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Barrett BF, Wehmeyer M, Kolb J, Ostermann T, Sappok T. Impact of the emotional development approach on psychotropic medication in adults with intellectual and developmental disabilities: a retrospective clinical analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:941-953. [PMID: 38545626 DOI: 10.1111/jir.13136] [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: 05/31/2023] [Revised: 02/05/2024] [Accepted: 03/01/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Compared with the general population, adults with an intellectual developmental disorder (IDD) are more likely to develop mental health problems and to receive high levels of psychotropic medication, particularly antipsychotics. The emotional development (ED) approach may help to better understand the nature of challenging behaviour (CB) and tailor treatment and support accordingly. The aim of this retrospective study was to investigate the impact of the ED approach on the prescription of psychotropic medication during inpatient psychiatric treatment. METHODS The clinical data of 1758 patients were analysed within a retrospective study design over a period of 12 years. ED level was assessed (1) for the first time (INITIAL-SEO), (2) during a previous hospital stay (PAST-SEO) or (3) not at all (NO-SEO). The effects of the ED assessment and the respective intervention during the current admission on the number of psychotropics and the number and dosage of antipsychotics were analysed for the total sample, including those with CB, autism spectrum disorders and psychosis. Group differences were analysed by a chi-square test and a one-factorial analysis of variance. For analysing the impact of the application of the ED approach on psychotropic medication, a covariance model was applied. Changes between the subsamples were analysed by t-tests for dependent samples. RESULTS The ED approach had a significant impact on reducing the overall amount of psychotropic medication and the dosage of antipsychotics in all patients with IDD. These effects were mainly attributable to those showing CB. In patients with autism spectrum disorders, the developmental approach reduced the number of antipsychotics. No effects could be observed in patients with psychosis; in this subsample, both the number and dosage of antipsychotics increased. CONCLUSIONS The application of the ED approach in the current hospital stay reduced the number of psychotropic drugs and the number and dosage of antipsychotics, especially in those patients with IDD and CB, but also in those with autism spectrum disorders.
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Affiliation(s)
- B F Barrett
- Liebenau Kliniken, St. Lukas Klinik, Liebenau, Germany
| | - M Wehmeyer
- Department of Pedagogy and Rehabilitation, Faculty of Psychology and Pedagogy, Ludwig Maximilians University, Munich, Germany
| | - J Kolb
- Liebenau Kliniken, St. Lukas Klinik, Liebenau, Germany
| | - T Ostermann
- Department of Psychology and Psychotherapy, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - T Sappok
- University Clinic for People with Neurodevelopmental Disorders, Mara, University Hospital OWL, Bielefeld University, Bielefeld, Germany
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2
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Mohamed AR. Using Attachment and Biobehavioral Catch-up with young children with developmental delays: A multiple-baseline trial of attachment, sensitivity, and cortisol. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:847-870. [PMID: 35648732 PMCID: PMC10647892 DOI: 10.1177/17446295221104614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
The Attachment and Biobehavioral Catchup intervention potentially offsets psychosocial risks facing dyads in which children have intellectual disability or developmental delays. In this single-case multiple-baseline study the efficacy of this intervention was tested across three such South African families. Maternal sensitivity, attachment security, and child affect regulation were measured weekly during a baseline and intervention period, using the Ainsworth Maternal Sensitivity Scales, Attachment Q-sort and salivary cortisol, respectively. Furthermore, post-intervention interviews invited parents' and intervenors' evaluations of the intervention. Visual analysis broadly indicated improvement in maternal sensitivity and attachment security across subjects over time following the introduction of the intervention, although randomisation tests were not statistically significant. Effects on affect regulation were not clearly observed and may have been influenced by case-specific variables. Parent-participants and intervenors also identified particularly helpful contributions from the intervention. Findings underscore the importance of individual-level effects evaluation, especially when implementing interventions outside the original population.
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Affiliation(s)
- Ahmed Riaz Mohamed
- Ahmed Riaz Mohamed, Department of Psychology, University of Pretoria, Private Bag X20, Hatfield, 0028, Pretoria, South Africa.
