (CBT) is increasingly used to address the emotional and interpersonal problems of people with ID. There is a limited but promising evidence base supporting this activity. However, these individuals face real and continuing challenges in their lives that have implications for their self and interpersonal perceptions. These adversities have implications for the adaptation of CBT. First, it may mean that characteristically negative perceptions may be more common and may be the result of a complex interaction with a truly aversive environment and should not simply be considered as cognitive distortions. Secondly, clients may have limited control over their everyday lives, with limited opportunity to negotiate change with their informal and formal sources of support. This review suggests that it is important to consider the interpersonal context of therapy both to ensure effective work within sessions and to enable real change in clients' everyday lives. The review draws upon Vygotsky's theory of the zone of proximal development and ecological models of change to consider the challenges of establishing collaborative relationships and the potential to use CBT within a broad psychosocial model. The aim is to offer a helpful framework for practitioners and to identify directions for future research.
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Affiliation(s)
- A Jahoda
- Section of Psychological Medicine, Division of Community Based Sciences, University of Glasgow, Glasgow, UK.
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Davis C, Kellett S, Beail N. Utility of the Rosenberg self-esteem scale. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2009; 114:172-178. [PMID: 19374464 DOI: 10.1352/1944-7558-114.3.172] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The Rosenberg Self-Esteem Scale (RSES) continues to be used to purportedly measure self-esteem of people with intellectual disabilities, despite the lack of sound evidence concerning its validity and reliability when employed with this population. The psychometric foundations of the RSES were analyzed here with a sample of 219 participants with intellectual disabilities. The factor analytic methods employed revealed two factors (Self-Worth and Self-Criticism) and more specific problems with RSES Items 5 and 8. Overall, this scale showed only moderate temporal and moderate internal reliability and poor aspects of criterion validity. Results are discussed with reference to either developing a new measure of self-esteem or redesigning and simplifying the RSES in order to increase its initial face validity in intellectual disability samples.
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Hartley SL, Maclean WE. Depression in adults with mild intellectual disability: role of stress, attributions, and coping. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2009; 114:147-60. [PMID: 19374469 PMCID: PMC2831402 DOI: 10.1352/1944-7588-114.3.147] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The experience of stressful social interactions, negative causal attributions, and the use of maladaptive coping efforts help maintain depression over time in the general population. We investigated whether a similar experience occurs among adults with mild intellectual disability. We compared the frequency and stress impact of such interactions, identified causal attributions for these interactions, and determined the coping strategies of 47 depressed and 47 nondepressed adults with mild intellectual disability matched on subject characteristics. The depressed group reported a higher frequency and stress impact of stressful social interactions, more negative attribution style, and more avoidant and less active coping strategies did than the nondepressed group. Findings have implications for theory building and development of psychotherapies to treat depression.
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46
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Emerson E, Hatton C. Chapter 4 Socioeconomic Position, Poverty, and Family Research. FAMILIES 2009. [DOI: 10.1016/s0074-7750(09)37004-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Hayes S. The Relationship Between Childhood Abuse, Psychological Symptoms and Subsequent Sex Offending. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2009. [DOI: 10.1111/j.1468-3148.2008.00459.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lunsky Y, Bradley EA, Gracey CD, Durbin J, Koegl C. Gender differences in psychiatric diagnoses among inpatients with and without intellectual disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2009; 114:52-60. [PMID: 19143463 DOI: 10.1352/2009.114:52-60] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities, women were more likely to have a diagnosis of mood disorder and sexual abuse history; men were more likely to have a substance abuse diagnosis, legal issues, and past destructive behavior. Gender difference patterns found for individuals with intellectual disabilities were similar to those of persons without intellectual disabilities, with the exception of eating disorder and psychotic disorder diagnoses. Gender issues should receive greater attention in intellectual disabilities inpatient care.
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Affiliation(s)
- Yona Lunsky
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Dagnan D. Psychological assessment with people with learning disabilities and mental ill‐health. ACTA ACUST UNITED AC 2008. [DOI: 10.1108/17530180200800033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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50
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Dagnan D, Jahoda A, McDowell K, Masson J, Banks P, Hare D. The psychometric properties of the Hospital Anxiety and Depressions Scale adapted for use with people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:942-949. [PMID: 18393957 DOI: 10.1111/j.1365-2788.2008.01053.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND There is increasing recognition of depression in people with intellectual disabilities (ID). There is a need to develop well-standardised self-report measures for both clinical and research purposes. This paper presents some psychometric properties of the Hospital Anxiety and Depression Scale (HADS) adapted for use with people with ID. The anhedonic emphasis in the depression scale of the HADS may be particularly useful for people with ID who present with high rates of physical co-morbidity. METHOD A total of 197 people with ID completed an adapted HADS; 32 participants also completed the Zung Depression Scale and 42 also completed the Glasgow Depression Scale. RESULTS The obtained factor structure is similar to the original form of the scale used with people without ID. However, the underlying question wording of the HADS, where most depression items are phrased positively and most anxiety items are phrased negatively, makes clear interpretation of the factor structure difficult. The HADS has an adequate internal reliability and correlates well with other self-report measures of depression. CONCLUSIONS The HADS may need further adaptation; however, the measurement of anhedonia is a useful addition to the self-report measures of depression available for people with ID.
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Affiliation(s)
- D Dagnan
- Cumbria Partnership NHS Foundation Trust, Community Learning Disabilities Service, The Old School, Main Street, Distington, Workington, Cumbria CA 14 5UJ, UK.
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