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Jahoda A, Dagnan D, Hastings R, Gillooly A, Miller J, Baines S, Hatton C. Adapting psychological interventions for people with severe and profound intellectual disabilities: A behavioural activation exemplar. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13199. [PMID: 38361369 DOI: 10.1111/jar.13199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/06/2023] [Accepted: 01/01/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND People with severe to profound intellectual disabilities experience similar or higher levels of depression than those with more mild intellectual disabilities. Yet, there is an absence of evidence about how to adapt existing psychological therapies for this population. METHOD A behavioural activation intervention (BeatIt) for people with mild to moderate intellectual disabilities was adapted for people with severe to profound intellectual disabilities and depression. Key considerations include: (i) beginning with a more in-depth assessment process; (ii) including the person in session activities and developing a relationship with them; (iii) formulation and the use of film to document the link between activity and mood; and (iv) addressing barriers to change at an individual and inter-personal level and considering how the carer could support the person's engagement in activity. RESULTS Successfully adapting BeatIt represents a first step towards gathering evidence about the effectiveness of behavioural activation for people with severe to profound intellectual disabilities.
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Affiliation(s)
- Andrew Jahoda
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Dave Dagnan
- Community Learning Disability Services, Cumbria Northumberland, Tyne and Wear NHS Foundation Trust, Workington, UK
| | - Richard Hastings
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - Amanda Gillooly
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jenny Miller
- Promoting A More Inclusive Society (PAMIS), Dundee, UK
| | - Susie Baines
- Division of Health Research, University of Lancaster, Lancaster, UK
| | - Chris Hatton
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
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Wallace D, Cooper NR, Sel A, Russo R. The social readjustment rating scale: Updated and modernised. PLoS One 2023; 18:e0295943. [PMID: 38109368 PMCID: PMC10727443 DOI: 10.1371/journal.pone.0295943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/02/2023] [Indexed: 12/20/2023] Open
Abstract
The Social Readjustment Rating Scale, originally devised in 1967 by Holmes and Rahe, measures the impact of life events stress. At the time, the SRRS advanced its field of research by standardising the impact of stress with a set of independently derived weights called 'life change units' (LCUs) for 43 life events found to predict illness onset. The scale has been criticised for being outdated, e.g. "Mortgage over $10,000" and biased, e.g. "Wife begin or stop work". The aim of this cross-sectional survey study is to update and improve the SRRS whilst allowing backwards compatibility. We successfully updated the SRRS norms/LCUs using the ratings of 540 predominantly UK adults aged 18 to 84. Moreover, we also updated wording of 12 SRRS items and evaluated the impact of demographics, personal experience and loneliness. Using non-parametric frequentist and Bayesian statistics we found that the updated weights were higher but broadly consistent with those of the original study. Furthermore, changes to item wording did not affect raters' evaluations relative to the original thereby ensuring cross-comparability with the original SRRS. The raters were not unduly influenced by their personal experiences of events nor loneliness. The target sample was UK rather than US-based and was proportionately representative regarding age, sex and ethnicity. Moreover, the age range was broader than the original SRRS. In addition, we modernised item wording, added one optional extra item to the end of the scale to evaluate the readjustment to living alone and identified 3 potential new items proposed by raters. Backwards-compatibility is maintained.
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Affiliation(s)
- Denise Wallace
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, Essex, United Kingdom
| | - Nicholas R. Cooper
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, Essex, United Kingdom
| | - Alejandra Sel
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, Essex, United Kingdom
| | - Riccardo Russo
- Department of Psychology and Centre for Brain Science, University of Essex, Colchester, Essex, United Kingdom
- Department of Behavioral and Brain Sciences, University of Pavia, Pavia, Italy
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Tapp K, Vereenooghe L, Hewitt O, Scripps E, Gray KM, Langdon PE. Psychological therapies for people with intellectual disabilities: An updated systematic review and meta-analysis. Compr Psychiatry 2023; 122:152372. [PMID: 36724728 DOI: 10.1016/j.comppsych.2023.152372] [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] [Received: 09/21/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis (PROSPERO 2020 CRD42020169323) was to evaluate the efficacy of psychological therapy for people with intellectual disabilities. METHOD A comprehensive literature search yielded 22,444 studies which were screened for eligibility. Studies were eligible for inclusion if a psychological therapy was delivered to people with intellectual disabilities compared to a group who did not receive the therapy. Thirty-three controlled trials were eligible for inclusion in the review, with 19 included within a DerSimonian-Laird random effects meta-analysis. Subgroup analysis was completed by clinical presentation, and by comparing randomised trials to non-randomised trials, and group-based to individually delivered psychotherapy. RESULTS Following the removal of outliers, psychological therapy for a range of mental health problems was associated with a small and significant effect size, g = 0.43, 95% CI [0.20, 0.67], N = 698. There was evidence of heterogeneity and bias due to studies with small sample sizes and a lack of randomisation. Non-randomised studies were associated with a large effect size, g = 0.90, 95% CI [0.47, 1.32], N = 174, while randomised studies were associated with a small effect size, g = 0.36, 95% CI [0.17, 0.55], N = 438, excluding outliers. Individually delivered psychological therapy was associated with a small and non-significant effect size, g = 0.32, 95% CI [-0.01, 0.65], N = 146, while group-based interventions were associated with a small and significant effect size, g = 0.37, 95% CI [0.05, 0.68], N = 361, again, excluding outliers. Psychological therapy for anger was associated with a moderate effect size, g = 0.60, 95% CI [0.26, 0.93], N = 324, while treatment for depression and anxiety was associated with a small and non-significant effect size, g = 0.38, 95% CI [-0.10, 0.85], N = 216, after outliers were removed. CONCLUSIONS Studies are fraught with methodological weaknesses limiting the ability to make firm conclusions about the effectiveness of psychological therapy for people with intellectual disabilities. Improved reporting standards, appropriately powered and well-designed trials, and greater consideration of the nature and degree of adaptations to therapy are needed to minimise bias and increase the certainty of conclusions.
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Affiliation(s)
- Katherine Tapp
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Leen Vereenooghe
- v. Bodelschwinghsche Stiftungen Bethel, Psychologischer Dienst, proWerk, Nazarethweg 4, 33617 Bielefeld, Germany
| | - Olivia Hewitt
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom; Berkshire Healthcare NHS Foundation Trust, Learning Disabilities Service, Erlegh House, Earley Gate, Whiteknights Road, Reading, Berkshire RG6 6BZ, United Kingdom
| | - Emma Scripps
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Kylie M Gray
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom; Department of Psychiatry, School of Clinical Health Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia; Centre for Mental Health and Wellbeing Research, University of Warwick, Coventry CV4 7AL, United Kingdom
| | - Peter E Langdon
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom; Brooklands Hospital, Coventry and Warwickshire Partnership NHS Trust, Birmingham B37 5RY, United Kingdom; Herefordshire and Worcestershire Health and Care NHS Trust, 2 Kings Way, Charles Hastings Way, Worcester WE5 1JR, United Kingdom; Centre for Mental Health and Wellbeing Research, University of Warwick, Coventry CV4 7AL, United Kingdom.
