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O'Riordan D, Conway E, Dodd P, Guerin S. Adapting Complicated Grief Therapy for Use With People With Intellectual Disabilities: An Action Research Study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13296. [PMID: 39328025 DOI: 10.1111/jar.13296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/02/2024] [Accepted: 08/06/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND There is established evidence of complicated grief among people with an intellectual disability. This paper describes the process of adapting complicated grief therapy (CGT) for this population. METHOD Action research documented the adaptation of CGT. Qualitative methods included analysing meeting notes, reflective interviews with two members of the team involved in adapting the materials, and interviews with six professionals working in disability settings who reviewed the adapted materials. RESULTS Key processes included adapting the standardised tools that form part of CGT and developing adapted approaches to abstract concepts related to death, dying and bereavement. Key therapeutic components such as imaginal revisiting and the role of significant others required adaptation for implementation with people with intellectual disabilities. CONCLUSION The importance of adapting evidence-based therapies for people with intellectual disabilities is emphasised. This research provides an adapted form of an established therapy for piloting with this population.
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Kjærvik SL, Bushman BJ. A meta-analytic review of anger management activities that increase or decrease arousal: What fuels or douses rage? Clin Psychol Rev 2024; 109:102414. [PMID: 38518585 DOI: 10.1016/j.cpr.2024.102414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Anger is an unpleasant emotion that most people want to get rid of. Some anger management activities focus on decreasing arousal (e.g., deep breathing, mindfulness, meditation), whereas others focus on increasing arousal (e.g., hitting a bag, jogging, cycling). This meta-analytic review, based on 154 studies including 184 independent samples involving 10,189 participants, tested the effectiveness of both types of activities. The results indicated that arousal-decreasing activities decreased anger and aggression (g = -0.63, [-0.82, -0.43]), and the results were robust. Effects were stable over time for participants of different genders, races, ages, and cultures. Arousal-decreasing activities were effective in students and non-students, in criminal offenders and non-offenders, and in individuals with and without intellectual disabilities. Arousal-decreasing activities were effective regardless of how they were delivered (e.g., digital platforms, researchers, therapists), in both group and individual sessions, and in both field and laboratory settings. In contrast, arousal-increasing activities were ineffective overall (g = -0.02, [-0.13, 0.09]) and were heterogenous and complex. These findings do not support the ideas that venting anger or going for a run are effective anger management activities. A more effective approach for managing anger is "turning down the heat" or calming down by engaging in activities that decrease arousal.
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Affiliation(s)
- Sophie L Kjærvik
- The Ohio State University, USA; Virginia Commonwealth University, USA.
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Taylor JL, Novaco RW. Cognitive behavioural anger treatment for adults with intellectual disabilities: effects of therapist experience on outcome. Behav Cogn Psychother 2023; 51:533-542. [PMID: 37170761 DOI: 10.1017/s1352465823000061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Anger has been shown to be associated with aggression and violence in adults with intellectual disabilities in both community and secure settings. Emerging evidence has indicated that cognitive behavioural anger treatment can be effective in reducing assessed levels of anger and violent behaviour in these patient populations. However, it has been suggested that the effectiveness of these types of interventions is influenced by the experience and training of the therapists. METHOD In this service evaluation study, the pre- and post-treatment and 12-month follow-up assessment scores of 88 detained in-patient adults with intellectual disabilities and forensic histories who received cognitive behavioural anger treatment were examined in order to investigate whether participants' responsiveness to treatment was associated with treatment being delivered by qualified versus unqualified therapists. RESULTS Overall significant reductions in self-reported measures of anger disposition and anger reactivity were found with no significant time × therapist experience interaction effects. However, the patients treated by qualified therapists improved significantly on measures of anger control compared with those allocated to unqualified therapists. CONCLUSIONS Male and female detained patients with intellectual disabilities and forensic histories can benefit from an individual cognitive behavioural anger treatment intervention delivered by qualified and unqualified therapists, but therapist experience may be important in supporting patients to develop more complex anger control coping skills.