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3
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Doodeman TWM, Schuengel C, Sterkenburg PS. Effects of the Attune & Stimulate-checklist for caregivers of people with severe and profound intellectual disabilities: A randomised controlled trial. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1136-1149. [PMID: 37365773 DOI: 10.1111/jar.13135] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/23/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Sensitive responsiveness is an important aspect in affect-regulation of people with severe to profound intellectual disabilities. AIM This randomized controlled trial evaluated the Attune & Stimulate-checklist, a tool for detecting subtle and idiosyncratic communicative behaviours and responding adequately. METHODS Effects on the sensitive responsiveness of professional caregivers and the arousal and valence of adults with severe to profound intellectual disabilities were investigated. Video recordings of 102 interactions were analysed with several observation instruments. RESULTS Although no significant effect was found on the checklist-suggestions of responsive behaviours (d = 0.33, p = .052), the intervention increased caregivers' sensitive responsive and affective behaviour (d = 0.94 - 1.10, p < .001) and clients' optimal arousal (d = 0.48, p = .019) and interactive engagement (d = 0.40 - 0.48, p = .018 - .050). CONCLUSION This low-intensity intervention had a medium to large immediate effect on the interaction. Future research should investigate medium- and long-term effects.
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Affiliation(s)
- Tanja W M Doodeman
- Faculty of Behavioural and Movement Sciences, Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Carlo Schuengel
- Faculty of Behavioural and Movement Sciences, Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Paula S Sterkenburg
- Faculty of Behavioural and Movement Sciences, Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Assessment and Treatment, Bartiméus, Doorn, The Netherlands
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Schraauwers R, Ketelaar ME, Sterkenburg PS. Investigating functional visual loss in children and adolescents. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2023. [DOI: 10.1177/02646196221148333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Patients with a functional neurological disorder (FND) experience a lower psychological quality of life and have more mental health concerns. These patients deserve to be treated with a treatment that is evidence-based and proven effective. However, when we look children or adolescents with functional visual disorder (FVD; a subgroup of FND), we see that there is not much evidence for the effectiveness of their treatments. Possible reasons for this lack of evidence and the difficulties in studying children and adolescents with FVD are discussed in this article. This article concludes with possible ways of persuading children and adolescents with FVD in participating in research.
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Sappok T, Hassiotis A, Bertelli M, Dziobek I, Sterkenburg P. Developmental Delays in Socio-Emotional Brain Functions in Persons with an Intellectual Disability: Impact on Treatment and Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013109. [PMID: 36293690 PMCID: PMC9603789 DOI: 10.3390/ijerph192013109] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/02/2022] [Accepted: 10/10/2022] [Indexed: 05/06/2023]
Abstract
Intellectual disability is a neurodevelopmental disorder with a related co-occurrence of mental health issues and challenging behaviors. In addition to purely cognitive functions, socio-emotional competencies may also be affected. In this paper, the lens of developmental social neuroscience is used to better understand the origins of mental disorders and challenging behaviors in people with an intellectual disability. The current concept of intelligence is broadened by socio-emotional brain functions. The emergence of these socio-emotional brain functions is linked to the formation of the respective neuronal networks located within the different parts of the limbic system. Thus, high order networks build on circuits that process more basic information. The socio-emotional skills can be assessed and complement the results of a standardized IQ-test. Disturbances of the brain cytoarchitecture and function that occur at a certain developmental period may increase the susceptibility to certain mental disorders. Insights into the current mental and socio-emotional functioning of a person may support clinicians in the calibration of treatment and support. Acknowledging the trajectories of the socio-emotional brain development may result in a more comprehensive understanding of behaviors and mental health in people with developmental delays and thus underpin supports for promotion of good mental health in this highly vulnerable population.