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Scheffers F, Moonen X, van Vugt E. External sources promoting resilience in adults with intellectual disabilities: A systematic literature review. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2022; 26:227-243. [PMID: 32985320 PMCID: PMC9016661 DOI: 10.1177/1744629520961942] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND Persons with an intellectual disability are at increased risk of experiencing adversities. The current study aims at providing an overview of the research on how resilience in adults with intellectual disabilities, in the face of adversity, is supported by sources in their social network. METHOD A literature review was conducted in the databases Psycinfo and Web of Science. To evaluate the quality of the included studies, the Mixed Method Appraisal Tool (MMAT) was used. RESULTS The themes: "positive emotions," "network acceptance," "sense of coherence" and "network support," were identified as sources of resilience in the social network of the adults with intellectual disabilities. CONCLUSION The current review showed that research addressing sources of resilience among persons with intellectual disabilities is scarce. In this first overview, four sources of resilience in the social network of people with intellectual disabilities were identified that interact and possibly strengthen each other.
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Affiliation(s)
- Femke Scheffers
- Femke Scheffers, Department of Behavioral
Expertise, MEE ZHN, Rijnsburgersingel 60, 2316 XX Leiden, The Netherlands.
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de Witte M, Kooijmans R, Hermanns M, van Hooren S, Biesmans K, Hermsen M, Stams GJ, Moonen X. Self-Report Stress Measures to Assess Stress in Adults With Mild Intellectual Disabilities-A Scoping Review. Front Psychol 2021; 12:742566. [PMID: 34759870 PMCID: PMC8573329 DOI: 10.3389/fpsyg.2021.742566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/22/2021] [Indexed: 11/24/2022] Open
Abstract
Stress has a major negative impact on the development of psychopathology and contributes to the onset of adverse physical conditions. Timely recognition and monitoring of stress-related problems are therefore important, especially in client populations that are more vulnerable to stress, such as people with mild intellectual disabilities (MID). Recent research on the use of physiological measures to assess stress levels emphasize that, in addition to these measures, self-report instruments are necessary to gain insight into the individual perception and impact of stress on daily life. However, there is no current overview of self-report stress measures that focus on the experience of stress in the present moment or in daily life. To provide an overview of the existing self-report stress measures for clinicians and researchers, a scoping review was conducted. In addition, to advise clinical professionals on the use of self-report measures of stress for people with MID, the results of an expert consultation were used to refine the preliminary findings. A systematic scoping literature search resulted in a total of 13 self-reported stress measures that met the final inclusion criteria, of which three were developed specifically for assessing stress in adults with MID (GAS-ID, LI, and SAS-ID). For each included self-report stress measure, the psychometric quality, assessment procedure, and suitability for adults with MID were reported. These were supplemented by the findings from the expert consultation. Implications for clinical practice on the use of self-report stress measures, particularly for people with MID, are discussed. Recommendations for future research and development are given.
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Affiliation(s)
- Martina de Witte
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Faculty of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
- Stevig, Expert Centre for People With Mild Intellectual Disabilities, Gennep, Netherlands
| | - Roel Kooijmans
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Koraal Center of Expertise, Sittard, Netherlands
| | - Maria Hermanns
- Faculty of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Susan van Hooren
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
- Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands
- Faculty of Psychology and Educational Sciences, Open University, Heerlen, Netherlands
| | - Kim Biesmans
- Stevig, Expert Centre for People With Mild Intellectual Disabilities, Gennep, Netherlands
| | - Maaike Hermsen
- Faculty of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Geert Jan Stams
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Xavier Moonen
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
- Koraal Center of Expertise, Sittard, Netherlands
- Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands
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de Witte M, Lindelauf E, Moonen X, Stams GJ, van Hooren S. Music Therapy Interventions for Stress Reduction in Adults With Mild Intellectual Disabilities: Perspectives From Clinical Practice. Front Psychol 2020; 11:572549. [PMID: 33362637 PMCID: PMC7759728 DOI: 10.3389/fpsyg.2020.572549] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/02/2020] [Indexed: 01/16/2023] Open
Abstract
Stress is increasingly being recognized as one of the main factors that is negatively affecting our health, and therefore there is a need to regulate daily stress and prevent long-term stress. This need seems particularly important for adults with mild intellectual disabilities (MID) who have been shown to have more difficulties coping with stress than adults without intellectual disabilities. Hence, the development of music therapy interventions for stress reduction, particularly within populations where needs may be greater, is becoming increasingly important. In order to gain more insight into the practice-based knowledge on how music therapists lower stress levels of their patients with MID during music therapy sessions, we conducted focus group interviews with music therapists working with adults with MID (N = 13) from different countries and clinical institutions in Europe. Results provide an overview of the most-used interventions for stress reduction within and outside of music. Data-analysis resulted in the further specification of therapeutic goals, intervention techniques, the use of musical instruments, and related therapeutic change factors. The main findings indicate that music therapists used little to no receptive (e.g., music listening) interventions for stress reduction, but preferred to use active interventions, which were mainly based on musical improvisation. Results show that three therapy goals for stress relief could be distinguished. The goal of “synchronizing” can be seen as a sub goal because it often precedes working on the other two goals of “tension release” or “direct relaxation,” which can also be seen as two ways of reaching stress reduction in adults with MID through music therapy interventions. Furthermore, the tempo and the dynamics of the music are considered as the most important musical components to reduce stress in adults with MID. Practical implications for stress-reducing music therapy interventions for adults with MID are discussed as well as recommendations for future research.
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Affiliation(s)
- Martina de Witte
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Academy of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands.,Stevig, Expert Centre for People with Mild Intellectual Disabilities, Gennep, Netherlands.,KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands
| | - Esther Lindelauf
- Academy of Health and Vitality, HAN University of Applied Sciences, Nijmegen, Netherlands
| | - Xavier Moonen
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands.,Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands
| | - Geert-Jan Stams
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Susan van Hooren
- KenVaK, Research Centre for the Arts Therapies, Heerlen, Netherlands.,Faculty of Healthcare, Zuyd University of Applied Sciences, Heerlen, Netherlands.,Faculty of Psychology and Educational Sciences, Open University, Heerlen, Netherlands
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8
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Syed AA, Neelofur S, Moran A, O'Reilly G. Investigating the potential clinical utility of therapeutic techniques based on eidetic imagery as adapted by the Eidetic Model of Growth (EMG) for people with intellectual disability (ID). Heliyon 2020; 6:e05115. [PMID: 33033764 PMCID: PMC7533367 DOI: 10.1016/j.heliyon.2020.e05115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/07/2020] [Accepted: 09/25/2020] [Indexed: 11/03/2022] Open
Abstract
Eidetic model of growth (EMG) is a form of psychotherapy developed for people with intellectual disabilities (ID). EMG is based on the theoretical tenets of eidetic psychotherapy of Akhter Ahsen, which uses eidetic imagery as its major therapeutic tool. The literature review did not find any empirical study on eidetic imagery-based psychotherapy for people with ID except reviews and case histories. This study investigates the clinical utility of therapeutic techniques based on eidetic imagery as developed by Ahsen and Syed. In this study thirty participants with mild and moderate ID were recruited. Participants were recruited from the services for people with ID. These services were contacted to recruit participants who had experiential (i.e., abuse, trauma etc.), emotional (i.e., bereavement, attachment problems), psychiatric (i.e., anxiety, depression) and behavioural (i.e., anger, aggression) problems and to seek consent from the potential participants. The Anxiety Depression and Mood Scale (ADAMS) was administered to the participants before the therapy started, after every 5th session and once the therapy was terminated. The statistical analysis of the pre-therapy and post-therapy scores of participants on the ADAMS was carried out to measure the therapeutic outcome. Paired-sample t-test revealed a significant difference between the pre-therapy and post-therapy scores of participants on ADAMS, with a large effect size (d = 1.54). The result indicates existence of eidetic imagery in people with ID and its promising therapeutic utility.