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Affiliation(s)
- John L Taylor
- Northumbria University and Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, UK
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Fernandez E, Perez B, Sun R, Kolaparthi K, Pham T, Iwuala E, Garza R, Shattuck EC, Wu W. Anger treatment via CBAT delivered remotely: Outcomes on psychometric and self-monitored measures of anger. Clin Psychol Psychother 2023. [PMID: 37699599 DOI: 10.1002/cpp.2907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/04/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023]
Abstract
Studies of anger treatment have often reported on reappraisal and relaxation techniques delivered in person to forensic and psychiatric samples. The present study evaluated an integrative programme of cognitive-behavioural affective therapy (CBAT) delivered remotely to chronic pain sufferers with comorbid anger. Volunteers (N = 54) were randomly assigned to either CBAT or an Emotional Education (EE) group, both receiving hour-long videorecorded sessions twice a week for 4 weeks plus weekly calls by telephone. At 1-month post-treatment, follow-up was conducted. Outcomes were measured using the Anger Parameters Scale (APS) and its five subscales (frequency, duration, intensity, latency and threshold) as well as daily self-monitored anger logs. As hypothesized, pre- to post-treatment decline in APS total scores was significant for CBAT, Hedges' g = 0.65, 95% CI [0.14, 1.16] but nonsignificant and small for EE, g = 0.17, CI [-0.41, 0.75]. At the primary endpoint (post-treatment), APS total scores were significantly lower for CBAT than for EE. Treatment gains were maintained till follow-up. On all five APS subscales, pre-post effect sizes were medium-sized for CBAT and generally small for EE. This picture was mirrored in the self-monitored frequency, duration and intensity of anger. Findings support the efficacy of CBAT over time, its comparative efficacy over EE and its ecological generalizability. Future research could expand sample size, reduce sample imbalance, extend follow-up and strengthen treatment potency with more sessions. The present study renews enthusiasm for teletherapy and is the first to demonstrate CBAT efficacy in treating maladaptive anger in the chronic pain population.
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Affiliation(s)
- Ephrem Fernandez
- Psychology Department, University of Texas San Antonio, San Antonio, Texas, USA
| | - Brandon Perez
- University of Texas San Antonio, San Antonio, Texas, USA
| | - Renhao Sun
- Dept. of Management Science and Statistics, University of Texas San Antonio, San Antonio, Texas, USA
| | - Krishna Kolaparthi
- Institute for Health Disparities Research, University of Texas San Antonio, San Antonio, Texas, USA
| | - Tuan Pham
- University of Texas Medical Branch, San Antonio, Texas, USA
| | | | - Rudy Garza
- University of Texas San Antonio, San Antonio, Texas, USA
| | - Eric C Shattuck
- Institute for Health Disparities Research and Department of Public Health, University of Texas San Antonio, San Antonio, Texas, USA
| | - Wenbo Wu
- Dept. of Management Science and Statistics, University of Texas San Antonio, San Antonio, Texas, USA
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Sakdalan J, Mitchell B. Development of an Evidence-based Violence Rehabilitation Program for Offenders With Intellectual Disability. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023:306624X231176005. [PMID: 37415459 DOI: 10.1177/0306624x231176005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
A review of the current literature on evidence-based violence prevention programs developed for individuals with an intellectual disability (ID) reveals a paucity of direct evidence for this population. In addition, the existing offence-specific programs are primarily grounded in adapted cognitive behaviour therapy (CBT) programs designed for the mainstream offender population, which may not be suitable for offenders with co-morbid mental health and personality disorders. The current paper discusses the development of a violence rehabilitation program for offenders with an ID. The focus of the article is on the exploration of the empirically supported risk factors associated with violent offending and the incorporation of these dynamic risk factors into the program modules. A case study example was utilized to examine the process of VRP-ID and how the modules targeted the offenders' treatment needs. Responsivity issues are addressed by identifying cognitive difficulties experienced by this cohort and the implications for treatment. The Risk/Need/Responsivity (RNR) model and the good lives Model (GLM) are widely used offender rehabilitation models that can be considered the guiding principles in developing this program. Furthermore, it utilizes contemporary therapeutic frameworks such as motivational interviewing (MI), cognitive behavior therapy (CBT), dialectical behavior therapy (DBT), and GLM reconceptualization and skills. The program is grounded in trauma-informed principles, which acknowledge this client group's high prevalence of victimization.