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Affiliation(s)
- Tanja Sappok
- Berlin Center for Mental Health in Developmental Disabilities, Ev. Krankenhaus Königin Elisabeth Herzberge, 10365 Berlin, Germany
- Correspondence:
| | - Angela Hassiotis
- Division of Psychiatry, University College London, London W1T 7BN, UK
- Camden and Islington NHS Foundation Trust, London NW1 0PE, UK
| | - Marco Bertelli
- CREA (Research and Clinical Centre), San Sebastiano Foundation, Misericordia di Firenze, 50142 Florence, Italy
| | - Isabel Dziobek
- Clinical Psychology of Social Interaction, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| | - Paula Sterkenburg
- Bartiméus, 3941 XM Doorn, The Netherlands
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands
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An Exploratory Study among Intellectual Disability Physicians on the Care and Coercion Act and the Use of Psychotropic Drugs for Challenging Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910240. [PMID: 34639540 PMCID: PMC8547136 DOI: 10.3390/ijerph181910240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/19/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022]
Abstract
The new Dutch Care and Coercion Act aims to better regulate the use of psychotropic drugs for challenging behaviour in people with an intellectual disability. This study explores experiences of intellectual disability physicians (IDPs) in prescribing psychotropic drugs and investigates how the Act and the new multidisciplinary guideline on challenging behaviour affects their practice. A qualitative study was conducted, consisting of nine semi-structured in-depth interviews with IDPs, followed by a thematic analysis. It was found that IDPs experienced the new Act and guideline as supportive of their work as guardians of the appropriate use of psychotropic drugs. The multidisciplinary character of the guideline was experienced positively. However, IDPs are faced with organisational barriers and time constraints, as such, they question the feasibility of implementing the Act. Based on these findings, it can be concluded that the Care and Coercion Act may support the existing shift towards the appropriate use of psychotropic drugs if required conditions can be met.
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Vandesande S, Bosmans G, Sterkenburg P, Schuengel C, Van Den Noortgate W, Maes B. Comfort provided by parents versus strangers after eliciting stress in children with severe or profound intellectual disabilities: does it make a difference? Attach Hum Dev 2019; 22:425-447. [PMID: 31476969 DOI: 10.1080/14616734.2019.1659835] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The relationships between children with severe or profound intellectual disabilities (ID) and their parents may fulfil attachment functions, such as regulating emotional responses to stress. This study examined the extent to which children with severe or profound ID differentiate between their parents and a stranger as a resource for stress-regulation. A home-based experimental paradigm was conducted and video-recorded in 38 families. Children (1-8 years) were exposed to four naturalistic stressors followed by comfort, randomly provided by the parents or the stranger. Emotional behaviour (arousal and valence) and the skin conductance level were simultaneously recorded. With regard to both emotional behaviour and skin conductance, children significantly differentiated between their parents as attachment figures and the stranger during stress and comfort, despite their impairments on various developmental domains. Behavioural observation and physiology show complementary manifestations of parent-child attachment in this population.
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Affiliation(s)
- Sien Vandesande
- Special Education and Parenting, KU Leuven , Leuven, Belgium
| | - Guy Bosmans
- Special Education and Parenting, KU Leuven , Leuven, Belgium
| | - Paula Sterkenburg
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam , Amsterdam, The Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam , Amsterdam, The Netherlands
| | | | - Bea Maes
- Special Education and Parenting, KU Leuven , Leuven, Belgium
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Sterkenburg P, Vacaru V. The effectiveness of a serious game to enhance empathy for care workers for people with disabilities: A parallel randomized controlled trial. Disabil Health J 2018; 11:576-582. [DOI: 10.1016/j.dhjo.2018.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 03/08/2018] [Accepted: 03/24/2018] [Indexed: 10/17/2022]
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Vandesande S, Bosmans G, Schuengel C, Maes B. Young children with significant developmental delay differentiate home observed attachment behaviour towards their parents. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:106-120. [PMID: 29993197 DOI: 10.1111/jar.12513] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 04/09/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The hallmark of attachment is that contact, proximity and relief from stress are sought from specific individuals, laying important groundwork for healthy socioemotional functioning. This study investigated the extent to which differentiated attachment behaviour can be observed in young children with significant developmental delay (DD). METHOD Video-taped observations of the parent-child and stranger-child interaction were conducted at home and complemented with questionnaires in 20 families with a child with significant DD (age 2-7 years with an average DD of 49 months). RESULTS Children displayed more intense and persistent contact-seeking, contact-maintaining and resistant behaviour in the episodes with their parent compared to the episodes with the stranger. Parent-reported secure attachment behaviour was slightly more characteristic towards mother compared to father. CONCLUSIONS Even children with significant DD develop differentiated attachment behaviour. Detailed observations may support parents in identifying the interactions that make the attachment relationship with their child special.