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Evans L, Randle-Phillips C. People with intellectual disabilities' experiences of psychological therapy: A systematic review and meta-ethnography. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2020; 24:233-252. [PMID: 30003831 DOI: 10.1177/1744629518784359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The effectiveness of a range of psychological models adapted for use with people with intellectual disabilities has been well documented. A number of studies have used qualitative methods to examine people with intellectual disabilities' experiences of these adapted interventions. Such research is important for identifying service users' views on the helpful and challenging aspects of psychological interventions to ensure that they meet the needs of people with intellectual disabilities. To consolidate this research, a systematic review using a meta-ethnographic approach was undertaken. A systematic search identified 16 relevant studies. These studies were reviewed, critically appraised and key themes were extracted. Five key concepts were identified: adapting to therapy, the therapeutic environment, group dynamics, the therapeutic relationship and the impact of therapy on life. The need for further consideration of power differentials within the therapeutic relationship and further adaptations to ensure accessibility of therapy for people with intellectual disabilities is discussed.
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Gormez A, Kurtulmus A, Ince Z, Torun P, Uysal O, Cıtak S. Psychiatric symptoms, challenging behaviour and utilization of psychiatric services among adults with intellectual disabilities in Turkey. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1038-1048. [PMID: 32207206 DOI: 10.1111/jar.12726] [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: 04/06/2019] [Revised: 02/14/2020] [Accepted: 02/27/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND The aim of this study was to investigate the prevalence of and the factors associated with psychiatric symptoms (PS) and challenging behaviour (CB) in adults with intellectual disabilities, and the utilization of psychiatric services in Turkey. METHOD Psychiatric Assessment Schedule for Adults with Developmental Disorders Checklist-Revised was used for PS and a structured form for other variables in 771 participants. RESULTS Of the participants, 50.1% had PS and 36.4% presented with CB. Multivariate analysis revealed that a higher level of needs, better verbal ability, residential living, incontinence and CB, and lifetime suicidal ideation/attempt were independently associated with PS. For CB, it emerged as male carer, PS, lifetime suicidal attempt/ideation, lower level of verbal ability and autism spectrum disorder. Barriers were experienced by 64.7% of participants within the previous year. CONCLUSIONS Psychiatric symptoms and CB seem to be problems for a significant proportion of adults with intellectual disabilities in Turkey, and there are certain barriers to psychiatric services.
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Affiliation(s)
- Aynur Gormez
- Department of Psychiatry, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ayse Kurtulmus
- Department of Psychiatry, Bezmialem Vakif University, Istanbul, Turkey
| | - Zeynep Ince
- Bagcilar Basak Special Education and Rehabilitation Centre, Istanbul, Turkey
| | - Perihan Torun
- Department of Public Health, Bezmialem Vakif University, Istanbul, Turkey
| | - Omer Uysal
- Department of Statistics, Bezmialem Vakif University, Istanbul, Turkey
| | - Serhat Cıtak
- Department of Psychiatry, Istanbul Medeniyet University, Istanbul, Turkey
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Longtin V, Dufour S, Morin D. Typology of Community Living Transitions for People with Intellectual Disabilities: Are Current Experience in Rehabilitation Centers Tied to the Best Practices? JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2020. [DOI: 10.1111/jppi.12331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Véronique Longtin
- Quebec Services of Expertise in Severe Challenging Behavior Montreal QC Canada
- Université de Montreal Montreal QC Canada
| | | | - Diane Morin
- Université du Québec à Montréal Montreal QC Canada
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Schepens HR, Van Puyenbroeck J, Maes B. “One does not forget, it all comes back”: elderly people with intellectual disability review adversities and stress-protection in their lives. QUALITY IN AGEING AND OLDER ADULTS 2019. [DOI: 10.1108/qaoa-11-2018-0061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
People with intellectual disability are reported to encounter many negative life events during their increasingly long lives. In the absence of protective elements, these may cause toxic stress and trauma. Given the reported negative effects of such adverse events on their quality of life (QoL), the perspective of older people with intellectual disability themselves may be of relevance. The paper aims to discuss these issues.
Design/methodology/approach
The authors questioned nine participants with mild intellectual disability, aged 61–88 years old, in four 90-min focus group sessions and thematically analysed the data.
Findings
Many recent and bygone negative life events still weighed heavily on the participants. Negative interactions, experiences of loss, lack of control and awareness of one’s disability caused stress. Their emotional response contrasted with their contentment, compliance and resilience. Having (had) good relationships, having learnt coping skills, remaining active, talking about past experiences and feeling free of pain, safe, well supported, capable, respected and involved seemed to heighten resilience and protect participants from toxic stress.
Research limitations/implications
Monitoring and preventing adverse (childhood) experiences, supporting active/emotional coping strategies, psychotherapy and life story work may facilitate coping with negative events and enhance QoL of elderly people with intellectual disability.
Originality/value
Elderly people with mild intellectual disability run a higher risk of experiencing (early) adverse events in life. They are very capable of talking about their experiences, QoL, and the support they need. Focus groups were a reliable method to capture their insights.
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Shimoyama M, Iwasa K, Sonoyama S. The prevalence of mental health problems in adults with intellectual disabilities in Japan, associated factors and mental health service use. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:931-940. [PMID: 29968366 DOI: 10.1111/jir.12515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/15/2018] [Accepted: 06/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND People with intellectual disabilities are more likely than people in the general population to experience life events associated with an increased risk of mental health problems. However, there has been little research in Japan on the prevalence of mental health problems in adults with intellectual disability (ID) or on associated factors and access to relevant services. METHODS Informants completed the Japanese version of the Psychiatric Assessment Schedule for Adults with Developmental Disabilities Checklist, and questions on the use of mental health services, for 126 adults with ID living in Tokyo. RESULTS A total of 23.8% of adults with ID had scores above the Psychiatric Assessment Schedule for Adults with Developmental Disabilities Checklist threshold score. Mental health problems were associated with age, gender and life events and not associated with the level of ID or living environment. Approximately 60% of participants with mental health problems were treated by psychiatrists and 6% of them received psychotherapy. CONCLUSION In the present study, mental health problems occurred in adults with ID at similar frequencies as in previous studies. Adults with ID who experienced mental health problems tended to receive less psychological therapy than the general Japanese population experiencing such problems. This result may indicate poor provision of psychological services for people with intellectual disabilities in Japan.
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Affiliation(s)
- M Shimoyama
- Faculty of Education, Shinshu University, Nagano, Japan
| | - K Iwasa
- Department of Educational Psychology, Shujitsu University, Okayama, Japan
| | - S Sonoyama
- Faculty of Human Sciences, University of Tsukuba, Ibaraki, Japan
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Axmon A, Björne P, Nylander L, Ahlström G. Psychiatric diagnoses in relation to severity of intellectual disability and challenging behaviors: a register study among older people. Aging Ment Health 2018; 22:1344-1350. [PMID: 28825845 DOI: 10.1080/13607863.2017.1348483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the possible association between severity of intellectual disability (ID) and presence of challenging behavior, respectively, on diagnoses of psychiatric disorders among older people with ID. METHODS People with a diagnosis of ID in inpatient or specialist outpatient care in 2002-2012 were identified (n = 2147; 611 with mild ID, 285 with moderate ID, 255 with severe or profound ID, and 996 with other/unspecified ID). Moreover, using impairment of behavior as a proxy for challenging behavior, 627 people with, and 1514 without such behavior were identified. RESULTS Severe/profound ID was associated with lower odds of diagnoses of psychotic, affective, and anxiety disorders than was mild/moderate ID. People with moderate ID had higher odds than those with mild ID of having diagnoses of affective disorders. Diagnoses of psychotic, affective, and anxiety disorders, and dementia were more common among people with challenging behavior than among those without. CONCLUSIONS People with severe/profound ID had lower odds of receiving psychiatric diagnoses than those with mild and moderate ID. Whether this is a result of differences in prevalence of disorders or diagnostic difficulties is unknown. Further, challenging behaviors were associated with diagnoses of psychiatric disorders. However, the nature of this association remains unclear.