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Prior D, Win S, Hassiotis A, Hall I, Martiello MA, Ali AK. Behavioural and cognitive-behavioural interventions for outwardly directed aggressive behaviour in people with intellectual disabilities. Cochrane Database Syst Rev 2023; 2:CD003406. [PMID: 36745863 PMCID: PMC9901280 DOI: 10.1002/14651858.cd003406.pub5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Outwardly directed aggressive behaviour in people with intellectual disabilities is a significant issue that may lead to poor quality of life, social exclusion and inpatient psychiatric admissions. Cognitive and behavioural approaches have been developed to manage aggressive behaviour but the effectiveness of these interventions on reducing aggressive behaviour and other outcomes are unclear. This is the third update of this review and adds nine new studies, resulting in a total of 15 studies in this review. OBJECTIVES To evaluate the efficacy of behavioural and cognitive-behavioural interventions on outwardly directed aggressive behaviour compared to usual care, wait-list controls or no treatment in people with intellectual disability. We also evaluated enhanced interventions compared to non-enhanced interventions. SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was March 2022. We revised the search terms to include positive behaviour support (PBS). SELECTION CRITERIA We included randomised and quasi-randomised trials of children and adults with intellectual disability of any duration, setting and any eligible comparator. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were change in 1. aggressive behaviour, 2. ability to control anger, and 3. adaptive functioning, and 4. ADVERSE EFFECTS Our secondary outcomes were change in 5. mental state, 6. medication, 7. care needs and 8. quality of life, and 9. frequency of service utilisation and 10. user satisfaction data. We used GRADE to assess certainty of evidence for each outcome. We expressed treatment effects as mean differences (MD) or odds ratios (OR), with 95% confidence intervals (CI). Where possible, we pooled data using a fixed-effect model. MAIN RESULTS This updated version comprises nine new studies giving 15 included studies and 921 participants. The update also adds new interventions including parent training (two studies), mindfulness-based positive behaviour support (MBPBS) (two studies), reciprocal imitation training (RIT; one study) and dialectical behavioural therapy (DBT; one study). It also adds two new studies on PBS. Most studies were based in the community (14 studies), and one was in an inpatient forensic service. Eleven studies involved adults only. The remaining studies involved children (one study), children and adolescents (one study), adolescents (one study), and adolescents and adults (one study). One study included boys with fragile X syndrome. Six studies were conducted in the UK, seven in the USA, one in Canada and one in Germany. Only five studies described sources of funding. Four studies compared anger management based on cognitive behaviour therapy to a wait-list or no treatment control group (n = 263); two studies compared PBS with treatment as usual (TAU) (n = 308); two studies compared carer training on mindfulness and PBS with PBS only (n = 128); two studies involving parent training on behavioural approaches compared to wait-list control or TAU (n = 99); one study of mindfulness to a wait-list control (n = 34); one study of adapted dialectal behavioural therapy compared to wait-list control (n = 21); one study of RIT compared to an active control (n = 20) and one study of modified relaxation compared to an active control group (n = 12). There was moderate-certainty evidence that anger management may improve severity of aggressive behaviour post-treatment (MD -3.50, 95% CI -6.21 to -0.79; P = 0.01; 1 study, 158 participants); very low-certainty evidence that it might improve self-reported ability to control anger (MD -8.38, 95% CI -14.05 to -2.71; P = 0.004, I2 = 2%; 3 studies, 212 participants), adaptive functioning (MD -21.73, 95% CI -36.44 to -7.02; P = 0.004; 1 study, 28 participants) and psychiatric symptoms (MD -0.48, 95% CI -0.79 to -0.17; P = 0.002; 1 study, 28 participants) post-treatment; and very low-certainty evidence that it does not improve quality of life post-treatment (MD -5.60, 95% CI -18.11 to 6.91; P = 0.38; 1 study, 129 participants) or reduce service utilisation and costs at 10 months (MD 102.99 British pounds, 95% CI -117.16 to 323.14; P = 0.36; 1 study, 133 participants). There was moderate-certainty evidence that PBS may reduce aggressive behaviour post-treatment (MD -7.78, 95% CI -15.23 to -0.32; P = 0.04, I2 = 0%; 2 studies, 275 participants) and low-certainty evidence that it probably does not reduce aggressive behaviour at 12 months (MD -5.20, 95% CI -13.27 to 2.87; P = 0.21; 1 study, 225 participants). There was low-certainty evidence that PBS does not improve mental state post-treatment (OR 1.44, 95% CI 0.83 to 2.49; P = 1.21; 1 study, 214 participants) and very low-certainty evidence that it might not reduce service utilisation at 12 months (MD -448.00 British pounds, 95% CI -1660.83 to 764.83; P = 0.47; 1 study, 225 participants). There was very low-certainty evidence that mindfulness may reduce incidents of physical aggression (MD -2.80, 95% CI -4.37 to -1.23; P < 0.001; 1 study; 34 participants) and low-certainty evidence that MBPBS may reduce incidents of aggression post-treatment (MD -10.27, 95% CI -14.86 to -5.67; P < 0.001, I2 = 87%; 2 studies, 128 participants). Reasons for downgrading the certainty of evidence were risk of bias (particularly selection and performance bias); imprecision (results from single, often small studies, wide CIs, and CIs crossing the null effect); and inconsistency (statistical heterogeneity). AUTHORS' CONCLUSIONS There is moderate-certainty evidence that cognitive-behavioural approaches such as anger management and PBS may reduce outwardly directed aggressive behaviour in the short term but there is less certainty about the evidence in the medium and long term, particularly in relation to other outcomes such as quality of life. There is some evidence to suggest that combining more than one intervention may have cumulative benefits. Most studies were small and there is a need for larger, robust randomised controlled trials, particularly for interventions where the certainty of evidence is very low. More trials are needed that focus on children and whether psychological interventions lead to reductions in the use of psychotropic medications.