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Affiliation(s)
- Sien Vandesande
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium
| | - Guy Bosmans
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bea Maes
- Parenting and Special Education Research Group, KU Leuven, Leuven, Belgium
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10
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Vacaru VS, Sterkenburg PS, Schuengel C. Self-concept in institutionalized children with disturbed attachment: The mediating role of exploratory behaviours. Child Care Health Dev 2018; 44:476-484. [PMID: 28895183 DOI: 10.1111/cch.12521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 08/07/2017] [Accepted: 08/19/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Self-concept is seen as both an outcome of sociocognitive and emotional development, and a factor in social and mental health outcomes. Although the contribution of attachment experiences to self-concept has been limited to quality of primary attachment relationships, little is known of the effects of disturbed attachment on self-concept in institutionalized children. Thus, the current study examined associations between disturbed attachment behaviours in institutionalized children and self-concept, testing limited exploration as an explanatory factor. METHODS Thirty-three institutionalized children, aged 4-12, participated in a multimethod and multi-informant assessment of disturbed attachment behaviours (i.e., Disturbances of Attachment Interview and Behavioral Signs of Disturbed Attachment in Young Children), self-concept (i.e., Pictorial Scale of Perceived Competence and Social Acceptance for Young Children), and exploratory behaviours (i.e., Student Exploratory Behaviours Observation Scale). Analyses were conducted using bootstrapping techniques. RESULTS Global self-concept converged with teacher-rated children's self-concept, except for physical competence domain. Disturbed attachment behaviours were identified in 62.5% of the children, and this was associated with lower levels of exploration and lower scores on self-concept, compared with children without disturbed attachment behaviours. Furthermore, exploratory behaviours mediated the effects of disturbed attachment behaviours on self-concept. CONCLUSIONS Institution-reared children with disturbed attachment behaviours were likely to have a negative perception of self and one's own competences. Limited exploratory behaviours explained this linkage. Targeting disordered attachment in children reared in institutions and their caregivers should become a high priority as a means for preventing socioemotional development issues.
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Affiliation(s)
- V S Vacaru
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - P S Sterkenburg
- Department of Clinical Child and Family Studies, VU University, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,Bartiméus, Doorn, The Netherlands
| | - C Schuengel
- Department of Clinical Child and Family Studies, VU University, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
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Le développement de l’attachement chez les enfants porteurs d’une trisomie 21 : revue de la littérature. ANNEE PSYCHOLOGIQUE 2017. [DOI: 10.4074/s0003503317000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Vanwalleghem S, Miljkovitch R. Le développement de l’attachement chez les enfants porteurs d’une trisomie 21 : revue de la littérature. ANNEE PSYCHOLOGIQUE 2017. [DOI: 10.3917/anpsy.171.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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13
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Le développement de l’attachement chez les enfants porteurs d’une trisomie 21 : revue de la littérature. ANNEE PSYCHOLOGIQUE 2017. [DOI: 10.4074/s000350331700104x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Mohamed AR, Mkabile S. An attachment-focused parent-child intervention for biting behaviour in a child with intellectual disability: A clinical case study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2015; 19:251-65. [PMID: 25691440 DOI: 10.1177/1744629515572711] [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: 01/17/2015] [Indexed: 05/08/2023]
Abstract
Attachment and attachment-related psychopathology has increasingly gained focus since Bowlby introduced the concept into the clinical repertoire. However, little has been done to explore attachment, or attachment-based interventions, within the context of intellectual disability. Clinical experience, however, has demonstrated significant attachment-related problems in children with intellectual disability. This article explores one such case of a 13-year-old girl with moderate intellectual disability and severe and persistent externalizing behavioural difficulties - biting, in particular. Once the severity of the behaviour was formulated within the framework of attachment, a structured attachment-focused parent-child intervention was designed in order to repair the damaged attachment between mother and daughter as a way of addressing the problematic behaviour. Outcomes demonstrated a sustained - immediately, at 3- and 6-month follow-up - positive impact of the intervention not only on the presenting problem but also on the quality of the relationship between mother and daughter. Research and clinical implications are discussed.