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Affiliation(s)
- A Axmon
- a Department of Occupational and Environmental Medicine , Lund University , Lund , Sweden
| | - P Björne
- b Research and Development Unit, City Office , City of Malmö , Malmö , Sweden
| | - L Nylander
- c Department of Clinical Sciences/Psychiatry , Lund University , Lund , Sweden , and Gillberg Neuropsychiatry Centre , University of Gothenburg , Gothenburg , Sweden
| | - G Ahlström
- d Department of Health Sciences, Faculty of Medicine , Lund University , Lund , Sweden
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Mason-Roberts S, Bradley A, Karatzias T, Brown M, Paterson D, Walley R, Truesdale M, Taggart L, Sirisena C. Multiple traumatisation and subsequent psychopathology in people with intellectual disabilities and DSM-5 PTSD: a preliminary study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:730-736. [PMID: 29856097 DOI: 10.1111/jir.12505] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/18/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Individuals with intellectual disability (ID) are at greater risk of exposure to traumatic life events compared with the non-ID population. Yet no study to date has examined the role of multiple traumatisation and subsequent psychopathology in people with ID. The aim of this study was to explore the association between multiple traumatisation and subsequent mental health. METHODS A preliminary cross-sectional study involving 33 participants with DSM-5 post-traumatic stress disorder completed self-report questionnaires on exposure to traumatic life events and post-traumatic stress disorder symptoms, anxiety, depression and general distress. RESULTS A proportion of 42.4% of the sample reported multiple traumatisation, including exposure to life events in both childhood and adulthood. Those who reported exposure to life events in childhood and adulthood reported significantly higher risk of harm, depression and general psychological distress compared with those who reported exposure to life events only in adulthood. CONCLUSIONS Preliminary results indicate that more severe psychopathology is associated with multiple traumatisation in childhood and adulthood compared with trauma experienced solely in adulthood.
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Affiliation(s)
- S Mason-Roberts
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - A Bradley
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - T Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - M Brown
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - D Paterson
- Learning Disability Service, NHS Ayrshire & Arran, Crosshouse, UK
| | - R Walley
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - M Truesdale
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - L Taggart
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Newtownabbey, UK
| | - C Sirisena
- Learning Disability Service, NHS Borders, Newstead, UK
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Vereenooghe L, Flynn S, Hastings RP, Adams D, Chauhan U, Cooper SA, Gore N, Hatton C, Hood K, Jahoda A, Langdon PE, McNamara R, Oliver C, Roy A, Totsika V, Waite J. Interventions for mental health problems in children and adults with severe intellectual disabilities: a systematic review. BMJ Open 2018; 8:e021911. [PMID: 29921688 PMCID: PMC6020952 DOI: 10.1136/bmjopen-2018-021911] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment options have received little attention. The aim of this study was to identify and evaluate the effectiveness of pharmacological and psychological interventions in the treatment of mental health problems in children and adults with severe and profound intellectual disabilities, given their difficulties in accessing standard mental health interventions, particularly talking therapies, and difficulties reporting drug side effects. DESIGN A systematic review using electronic searches of PsycINFO, PsycTESTS, EMBASE, MEDLINE, CINAHL, ERIC, ASSIA, Science Citation Index, Social Science Citation Index and CENTRAL was conducted to identify eligible intervention studies. Study selection, data extraction and quality appraisal were performed by two independent reviewers. PARTICIPANTS Study samples included at least 70% children and/or adults with severe or profound intellectual disabilities or reported the outcomes of this subpopulation separate from participants with other levels of intellectual disabilities. INTERVENTIONS Eligible intervention studies evaluated a psychological or pharmacological intervention using a control condition or pre-post design. OUTCOMES Symptom severity, frequency or other quantitative dimension (e.g., impact), as assessed with standardised measures of mental health problems. RESULTS We retrieved 41 232 records, reviewed 573 full-text articles and identified five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two studies evaluating psychological interventions. Study designs ranged from double-blind placebo controlled crossover trials to single-case experimental reversal designs. Quality appraisals of this very limited literature base revealed good experimental control, poor reporting standards and a lack of follow-up data. CONCLUSIONS Mental ill health requires vigorous treatment, yet the current evidence base is too limited to identify with precision effective treatments specifically for children or adults with severe and profound intellectual disabilities. Clinicians therefore must work on the basis of general population evidence, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities. PROSPERO REGISTRATION NUMBER CRD 42015024469.
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Affiliation(s)
- Leen Vereenooghe
- Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Samantha Flynn
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Dawn Adams
- Autism Centre of Excellence, Griffith University, Brisbane, Queensland, Australia
| | - Umesh Chauhan
- Mackenzie Chair in Primary Care Medicine, School of Medicine, University of Central Lancashire, Preston, UK
| | - Sally-Ann Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nick Gore
- Tizard Centre, University of Kent, Canterbury, UK
| | - Chris Hatton
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Kerry Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Andrew Jahoda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | | | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Ashok Roy
- Brooklands Hospital, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Vasiliki Totsika
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Centre for Education Studies, University of Warwick, Coventry, UK
| | - Jane Waite
- School of Life & Health Sciences, Aston University, Birmingham, UK
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A case series to examine whether people with learning disabilities can learn prerequisite skills for cognitive behavioural therapy. COGNITIVE BEHAVIOUR THERAPIST 2018. [DOI: 10.1017/s1754470x1700023x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractAlthough cognitive behavioural therapy (CBT) is recommended for the treatment of a number of mental disorders among the general population, the ability of individuals with learning disabilities (LD) to understand CBT concepts and engage in CBT has been questioned. Aims: To examine whether specific prerequisite skills for CBT can be taught to people with LD using a newly developed training intervention and to investigate the acceptability of the intervention. Method: The study adopted a within-subjects case series research design. Quantitative assessment methods were used to evaluate the CBT skills of six adults with mild to moderate LD pre-intervention, following intervention and at 1-week follow-up. Participants were also asked to provide some qualitative feedback about how they had experienced the intervention. Results: The cognitive mediation skills and the ability of most participants to link activating events to emotions increased following intervention training and this improvement was maintained for four of them at follow-up. The feedback of participants regarding the process and content of the task demands was positive. Conclusions: The findings suggest that people with LD can learn some of the skills considered necessary to participate in CBT, such as cognitive mediation. However, further and more robust research is required to substantiate these findings.
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Hove O, Assmus J, Braatveit K, Havik OE. Inter-rater reliability of professional-caregiver-reported life events in adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:697-706. [PMID: 28612474 DOI: 10.1111/jir.12386] [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: 10/21/2016] [Revised: 02/17/2017] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The inter-rater reliability (IRR) of the measure of life events in adults with intellectual disabilities was investigated. METHOD Two staff members for each of 79 adults with intellectual disabilities (ID) living in group homes used a checklist to report the adults' exposure to and intensity of life events over the previous 12 months. The IRR was estimated with intraclass correlation analysis (ICC). The factors of the level of ID, number of years the rater knew the rated person and quality of community care were investigated for possible associations with level of reliability. RESULTS The ICC values for the occurrence of life events were .44-.80 depending on the category of life events. In general, intensity measures showed lower ICC values. When the rater had known the person rated for 2 or more years or the quality of community care was high, the ICC values increased, whereas lower levels of ID were associated with lower ICC values. CONCLUSIONS Inter-rater reliability in general was found to be acceptable. Further development and research are needed to improve the reliability of life event measures for more severe ID.