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Affiliation(s)
- David Prior
- Forensic Intellectual and Neurodevelopmental Disabilities (FIND) Community Team South London Partnership, Oxleas NHS Foundation Trust, London, UK
| | - Soe Win
- Services for People with Learning Disabilities (Luton), East London NHS Foundation Trust, London, UK
| | | | - Ian Hall
- Hackney Integrated Learning Disability Service, East London NHS Foundation Trust, London, UK
| | - Michele A Martiello
- More Ward, Goodmayes Hospital, North East London NHS Foundation Trust, London, UK
| | - Afia K Ali
- Unit for Social and Community Psychiatry, East London NHS Foundation Trust, London, UK
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Manfredi P, Taglietti C. A psychodynamic contribution to the understanding of anger - The importance of diagnosis before treatment. RESEARCH IN PSYCHOTHERAPY: PSYCHOPATHOLOGY, PROCESS AND OUTCOME 2022; 25. [PMID: 35796598 PMCID: PMC9422318 DOI: 10.4081/ripppo.2022.587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/16/2022] [Indexed: 11/23/2022]
Abstract
This paper starts from the claim that a shared understanding of anger, in both its normal and psychopathological dimensions, is missing and that there are various therapeutic paths that seem to be less effective than those related to other pathologies. A major limitation of anger research and of its treatments lies in the lack of precise clinical diagnoses to inform therapy. For this reason, the first aim of our work is to survey critical literature in order to find useful elements to differentiate anger, starting from the evidence of negative and positive outcomes of treatments. Such evidence will then be enhanced in our proposal of interpretation and intervention, within a dynamic framework and with particular reference to Orefice’s thought. The core focus is to explore the different functions that anger has for the patient and to investigate the elementary functioning of the self. Our reading of the phenomena related to anger will provide useful tools both for understanding the dynamics underlying anger and as a guide for clinical intervention.
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Byrne G. A Systematic Review of Treatment Interventions for Individuals With Intellectual Disability and Trauma Symptoms: A Review of the Recent Literature. TRAUMA, VIOLENCE & ABUSE 2022; 23:541-554. [PMID: 32969328 DOI: 10.1177/1524838020960219] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Individuals with intellectual disabilities (IDs) are at increased susceptibility to adverse life experiences and trauma sequelae. There is a disparate range of therapeutic interventions for post-traumatic stress disorder (PTSD) and associated symptoms. This systematic review aimed to appraise the effectiveness of both cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) for PTSD and associated symptoms for both adults and children with mild, moderate, or severe intellectual delay. A systematic search, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, of the PsychInfo, PubMed, Cochrane Database of Systematic Reviews, and MEDLINE databases were performed, and all relevant articles published between 2010 and March 2020 were included. A total of 11 articles were included, eight that focused on EMDR and three on CBT. The methodological quality of many of these articles was generally weak. Tentative findings suggest that EMDR and CBT are both acceptable and feasible treatment options among adults and children with varying levels of intellectual delay, but no firm conclusions can be drawn regarding effectiveness due to small sample sizes, lack of standardized assessment, and a paucity of methodological rigorous treatment designs. This review highlights the continued use of therapeutic approaches with clients presenting with IDs and PTSD. It adds to the extant literature by providing an expansive and broad overview of the current effectiveness of both EMDR and CBT. Further high-quality research is needed to provide more conclusive findings regarding treatment effectiveness and modifications to treatment needed with this population.