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Affiliation(s)
| | - Siyabulela Mkabile
- Lentegeur Psychiatric Hospital, South Africa; University of Cape Town, South Africa
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Penketh V, Hare DJ, Flood A, Walker S. Attachment in adults with intellectual disabilities: preliminary investigation of the psychometric properties of the manchester attachment scale-third party observational measure. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 27:458-70. [PMID: 24022943 DOI: 10.1111/jar.12070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Manchester Attachment Scale-Third party observational measure (MAST) was developed to assess secure attachment style for adults with intellectual disabilities. The psychometric properties of the MAST were examined. MATERIALS AND METHODS Professional carers (N = 40) completed the MAST and measures related to the construct of attachment theory [Edward Zigler-Yale Personality Questionnaire (EZPQ), Emotional Rating Scale (ERS) and the Learning Disability Casemix Scale (LDCS)] regarding individuals with an intellectual disability (N = 57). Individuals with an intellectual disability (N = 14) completed the Self-report Assessment of Attachment Security (SRAAS). RESULTS The MAST was found to have good internal consistency, test-retest reliability and convergent validity. MAST scores were negatively correlated with level of intellectual disability and challenging behaviour (CB) as measured by LDCS. CONCLUSIONS Support was provided for the reliability and validity of the MAST and a relationship between attachment security, level of intellectual disability and CB. The results of the study and implications of attachment theory for service provision are discussed.
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Schuengel C, de Schipper JC, Sterkenburg PS, Kef S. Attachment, Intellectual Disabilities and Mental Health: Research, Assessment and Intervention. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2012; 26:34-46. [DOI: 10.1111/jar.12010] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Carlo Schuengel
- Department of Clinical Child and Family Studies and EMGO+ Institute for Health and Care Research; VU University Amsterdam; Amsterdam The Netherlands
| | - Johanna Clasien de Schipper
- Department of Clinical Child and Family Studies and EMGO+ Institute for Health and Care Research; VU University Amsterdam; Amsterdam The Netherlands
| | - Paula S. Sterkenburg
- Department of Clinical Child and Family Studies and EMGO+ Institute for Health and Care Research; VU University Amsterdam; Amsterdam The Netherlands
| | - Sabina Kef
- Department of Clinical Child and Family Studies and EMGO+ Institute for Health and Care Research; VU University Amsterdam; Amsterdam The Netherlands
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Bell BG, Clegg J. An Ecological Approach to Reducing the Social Isolation of People With an Intellectual Disability. ECOLOGICAL PSYCHOLOGY 2012. [DOI: 10.1080/10407413.2012.673983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Looking beyond Maternal Sensitivity: Mother–Child Correlates of Attachment Security among Children with Intellectual Disabilities in Urban India. J Autism Dev Disord 2012; 42:2335-45. [DOI: 10.1007/s10803-012-1479-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Roeden JM, Maaskant MA, Koomen HMY, Candel MJJM, Curfs LMG. Assessing client-caregiver relationships and the applicability of the 'student-teacher relationship scale' for people with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:104-110. [PMID: 22093654 DOI: 10.1016/j.ridd.2011.08.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 08/30/2011] [Accepted: 08/30/2011] [Indexed: 05/31/2023]
Abstract
Improvements in client-caregiver relationships may lead to improvements in the quality of life of clients with intellectual disabilities (ID). For this reason, interventions aimed at influencing these relationships are important. To gain insight into the nature and intention of these relationships in the ID population, suitable measurement instruments are needed. This study examines the applicability of an existing relationship questionnaire designed for primary education, called the Student-Teacher Relationship Scale (STRS) on the basis of the following research questions: (1) What is the factor structure of the STRS? (2) Are there associations between STRS scales and other conceptually comparable instruments? (3) Is the STRS reliable? The participants in this study were 46 caregivers, who assessed 350 client-caregiver relationships. Psychometric research was conducted into the factor structure (n=350), construct validity (n=146), internal consistency (n=350) and test-retest reliability (n=177) of the STRS and the reliability of the individual scores (n=350) among a study population of people with moderate and severe ID. The three-factor model of the STRS as used in primary education (1. closeness, 2. conflict, 3. dependency) was, despite minor deviations, also found in the ID population. Research into the construct validity of the STRS showed statistically significant correlations with other scales with which similarities could be expected. The internal consistency and test-retest reliability of the STRS in the population studied were very good. The 95% confidence intervals of the means were small, and these measurements can be regarded as reliable.