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Affiliation(s)
- O Hove
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - J Assmus
- Center for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - K Braatveit
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - O E Havik
- Department of Clinical Psychology, Universitetet i Bergen, Bergen, Norway
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Medina Gómez B, Gil Ibáñez R. Estrés y estrategias de afrontamiento en personas con discapacidad intelectual: revisión sistemática. ANSIEDAD Y ESTRÉS 2017. [DOI: 10.1016/j.anyes.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hove O, Assmus J, Havik OE. Type and Intensity of Negative Life Events Are Associated With Depression in Adults With Intellectual Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:419-431. [PMID: 27611352 DOI: 10.1352/1944-7558-121.5.419] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study investigated the associations between types and intensity of life events and symptoms of depression among adults with intellectual disabilities. A community sample (N = 593) was screened for current depression and exposure to life events (i.e., loss, illness, change, and bullying) during the previous 12 months. Symptoms of depression were measured using the Psychopathology Checklists for Adults With Intellectual Disabilities. Exposure to three of the four types of life events studied (loss, illness, and bullying) and the intensity of the events were associated with depression, particularly in the cases of loss of relatives and bullying. Quality of care moderated the association between bullying and depression and may buffer the adverse consequences of bullying.
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Affiliation(s)
- Oddbjørn Hove
- Oddbjørn Hove, Department of Research and Innovation, Helse Fonna HF, and Department of Clinical Psychology, University of Bergen, Norway; Jörg Assmus, Center for Clinical Research, Haukeland University Hospital, Norway; and Odd E. Havik, Department of Clinical Psychology, University of Bergen, Norway
| | - Jörg Assmus
- Oddbjørn Hove, Department of Research and Innovation, Helse Fonna HF, and Department of Clinical Psychology, University of Bergen, Norway; Jörg Assmus, Center for Clinical Research, Haukeland University Hospital, Norway; and Odd E. Havik, Department of Clinical Psychology, University of Bergen, Norway
| | - Odd E Havik
- Oddbjørn Hove, Department of Research and Innovation, Helse Fonna HF, and Department of Clinical Psychology, University of Bergen, Norway; Jörg Assmus, Center for Clinical Research, Haukeland University Hospital, Norway; and Odd E. Havik, Department of Clinical Psychology, University of Bergen, Norway
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Taylor JL, Gotham KO. Cumulative life events, traumatic experiences, and psychiatric symptomatology in transition-aged youth with autism spectrum disorder. J Neurodev Disord 2016; 8:28. [PMID: 27468315 PMCID: PMC4962443 DOI: 10.1186/s11689-016-9160-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/17/2016] [Indexed: 11/30/2022] Open
Abstract
Background Co-occurring mood and anxiety symptomatology is commonly observed among youth with autism spectrum disorders (ASD) during adolescence and adulthood. Yet, little is known about the factors that might predispose youth with ASD to mood and anxiety problems. In this study, we focus on the role of cumulative stressful life events and trauma in co-occurring psychopathology among youth with ASD who are preparing to exit high school. Specifically, we examined the distribution of cumulative life events and traumatic experiences and their relations with mood and anxiety symptomatology. Methods Participants included 36 youth with ASD, all of whom were in their last year of high school. Cumulative life events and trauma were assessed by parent report. Mood and anxiety symptomatology was determined using a variety of methods (structured interview, questionnaire, self- and informant report). Frequencies were used to examine the distributions of cumulative life events (count of total events) and trauma (coded into any trauma vs. no trauma), as well as mood and anxiety symptomatology (categorized into clinical-level, sub-threshold, or none for each). Bivariate relations between life events/trauma and mood/anxiety symptomatology were assessed using analysis of variance and chi-square. Ordinal logistic regression models were used to test whether significant bivariate relations remained after controlling for the sex of the youth with ASD and his/her IQ. Results Over 50 % of youth had experienced at least one trauma. Nearly one half had clinical-level mood or anxiety symptomatology. There was a statistically significant relation between absence/presence of trauma and mood symptomatology; nearly 90 % of the youth with clinical-level mood symptoms had at least one trauma, compared to 40 % of those with no mood symptomatology. Conclusions Our findings suggest that contextual factors such as trauma might be important for the development of mood symptomatology in individuals with ASD. Although this idea is well-accepted in typically developing populations, contextual factors are rarely studied in investigations of psychopathology or transition outcomes in ASD. Given the high rates of psychiatric comorbidities in this population, future research should continue to identify the range of possible factors—both behavioral and contextual—that might influence the emergence of these disorders. Electronic supplementary material The online version of this article (doi:10.1186/s11689-016-9160-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julie Lounds Taylor
- Department of Pediatrics and Vanderbilt Kennedy Center, Vanderbilt University School of Medicine, PMB 40 - 230 Appleton Pl., Nashville, TN 37203 USA
| | - Katherine O Gotham
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University School of Medicine, Vanderbilt Kennedy Center, 1200 21st Ave. S, suite 2272, Nashville, TN 37203 USA
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Weiss JA, Ting V, Perry A. Psychosocial correlates of psychiatric diagnoses and maladaptive behaviour in youth with severe developmental disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:583-593. [PMID: 27073035 DOI: 10.1111/jir.12278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND We know little about the correlates of mental health problems in youth with severe and profound intellectual disability (ID), as most research includes these youth within larger samples that include greater proportions of mild and moderate disability. The purpose of the current study was to identify the child, family and psychosocial characteristics that were associated with the presence of psychiatric diagnoses and maladaptive behaviour in youth with severe ID. METHODS Participants were 141 parents of youth with severe or profound levels of ID, 4 to 18 years of age. The mean age of children was 11.04 years (SD = 3.38), with 68% male and 39% with autism spectrum disorder (ASD). Parents completed a primarily online survey of child and family characteristics, negative life events, family quality of life and their own mental health. RESULTS Logistic regression analyses revealed that youth with a psychiatric diagnosis had higher levels of adaptive behaviour and experienced more negative life events than youth without psychiatric diagnosis, while the presence of clinically significant maladaptive behaviour was related to higher levels of adaptive behaviour, parents' mental health problems and lower family quality of life. Child age, gender, ASD status and financial hardship were not related to either outcome variable. CONCLUSIONS Youth with severe and profound ID who experience psychosocial stressors are more likely reported to have mental health problems than youth without such stressors. It is likely that a combination of child and family based interventions, along with with policies that address larger systemic issues of social adversity, are needed to promote mental health and treat psychopathology when it arises.