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Affiliation(s)
- Gary Byrne
- Primary Care Psychology Department, Churchtown, Health Service Executive, Dublin, Ireland
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Tolentino-Castro JW, Raab M. Intellectual Disabilities Behavior Under the Lens of Embodied Cognition Approaches. Front Psychol 2021; 12:620083. [PMID: 34322048 PMCID: PMC8311120 DOI: 10.3389/fpsyg.2021.620083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 06/15/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Walter Tolentino-Castro
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany.,School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Markus Raab
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany.,School of Applied Sciences, London South Bank University, London, United Kingdom
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Dekker AD, Ulgiati AM, Groen H, Boxelaar VA, Sacco S, Falquero S, Carfi A, di Paola A, Benejam B, Valldeneu S, Fopma R, Oosterik M, Hermelink M, Beugelsdijk G, Schippers M, Henstra H, Scholten-Kuiper M, Willink-Vos J, de Ruiter L, Willems L, Loonstra-de Jong A, Coppus AM, Tollenaere M, Fortea J, Onder G, Rebillat AS, Van Dam D, De Deyn PP. The Behavioral and Psychological Symptoms of Dementia in Down Syndrome Scale (BPSD-DS II): Optimization and Further Validation. J Alzheimers Dis 2021; 81:1505-1527. [PMID: 33967040 PMCID: PMC8293661 DOI: 10.3233/jad-201427] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with Down syndrome (DS) are at high risk to develop Alzheimer's disease dementia (AD). Behavioral and psychological symptoms of dementia (BPSD) are common and may also serve as early signals for dementia. However, comprehensive evaluation scales for BPSD, adapted to DS, are lacking. Therefore, we previously developed the BPSD-DS scale to identify behavioral changes between the last six months and pre-existing life-long characteristic behavior. OBJECTIVE To optimize and further study the scale (discriminative ability and reliability) in a large representative DS study population. METHODS Optimization was based on item irrelevance and clinical experiences obtained in the initial study. Using the shortened and refined BPSD-DS II, informant interviews were conducted to evaluate 524 individuals with DS grouped according to dementia status: no dementia (DS, N = 292), questionable dementia (DS + Q, N = 119), and clinically diagnosed dementia (DS + AD, N = 113). RESULTS Comparing item change scores between groups revealed prominent changes in frequency and severity for anxious, sleep-related, irritable, restless/stereotypic, apathetic, depressive, and eating/drinking behavior. For most items, the proportion of individuals displaying an increased frequency was highest in DS + AD, intermediate in DS + Q, and lowest in DS. For various items within sections about anxious, sleep-related, irritable, apathetic, and depressive behaviors, the proportion of individuals showing an increased frequency was already substantial in DS + Q, suggesting that these changes may serve as early signals of AD in DS. Reliability data were promising. CONCLUSION The optimized scale yields largely similar results as obtained with the initial version. Systematically evaluating BPSD in DS may increase understanding of changes among caregivers and (timely) adaptation of care/treatment.
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Affiliation(s)
- Alain D. Dekker
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Practice-oriented Scientific Research (PWO), Alliade Care Group, Heerenveen, The Netherlands
| | - Aurora M. Ulgiati
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Practice-oriented Scientific Research (PWO), Alliade Care Group, Heerenveen, The Netherlands
| | - Henk Groen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Vincent A. Boxelaar
- Center for Information Technology, University of Groningen, Groningen, The Netherlands
| | | | | | - Angelo Carfi
- Department of Geriatrics, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - Antonella di Paola
- Department of Geriatrics, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy
| | - Bessy Benejam
- Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
| | - Silvia Valldeneu
- Memory Unit and Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Roelie Fopma
- Department of Practice-oriented Scientific Research (PWO), Alliade Care Group, Heerenveen, The Netherlands
| | | | | | | | | | | | | | | | | | | | | | - Antonia M.W. Coppus
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
- Dichterbij, Gennep, The Netherlands
| | - Marleen Tollenaere
- Laboratory of Neurochemistry and Behavior, Department of Biomedical Sciences and Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Juan Fortea
- Barcelona Down Medical Center, Fundació Catalana Síndrome de Down, Barcelona, Spain
- Memory Unit and Biomedical Research Institute Sant Pau (IIB Sant Pau), Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanitá, Rome, Italy
| | | | - Debby Van Dam
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Laboratory of Neurochemistry and Behavior, Department of Biomedical Sciences and Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Peter P. De Deyn
- Department of Neurology and Alzheimer Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Laboratory of Neurochemistry and Behavior, Department of Biomedical Sciences and Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
- Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
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Song MJ, Yu L, Enright RD. Trauma and healing in the underserved populations of homelessness and corrections: Forgiveness Therapy as an added component to intervention. Clin Psychol Psychother 2020; 28:694-714. [PMID: 33179387 DOI: 10.1002/cpp.2531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 11/06/2022]
Abstract
The purpose of this article is to begin applying the principles of the psychology of forgiveness to people who are without homes and people who are in prisons. A review of the literature shows trauma for both groups. When the trauma is caused by unjust treatment by others, then excessive anger can result, compromising one's psychological and physical health. We review the interventions that have been offered for those without homes and the imprisoned to examine which existing programmes address such anger. Forgiveness Therapy, although untried in these two settings, may be one beneficial approach for substantially reducing unhealthy anger. Forgiveness interventions have shown a cause-and-effect relationship between learning to forgive and overcoming psychological compromise such as strong resentment and clinical levels of anxiety and depression. The literature review here suggests that forgiveness therapy for those without homes and the imprisoned may be a new and important consideration for ameliorating anger and aiding in a changed life pattern.