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Child Maltreatment, Adolescent Attachment Style, and Dating Violence: Considerations in Youths with Borderline-to-Mild Intellectual Disability. Int J Ment Health Addict 2011. [DOI: 10.1007/s11469-011-9321-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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De Schipper JC, Schuengel C. Attachment behaviour towards support staff in young people with intellectual disabilities: associations with challenging behaviour. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2010; 54:584-596. [PMID: 20492348 DOI: 10.1111/j.1365-2788.2010.01288.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
BACKGROUND Attachment research has shown the importance of attachment behaviour for the prevention of dysregulated behaviour due to emotional distress. The support of an attachment figure may be especially important for people with intellectual disability (ID), because they are less adept in dealing with stressful situations on their own. Our purpose was to examine the role of support staff as targets of attachment behaviour for young people with ID by testing the hypothesis that young people who more often engage in attachment interactions with group care staff are less at risk for challenging behaviours. The study design included professional caregivers' report of young persons' attachment behaviour across different relationships to address the relationship-specific nature of attachment behaviour in a group care context. METHODS Support staff rated attachment behaviour of 156 young participants with moderate to severe ID who were attending a group care setting. For each participant, we asked two members of the classroom support staff to fill out the Secure Base Safe Haven Observation list. One of them also rated challenging behaviour (Abberant Behavior Checklist). RESULTS Young people who showed more secure attachment behaviour towards professional caregivers were less irritable, less lethargic and less stereotypic in their behaviour, even if we controlled for developmental age and Autism Spectrum Disorders. Two results point in the direction of relationship-specific attachment behaviour: the absence of high consistency in a person's attachment behaviour towards two different caregivers and the independent contribution of each of these relationships to explaining differences in lethargy and stereotypies. A certain preference in attachment behaviour towards specific caregivers was not associated with challenging behaviour. CONCLUSIONS Findings suggest that attachment behaviour may be part of young persons' adaptation to the stresses and challenges of group care. Furthermore, adaptation may be determined by the integration of relationships with support staff, because each relationship with a care staff member bears uniquely on challenging behaviour.
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Affiliation(s)
- J Clasien De Schipper
- Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
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Schuengel C, Kef S, Damen S, Worm M. 'People who need people': attachment and professional caregiving. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2010; 54 Suppl 1:38-47. [PMID: 20586883 DOI: 10.1111/j.1365-2788.2009.01236.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
From the perspective of attachment theory, this paper discusses individual differences in the quality of caregiving by direct-care staff for persons with intellectual disabilities. Theoretical arguments and findings from related literature are cited to support the probable role of professionals' own attachment experiences and their mental representations thereof. Case examples are drawn from a study on video-based interaction guidance for direct-care staff in group homes for persons with multiple, serious disabilities. These examples illustrate how interventions may avoid attachment-related defences against changing the quality and affective mutuality of personal contact with clients. However, the possibility is discussed that in parallel processes, quality management systems and institutional culture may selectively reinforce care patterns associated with insecure, dismissing attachment, while failing to reward the positive contribution that sensitive, affectively attuned caregiving makes to wellbeing of persons with disabilities.
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Affiliation(s)
- C Schuengel
- Department of Clinical Child and Family Studies and EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
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Schuengel C, Oosterman M, Sterkenburg PS. Children with disrupted attachment histories: interventions and psychophysiological indices of effects. Child Adolesc Psychiatry Ment Health 2009; 3:26. [PMID: 19732442 PMCID: PMC2749813 DOI: 10.1186/1753-2000-3-26] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Accepted: 09/04/2009] [Indexed: 11/30/2022] Open
Abstract
Diagnosis and treatment of children affected by disruptions of attachment (out of home placement, multiple changes of primary caregiver) is an area of considerable controversy. The possible contribution of psychobiological theories is discussed in three parts. The first part relates the attachment theoretical perspective to major psychobiological theories on the developmental associations of parent-child relationships and emotional response. The second part reviews studies of autonomic reactivity and HPA-axis activity with foster children, showing that foster children show more reactivity within physiological systems facilitating fight or flight behaviours rather than social engagement, especially foster children with atypical attachment behaviour. The third part is focused on treatment of children suffering from the consequences of disrupted attachment, based on a psychotherapy study with psychophysiological outcome measures. Implications are discussed for theory, diagnosis, and intervention.
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Affiliation(s)
- Carlo Schuengel
- Department of Clinical Child and Family Studies, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
| | - Mirjam Oosterman
- Department of Clinical Child and Family Studies, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
| | - Paula S Sterkenburg
- Department of Clinical Child and Family Studies, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands
- Department of Psychotherapy, Bartiméus, Doorn, The Netherlands
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