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Affiliation(s)
- J A Weiss
- York University, Department of Psychology, Toronto, ON, Canada
| | - V Ting
- York University, Department of Psychology, Toronto, ON, Canada
| | - A Perry
- York University, Department of Psychology, Toronto, ON, Canada
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Kurtek P. Role of Anxiety as a Trait and State in Youth With Mild Intellectual Disability: Coping With Difficult Situations. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12150] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Using computers to teach people with intellectual disabilities to perform some of the tasks used within cognitive behavioural therapy: A randomised experiment. Behav Res Ther 2015; 76:13-23. [PMID: 26600556 DOI: 10.1016/j.brat.2015.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 10/07/2015] [Accepted: 11/04/2015] [Indexed: 11/22/2022]
Abstract
AIMS Training has been shown to improve the ability of people with intellectual disabilities (IDs) to perform some cognitive behavioural therapy (CBT) tasks. This study used a computerised training paradigm with the aim of improving the ability of people with IDs to: a) discriminate between behaviours, thoughts and feelings, and b) link situations, thoughts and feelings. METHODS Fifty-five people with mild-to-moderate IDs were randomly assigned to a training or attention-control condition in a single-blind mixed experimental design. Computerised tasks assessed the participants' skills in: (a) discriminating between behaviours, thoughts and feelings (separately and pooled together), and (b) cognitive mediation by selecting appropriate emotions as consequences to given thoughts, and appropriate thoughts as mediators of given emotions. RESULTS Training significantly improved ability to discriminate between behaviours, thoughts and feelings pooled together, compared to the attention-control condition, even when controlling for baseline scores and IQ. Large within-group improvements in the ability to identify behaviours and feelings were observed for the training condition, but not the attention-control group. There were no significant between-group differences in ability to identify thoughts, or on cognitive mediation skills. CONCLUSIONS A single session of computerised training can improve the ability of people with IDs to understand and practise CBT tasks relating to behaviours and feelings. There is potential for computerised training to be used as a "primer" for CBT with people with IDs to improve engagement and outcomes, but further development on a specific computerised cognitive mediation task is needed.
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Flynn S, Hulbert-Williams N, Hulbert-Williams L, Bramwell R. Psychosocial experiences of chronic illness in individuals with an intellectual disability: A systematic review of the literature. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2015; 19:178-194. [PMID: 25567097 DOI: 10.1177/1744629514565680] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Increased life expectancy has led to an increase in diagnoses of chronic illness in people with an intellectual disability; despite this increase, research about the psychological impact is rare. This review explored the psychosocial experiences of chronic illness in adults with an intellectual disability, revealing potential predictors and moderators of these experiences. METHODS Online databases were systematically searched to identify relevant literature, using predefined inclusion criteria. Of the 25,058 titles initially identified, 4 were included, that is, those collecting data on people with an intellectual disability and diagnosed with cancer (n = 2), chronic pain (n = 1) and diabetes (n = 1). RESULTS Narrative synthesis of the data identified six themes, namely, (1) delayed diagnosis, (2) information, communication and understanding, (3) negative psychological consequences, (4) negative physical consequences, (5) social perception and (6) social support. CONCLUSIONS There are unmet needs within this population, including a lack of assistance in understanding their illness. A substantial gap in the literature should be addressed through further empirical work.
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Vereenooghe L, Reynolds S, Gega L, Langdon PE. Can a computerised training paradigm assist people with intellectual disabilities to learn cognitive mediation skills? A randomised experiment. Behav Res Ther 2015; 71:10-9. [PMID: 26004217 DOI: 10.1016/j.brat.2015.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 05/13/2015] [Accepted: 05/14/2015] [Indexed: 11/28/2022]
Abstract
AIMS The aim was to examine whether specific skills required for cognitive behavioural therapy (CBT) could be taught using a computerised training paradigm with people who have intellectual disabilities (IDs). Training aimed to improve: a) ability to link pairs of situations and mediating beliefs to emotions, and b) ability to link pairs of situations and emotions to mediating beliefs. METHOD Using a single-blind mixed experimental design, sixty-five participants with IDs were randomised to receive either computerised training or an attention-control condition. Cognitive mediation skills were assessed before and after training. RESULTS Participants who received training were significantly better at selecting appropriate emotions within situation-beliefs pairs, controlling for baseline scores and IQ. Despite significant improvements in the ability of those who received training to correctly select intermediating beliefs for situation-feelings pairings, no between-group differences were observed at post-test. CONCLUSIONS The findings indicated that computerised training led to a significant improvement in some aspects of cognitive mediation for people with IDs, but whether this has a positive effect upon outcome from therapy is yet to be established.
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Affiliation(s)
- Leen Vereenooghe
- Department of Psychological Sciences, Norwich Medical School, University of East Anglia, UK
| | | | | | - Peter E Langdon
- Tizard Centre, University of Kent, UK; Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust, Norfolk, UK
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Conder JA, Mirfin-Veitch BF, Gates S. Risk and Resilience Factors in the Mental Health and Well-Being of Women with Intellectual Disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 28:572-83. [DOI: 10.1111/jar.12153] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 12/01/2022]
Affiliation(s)
| | | | - Sue Gates
- Donald Beasley Institute; Dunedin New Zealand
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Emerson E, Brigham P. Exposure of children with developmental delay to social determinants of poor health: cross-sectional case record review study. Child Care Health Dev 2015; 41:249-57. [PMID: 24797435 DOI: 10.1111/cch.12144] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research on child development in general has highlighted the importance that the family environment plays in mediating the pathway between exposure to low socio-economic position (SEP) and child well-being. While child developmental models in intellectual disability have highlighted the interplay between social context, family environment and child development, little empirical work has attempted to formally evaluate the evidence in support of specific mediating pathways between low SEP and child outcomes. METHODS Secondary analysis of cross-sectional confidentialized needs analysis data collected in three Primary Care Trusts in England covering a total population of 1.25 million people. Case record reviews were undertaken for 46 023 households, 2236 (4.9%) of which contained a child in the target age range with developmental delay. RESULTS Children with developmental delay, when compared with their non-disabled peers, were at significantly increased risk of poorer health outcomes and of being exposed to a wide range of social determinants of poor health. Controlling for between-group differences in exposure to social determinants of poor health reduced the risk of developmental delay being associated with poorer health outcomes by 45% for behaviour problems and 89% for risk of significant harm. For children with developmental delay, parenting difficulties appears to play a particularly significant role in partially mediating the effects of low SEP. CONCLUSIONS The findings of the present study point to the potential effectiveness of family-focused early intervention to prevent the emergence and escalation of behavioural difficulties and health problems in children with developmental delay.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, University of Sydney, Sydney, NSW, Australia
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Scott HM, Havercamp SM. Mental health for people with intellectual disability: the impact of stress and social support. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 119:552-64. [PMID: 25354124 DOI: 10.1352/1944-7558-119.6.552] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A large, nationally representative sample from a preexisting dataset, the National Core Indicators, was used to examine the impact of stress and social support on the mental health of adults with intellectual disability (ID). Stress was significantly correlated with both mental illness and severity of behavior problems, with each additional stressor increasing the odds of poor mental health by 20%. This relationship held, even after controlling for level of ID, gender, and place of residence. Lack of social support was associated with having a mental illness; individuals who lacked social support were twice as likely to have a mental illness. The importance of considering these factors in the prevention, diagnosis, and treatment of mental health in this population is discussed.