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Affiliation(s)
| | - Lifan Yu
- Department of Psychology, University of North Florida, Jacksonville, Florida, USA
| | - Robert D Enright
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Graser J, Menge E, Lyons N, Willutzki U, Michalak J. Verhaltenstherapie bei Erwachsenen mit intellektueller Beeinträchtigung: Eine systematische Review. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000508955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
<b><i>Hintergrund:</i></b> Menschen mit intellektueller Beeinträchtigung (IB) sind häufig von psychischen Störungen betroffen. Gleichzeitig ist die psychotherapeutische Versorgung in diesem Bereich bisher unzureichend, und die Evidenz bezüglich der Wirksamkeit verhaltenstherapeutischer Interventionen bei Erwachsenen mit IB ist unklar. <b><i>Ziele:</i></b> Eine systematische Literaturrecherche in den Datenbanken PubMed, PsycINFO und Google Scholar wurde durchgeführt, um die aktuelle Studienlage zu verhaltenstherapeutischen Interventionen bei Menschen mit IB zu evaluieren. Ausgewählt wurden Studien zu verhaltenstherapeutischen Verfahren bei psychischen Störungen und Problemverhalten im Erwachsenenalter. <b><i>Ergebnisse:</i></b> Zweiunddreißig Studien entsprachen den Einschlusskriterien; es wurden sowohl einzeltherapeutische als auch gruppentherapeutische Interventionen eingeschlossen. Für Menschen mit leichter IB (IQ 50–69) und teilweise auch bei mittlerer IB (IQ 35–49) konnten in einigen Studien Hinweise auf effektive und gut umsetzbare Verfahren gefunden werden. Deutliche positive Effekte aus verschiedenen Studien zeigten sich bei depressiven Symptomen und bei aggressivem Verhalten sowohl im ambulanten wie auch im forensischen Setting. Für Angstsymptome und bei Raucherentwöhnung liegen ebenfalls positive Befunde vor. Bei psychotischen Störungen und bei pathologischem Horten muss die Wirksamkeit von verhaltenstherapeutischen Interventionen noch als unklar eingeschätzt werden. <b><i>Schlussfolgerungen:</i></b> Es bedarf weiterer Forschung (insbesondere randomisierter kontrollierter Studien mit aktiven Kontrollbedingungen), in der differenzierter überprüft wird, welche Aspekte der Therapien/welche Settingbedingungen die Effektivität bei den verschiedenen Graden der IB beeinflussen.
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Bruinsma E, van den Hoofdakker BJ, Groenman AP, Hoekstra PJ, de Kuijper GM, Klaver M, de Bildt AA. Non-pharmacological interventions for challenging behaviours of adults with intellectual disabilities: A meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:561-578. [PMID: 32558050 PMCID: PMC7384078 DOI: 10.1111/jir.12736] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/24/2020] [Accepted: 04/09/2020] [Indexed: 05/10/2023]
Abstract
BACKGROUND Non-pharmacological interventions are recommended for the treatment of challenging behaviours in individuals with intellectual disabilities by clinical guidelines. However, evidence for their effectiveness is ambiguous. The aim of the current meta-analysis is to update the existing evidence, to investigate long-term outcome, and to examine whether intervention type, delivery mode, and study design were associated with differences in effectiveness. METHOD An electronic search was conducted using the databases Medline, Eric, PsychINFO and Cinahl. Studies with experimental or quasi-experimental designs were included. We performed an overall random-effect meta-analysis and subgroup analyses. RESULTS We found a significant moderate overall effect of non-pharmacological interventions on challenging behaviours (d = 0.573, 95% CI [0.352-0.795]), and this effect appears to be longlasting. Interventions combining mindfulness and behavioural techniques showed to be more effective than other interventions. However, this result should be interpreted with care due to possible overestimation of the subgroup analysis. No differences in effectiveness were found across assessment times, delivery modes or study designs. CONCLUSIONS Non-pharmacological interventions appear to be moderately effective on the short and long term in reducing challenging behaviours in adults with intellectual disabilities.
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Affiliation(s)
- E. Bruinsma
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
| | - B. J. van den Hoofdakker
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
- University of GroningenDepartment of Clinical Psychology and Experimental PsychopathologyGroningenThe Netherlands
| | - A. P. Groenman
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
| | - P. J. Hoekstra
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
| | - G. M. de Kuijper
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
- Centre for Intellectual Disability and Mental HealthAssenThe Netherlands
| | - M. Klaver
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
- Centre for Intellectual Disability and Mental HealthAssenThe Netherlands
| | - A. A. de Bildt
- University of Groningen, University Medical Centre Groningen, Department of Child and Adolescent PsychiatryGroningenThe Netherlands
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Non-Behavioral and Non-Medical Psychosocial Interventions in Individuals with Intellectual Disabilities. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2019. [DOI: 10.1007/s40474-019-00184-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Patterson CW, Williams J, Jones R. Third-wave therapies and adults with intellectual disabilities: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1295-1309. [PMID: 31094063 DOI: 10.1111/jar.12619] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Third-wave therapies appear to produce positive outcomes for people without intellectual disabilities. This systematic review aimed to establish which third-wave therapies have been adapted for adults with intellectual disabilities and whether they produced positive outcomes. METHOD Four databases were searched systematically (PsycINFO, Web of Science, MEDLINE and PubMed), yielding 1,395 results. Twenty studies (N = 109) met the present review's inclusion/exclusion criteria. RESULTS Included studies used mindfulness-based approaches, dialectical behaviour therapy, compassion focused therapy and acceptance and commitment therapy. Due to considerable heterogeneity in the designs and outcome measures used, a meta-analysis was not possible. CONCLUSIONS Evidence indicated that third-wave therapies improved mental health symptoms for some and improved challenging/offending behaviour, smoking and mindfulness/acceptance skills for most. These findings must be interpreted with caution due to the low methodological quality of included studies. Future research should build on the current evidence base, using scientifically rigorous designs and standardized measures.
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Affiliation(s)
| | - Jonathan Williams
- Forensic Adolescent Consultation and Therapy Service, North Wales Adolescent Service, Abergele Hospital, Abergele, UK
| | - Robert Jones
- North Wales Clinical Psychology Programme, School of Psychology, Bangor University, Bangor, UK
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Barrowcliff AL, Oathamshaw SC, Evans C. Psychometric properties of the Clinical Outcome Routine Evaluation-Learning Disabilities 30-Item (CORE-LD30). JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:962-973. [PMID: 30239059 DOI: 10.1111/jir.12551] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/20/2018] [Accepted: 08/23/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND There is paucity in availability of valid and reliable measures of psychopathology that can be routinely applied with an intellectual disability (ID) population in clinical practice. The psychometric properties of the Clinical Outcome Routine Evaluation-Learning Disabilities 30-Item version (CORE-LD30) are examined. METHOD The CORE-LD30 was administered to 271 sequential referrals to three National Health Service (NHS) ID services providing psychological support. A principal components analysis with oblique rotation was conducted with examination of convergent validity for extracted domains. RESULTS Three rotated factors were extracted with good levels of internal consistency reported for the overall measure (α = 0.92) and each of the domains, conceptually labelled Problems/Symptoms (α = 0.90), Risk to Self (α = 0.76) and Risk to Others (α = 0.71). Convergent validity is reported for two domains [Problems/Symptoms with the Glasgow Depression Scale for people with a learning disability (LD) and Risk to Others with the Health of the Nation Outcome Scale-LD], and support for the CORE-LD30 as a 'core' measure indicated. CONCLUSIONS The CORE-LD30 is recommended as a useful broad ranging measure of psychopathology for use with an ID population. Domains may prove to be useful for research and clinical purposes. Further research is recommended to examine the ability to monitor clinical change associated with specific levels of presentation and different clinical presentations/cohorts.
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Affiliation(s)
- A L Barrowcliff
- Willis House Community Learning Disabilities Team, North West Boroughs Healthcare NHS Foundation Trust, Prescot, UK
| | - S C Oathamshaw
- Scottish Borders Learning Disability Service, Scottish Borders Health and Social Care Partnership, UK
| | - C Evans
- Psychology Department, University of Sheffield, Sheffield, UK
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Surley L, Dagnan D. A review of the frequency and nature of adaptations to cognitive behavioural therapy for adults with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:219-237. [PMID: 30353630 DOI: 10.1111/jar.12534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 06/28/2018] [Accepted: 09/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is increasing evidence that cognitive behavioural therapy (CBT) can be effective for people with intellectual disabilities. The aim of this review was to report the nature and frequency of adaptations reported in studies of CBT for people with intellectual disabilities. METHOD This review updated and extended a previous review by (Whitehouse et al. 2006, J Appl Res Intellect Disabil, 19, 55), which used a framework of adaptations developed by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Adaptations included simplification, language, activities, developmental level, use of directive style, flexible methods, involve caregivers, transference/countertransference and disability/rehabilitation approaches. A search identified peer-reviewed papers that reported individual CBT informed psychological interventions for people with an Intellectual Disability. RESULTS The search identified 23 studies which met the inclusion criteria for review. Studies reported the majority of the categories of adaptation described by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). CONCLUSIONS The results suggest that the framework of adaptations needs further development to increase sensitivity in identifying and categorizing adaptations of CBT. Increased, systematic reporting of adaptations to studies of CBT with people with intellectual disabilities is recommended.