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Hall JC, Jobson L, Langdon PE. Measuring symptoms of post-traumatic stress disorder in people with intellectual disabilities: The development and psychometric properties of the Impact of Event Scale-Intellectual Disabilities (IES-IDs). BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2014; 53:315-32. [DOI: 10.1111/bjc.12048] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 02/04/2014] [Indexed: 11/27/2022]
Affiliation(s)
- James C. Hall
- Department of Psychological Sciences; Norwich Medical School; University of East Anglia; Norwich UK
| | - Laura Jobson
- Department of Psychological Sciences; Norwich Medical School; University of East Anglia; Norwich UK
- MRC Cognition and Brain Sciences Unit; Cambridge UK
| | - Peter E. Langdon
- Tizard Centre; University of Kent; Canterbury UK
- Broadland Clinic; Hertfordshire Partnership University NHS Foundation Trust; Norfolk UK
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Keesler JM. A Call for the Integration of Trauma-Informed Care Among Intellectual and Developmental Disability Organizations. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12071] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hulbert-Williams L, Hastings R, Owen DM, Burns L, Day J, Mulligan J, Noone SJ. Exposure to life events as a risk factor for psychological problems in adults with intellectual disabilities: a longitudinal design. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:48-60. [PMID: 23627774 DOI: 10.1111/jir.12050] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2013] [Indexed: 05/07/2023]
Abstract
BACKGROUND Several cross-sectional studies have shown an association between exposure to life events and psychological problems in adults with intellectual disability (ID). To establish life events as a risk factor, prospective designs are needed. METHODS Support staff informants provided data on the psychological problems of 68 adults with ID and their recent exposure to life events. Using data collected on the same sample 3.5 to 4 years earlier, prospective analysis of the relationships between life events exposure and psychological problems over time was explored. RESULTS Hierarchical linear regression analyses demonstrated a contribution of life events to the prediction of later psychological problems after controlling for earlier psychological problems. Exploratory analyses showed that the relationship between life events and psychological problems might be unidirectional, and non-spurious; remaining present once the impact of other correlates of psychological problems was controlled. CONCLUSIONS These data offer support for the status of life events (with a negative valence) as a risk factor for psychological problems in adults with ID. To establish life events as a causal risk factor, research is needed to examine the mechanisms via which life events have their impact on psychological well-being.
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Affiliation(s)
- L Hulbert-Williams
- School of Applied Sciences, University of Wolverhampton, Wolverhampton, UK
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Fonseca LM, de Oliveira MC, de Figueiredo Ferreira Guilhoto LM, Cavalheiro EA, Bottino CM. Bereavement and behavioral changes as risk factors for cognitive decline in adults with Down syndrome. Neuropsychiatr Dis Treat 2014; 10:2209-19. [PMID: 25484589 PMCID: PMC4240187 DOI: 10.2147/ndt.s68831] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Cognitive decline and Alzheimer's disease often affect older adults with Down syndrome (DS) much earlier than those in the general population. There is also growing evidence of the effects of negative life events on the mental health and behavior of individuals with intellectual disability. However, to our knowledge, this is the first study investigating objective cognitive decline following bereavement in aging individuals with DS. OBJECTIVE The objective of this study was to determine whether cognitive decline correlates with bereavement following the recent loss of a caregiver or with behavioral changes in a sample of adult individuals with DS who do not meet the criteria for dementia or depression, using the longitudinal assessment of the Cambridge Cognitive Examination (CAMCOG), together with the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). METHODS We evaluated 18 subjects at baseline and over a follow-up period of 14-22 months, attempting to determine whether cognitive decline correlates with bereavement following the recent loss of the main caregiver or with behavioral changes (as assessed with the Neuropsychiatric Inventory). RESULTS The mean rate of change in CAMCOG was -1.83 (standard deviation 4.51). Behavioral changes had a significant direct influence on cognitive decline. When bereavement was accompanied by behavioral changes, the probability of cognitive decline was 87% (odds ratio 3.82). CONCLUSION The occurrence of behavioral changes attributed to bereavement following the loss of the primary caregiver significantly increases the probability of cognitive decline in individuals with DS. Longitudinal comparison of the CAMCOG and use of the IQCODE appear to enrich the analysis of cognitive decline in individuals with DS. Further studies involving larger samples are needed in order to corroborate and expand upon our findings, which can have implications for the clinical management of older adults with DS.
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Affiliation(s)
| | | | | | - Esper Abrao Cavalheiro
- Association of Parents and Friends of People with Intellectual Disability of São Paulo, São Paulo, Brazil ; Federal University of São Paulo, São Paulo, Brazil
| | - Cássio Mc Bottino
- Old Age Research Group, Department of Psychiatry, University of São Paulo, São Paulo, Brazil
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Vereenooghe L, Langdon PE. Psychological therapies for people with intellectual disabilities: a systematic review and meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:4085-4102. [PMID: 24051363 DOI: 10.1016/j.ridd.2013.08.030] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 08/16/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to evaluate the efficacy of psychological therapies for people with intellectual disabilities (IDs) through a systematic review and meta-analysis of the current literature. A comprehensive literature search identified 143 intervention studies. Twenty-two trials were eligible for review, and 14 of these were subsequently included in the meta-analysis. Many studies did not include adequate information about their participants, especially the nature of their IDs; information about masked assessment, and therapy fidelity was also lacking. The meta-analysis yielded an overall moderate between-group effect size, g=.682, while group-based interventions had a moderate but smaller treatment effect than individual-based interventions. Cognitive-behaviour therapy (CBT) was efficacious for both anger and depression, while interventions aimed at improving interpersonal functioning were not effectual. When CBT was excluded, there was insufficient evidence regarding the efficacy of other psychological therapies, or psychological therapies intended to treat mental health problems in children and young people with IDs. Adults with IDs and concurrent mental health problems appear to benefit from psychological therapies. However, clinical trials need to make use of improved reporting standards and larger samples.
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Affiliation(s)
- Leen Vereenooghe
- Department of Psychological Sciences, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Emerson E. Commentary: Childhood exposure to environmental adversity and the well-being of people with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2013; 57:589-600. [PMID: 22676228 DOI: 10.1111/j.1365-2788.2012.01577.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
People with intellectual disabilities have poorer health than their non-disabled peers. They are also more likely to be exposed to a wide range of environmental adversities in childhood. Research undertaken in the general population has demonstrated that exposure to environmental adversity in childhood can have an adverse impact on health and well-being across the life course. Recently, research in this area has added new breadth and depth to our understanding of: (1) the extent to which cumulative exposure to environmental adversities across the life course, but especially in early childhood, can reduce health and well-being; (2) the social, psychological and biological mediating pathways through which environmental adversities may impair health; (3) the processes associated with resilience and vulnerability in the face of exposure to adversity; and (4) the social significance of these effects in accounting for the magnitude of the inequalities in health that are apparent both between and within populations. This new knowledge is making a significant contribution to the development of social policies that seek to combine health gain with the reduction in health inequalities. This paper attempts to apply this knowledge to research aimed at understanding and improving the health and well-being of people with intellectual disabilities.
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Affiliation(s)
- E Emerson
- Centre for Disability Research, Lancaster University, Lancaster, UK.
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Tirosh E, Jaffe M. Global Developmental Delay and Mental Retardation-A Pediatric Perspective. ACTA ACUST UNITED AC 2013; 17:85-92. [DOI: 10.1002/ddrr.1103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 10/05/2012] [Indexed: 12/31/2022]
Affiliation(s)
- Emanuel Tirosh
- The Hannah Khoushy Child Development Center and The Bruce Rappaport Faculty of Medicine; The Technion, The Israeli Institute of Technology; Haifa; Israel
| | - Michael Jaffe
- The Hannah Khoushy Child Development Center and The Bruce Rappaport Faculty of Medicine; The Technion, The Israeli Institute of Technology; Haifa; Israel
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van Campen JS, Jansen FE, Steinbusch LC, Joëls M, Braun KPJ. Stress sensitivity of childhood epilepsy is related to experienced negative life events. Epilepsia 2012; 53:1554-62. [PMID: 22738200 DOI: 10.1111/j.1528-1167.2012.03566.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the effect of stress on seizure frequency in childhood epilepsy, and to assess possible differences between children in whom seizures are precipitated by stress and those in whom they are not. METHODS Parents or caregivers of children with active epilepsy (aged 2-16 years) were sent questionnaires on developmental and epilepsy characteristics, life-time stress exposure, and the effect of stressful periods and moments of acute stress on seizure frequency in their child. Further information was extracted from patient files. KEY FINDINGS Parents or caregivers of 153 children with a median age of 8.8 years responded to the questionnaires. Thirty-nine percent reported an increase in seizure frequency during periods of stress, with a median increase of 2.5 times the frequency compared to nonstressful periods. Thirty-seven percent reported that seizures were precipitated by acute stress, with stress being a precipitating factor in 33% (median value) of the seizures. Overall, 51% of the patients reported stress sensitivity of seizures. A higher number of negative life events experienced in total life was related to an increase in seizure frequency in stressful periods (odds ratio [OR] 1.3, p = 0.01) as well as to the precipitation of seizures by acute stress (OR 1.3, p = 0.02). SIGNIFICANCE Stress sensitivity is reported in half of the children with epilepsy. Results of this study suggest a relation between experienced negative life events and stress sensitivity of childhood epilepsy. One possible explanation could be that experiencing negative life events may cause a larger response to daily stressors, thereby increasing the likelihood to induce epileptic activity.
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Affiliation(s)
- Jolien S van Campen
- Department of Pediatric Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
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Hermans H, Evenhuis HM. Life events and their associations with depression and anxiety in older people with intellectual disabilities: results of the HA-ID study. J Affect Disord 2012; 138:79-85. [PMID: 22305429 DOI: 10.1016/j.jad.2011.12.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 12/08/2011] [Accepted: 12/08/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND People with intellectual disabilities (ID) may be exposed to more life events due to different living circumstances and limited coping abilities. The frequency of life events may increase with age due to age-related decline, loss of significant others and forced relocations. We studied the occurrence of life events in adults with mild to profound ID aged ≥ 50 years and their association with depression and anxiety. METHODS Occurrence and burden of life events were assessed with a checklist of 28 items, completed by professional caregivers. Depression and anxiety were assessed with self-report and informant-report screening instruments (n=988) and with a psychiatric interview (n=286). Associations with depression and anxiety were studied for life events in general and for specific life events. RESULTS 97% of the participants had been exposed to multiple life events during the preceding year and 72% had been exposed to one or more negative life events. The frequency was significantly higher in participants aged 65 years or over, in participants with mild or moderate ID and in participants with depression or anxiety. Minor physical illness and problems with a fellow resident were significantly associated with depression and anxiety, decline or loss of mobility and loss of leisure-time activities with depression and change at work or from work with anxiety. LIMITATIONS This study was cross-sectional and therefore lacks reliable information about causality. CONCLUSIONS Given the high prevalence of life events and their association with depression and anxiety, life events should be better monitored and, if possible, prevented.
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Affiliation(s)
- Heidi Hermans
- Intellectual Disability Medicine, Department of General Practice, Erasmus University Medical Center Rotterdam, The Netherlands.
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Mevissen L, Lievegoed R, Seubert A, De Jongh A. Do persons with intellectual disability and limited verbal capacities respond to trauma treatment? JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2011; 36:274-279. [PMID: 22017196 DOI: 10.3109/13668250.2011.621415] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is not one case report of successful trauma treatment with the use of an evidence-based treatment method in people with substantially limited verbal capacities. This paper assessed the applicability of eye movement desensitisation and reprocessing (EMDR) in two clients with moderate ID, serious behavioural problems, and histories of negative life events. METHOD The 8-phase protocol of EMDR, a first-line treatment for psychological trauma, was applied. RESULTS In both cases, posttraumatic stress disorder (PTSD)-like symptoms decreased in a total of only 6 and 5 sessions, respectively. Gains were maintained at 32 and 10 months' follow-up. CONCLUSIONS EMDR seems to be an applicable psychological trauma treatment for persons with limited verbal capacities. Considering the importance of these findings, further and more rigorous research is required.
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Rzepecka H, McKenzie K, McClure I, Murphy S. Sleep, anxiety and challenging behaviour in children with intellectual disability and/or autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2758-2766. [PMID: 21700417 DOI: 10.1016/j.ridd.2011.05.034] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 05/27/2011] [Indexed: 05/31/2023]
Abstract
Children with an intellectual disability (ID) and/or autism spectrum disorder (ASD) are known to suffer from significantly more sleep problems, anxiety and challenging behaviour (CB) than typically developing children (TD), yet little is known about the relationship between these factors in the child ID/ASD population. The study aim was to examine these relationships. We hypothesised that there would be significant positive correlations between the three factors and that sleep problems and anxiety would predict a significant amount of the variance in levels of CB. Parental measures of sleep problems, anxiety and CB were completed by 187 parents of children with ID and/or ASD. Significant positive associations were found between the three factors. A hierarchical multiple regression showed that medication, sleep problems and anxiety accounted for 42% of the variance in CB, with a large effect size. These findings suggest that these relationships should be considered during clinical practice, particularly in the case of CB interventions where sleep problems and/or anxiety are also present.
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Affiliation(s)
- Halina Rzepecka
- NHS Tayside, Centre for Child Health, 19 Dudhope Terrace, Dundee DD3 6HH, UK
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Lunsky Y, Elserafi J. Life events and emergency department visits in response to crisis in individuals with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:714-718. [PMID: 21492291 DOI: 10.1111/j.1365-2788.2011.01417.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Stressful life events have been linked to psychopathology in the general population, but few studies have considered the relationship between life events and psychopathology for people with intellectual disabilities (ID), and the link between particular life events and hospital use. METHODS Informants provided data on 746 adults with ID who had experienced at least one 'crisis'. Informants completed a checklist of recent life events from the Psychiatric Assessment for Adults with Developmental Disabilities Checklist (PAS ADD checklist) and also indicated whether the crisis resulted in a visit to the hospital emergency department. RESULTS Individuals experiencing life events in the past year were more likely to visit the emergency department in response to crisis than those who did not experience any life events. Individuals experiencing a move of house or residence, serious problem with family, friend or caregiver, problems with police or other authority, unemployed for more than 1 month, recent trauma/abuse, or a drug or alcohol problem were more likely to visit the emergency department. CONCLUSIONS Six specific life events were found to be associated with use of emergency departments in response to crisis. We suggest intervention efforts be targeted towards people who experience life events, particularly these events, as they may be a risk factor for hospital visits.
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Affiliation(s)
- Y Lunsky
- Dual Diagnosis Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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Hulbert-Williams L, Hastings RP, Crowe R, Pemberton J. Self-Reported Life Events, Social Support and Psychological Problems in Adults with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1468-3148.2011.00624.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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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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Biswas AB, Furniss FG. Life events and mental illness in people with learning disabilities. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.mppsy.2009.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
PURPOSE OF REVIEW The aim of the present review is to summarize recent research findings on the persistence of challenging behaviours in adults and children with an intellectual disability. RECENT FINDINGS Studies varied in their definition and measurement of persistence or change in challenging behaviours. Persistence levels tended to be high in adults and challenging behaviours were stable over time, especially in individuals with autism. Moderate to high stability levels were evident in children, although there was a tendency for decreases in mean scores for behaviour problems over time. SUMMARY A substantial proportion of people with an intellectual disability experience persistent and stable challenging behaviours across their lives. Our knowledge of the factors that drive these high levels of persistence remains limited.
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