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Affiliation(s)
- Laura Surley
- Northumberland, Tyne and Wear NHS Foundation Trust, Northumberland, UK
| | - Dave Dagnan
- Cumbria Partnership NHS Foundation Trust, Workington, UK
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Malda Castillo J, Smith I, Morris L, Perez-Algorta G. Violent incidents in a secure service for individuals with learning disabilities: Incident types, circumstances and staff responses. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:1164-1173. [PMID: 29953700 DOI: 10.1111/jar.12490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 04/09/2018] [Accepted: 05/23/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The issue of violence in secure services has long been recognized both in the UK and worldwide. However, there is currently scarce literature available about violence within learning disability (LD) secure settings. METHODS Secondary data analysis was conducted on violent incidents, using information routinely collected by the staff over a 1-year period. RESULTS Physical assaults were the most frequent type of incident, and the distribution in terms of days or months was homogenous and incidents were concentrated in the corridors, lounges and dining rooms of secure facilities. Antipsychotic medication was not regularly prescribed. Generalized linear modelling analyses revealed significant predictors that increased the chances of seclusion and physical restraint, such as being female or directing the violence towards staff. CONCLUSIONS These findings can inform staff training on violence prevention and suggest that increased ward-based supervision and enhanced use of psychological formulations may help in reducing violence within this service context.
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Affiliation(s)
- Javier Malda Castillo
- Furness College, Lancaster University, Lancaster, England.,Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College, Lancaster, England
| | - Ian Smith
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College, Lancaster, England
| | - Lucy Morris
- Mersey Care NHS Foundation Trust, Lancaster, England
| | - Guillermo Perez-Algorta
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Furness College, Lancaster, England
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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: 22] [Impact Index Per Article: 3.7] [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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21st Century Cognitive Behavioural Therapy for Anger: A Systematic Review of Research Design, Methodology and Outcome. Behav Cogn Psychother 2018; 46:385-404. [DOI: 10.1017/s1352465818000048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background:Past reviews of cognitive behavioural therapy (CBT) for anger have focused on outcome in specific subpopulations, with few questions posed about research design and methodology. Since the turn of the century, there has been a surge of methodologically varied studies awaiting systematic review.Aims:The basic aim was to review this recent literature in terms of trends and patterns in research design, operationalization of anger, and covariates such as social desirability bias (SDB). Also of interest was clinical outcome.Method:After successive culling, 42 relevant studies were retained. These were subjected to a rapid evidence assessment (REA) with special attention to design (ranked on the Scientific Methods Scale) measurement methodology (self-monitored behaviour, anger questionnaires, and others’ ratings), SDB assessment, and statistical versus clinical significance.Results:The randomized controlled trial characterized 60% of the studies, and the State Trait Anger Expression Inventory was the dominant measure of anger. All but one of the studies reported statistically significant outcome, and all but one of the 21 studies evaluating clinical significance laid claim to it. The one study with neither statistical nor clinical significance was the only one that had assessed and corrected for SDB.Conclusions:Measures remain relatively narrow in scope, but study designs have improved, and the outcomes suggest efficacy and clinical effectiveness. In conjunction with previous findings of an inverse relationship between anger and SDB, the results raise the possibility that the favourable picture of CBT for anger may need closer scrutiny with SDB and other methodological details in mind.
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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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Vlissides N, Beail N, Jackson T, Williams K, Golding L. Development and psychometric properties of the Psychological Therapies Outcome Scale - Intellectual Disabilities (PTOS-ID). JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:549-559. [PMID: 28124412 DOI: 10.1111/jir.12361] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 12/02/2016] [Accepted: 12/15/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND There are few valid and reliable psychological therapy outcome measures available for use with people with intellectual disabilities (ID). The current study involved the development of a new scale; the Psychological Therapies Outcome Scale - Intellectual Disabilities (PTOS-ID), and the examination of its validity and internal consistency. METHOD The PTOS-ID was administered to 175 people who have ID accessing specialist ID services. The construct validity of the scale was investigated through exploratory factor analysis, concurrent validity through comparison with the Brief Symptom Inventory and internal reliability through internal consistency analysis. RESULTS Three factors emerged from the principal components analysis with high levels of internal consistency: (1) anger and mood (α = 0.82); (2) positive well-being (α = 0.81); and (3) anxiety (α = 0.76). Factors (1) and (2) were combined to measure psychological distress (α = 0.85), which correlated strongly with the Global Severity Index of the Brief Symptom Inventory (r = 0.85). CONCLUSIONS This preliminary study suggests that the PTOS-ID is a psychometrically robust measure of psychological distress and psychological well-being that can be used with people with ID. Further research is required to assess its reliability and ability to detect change.
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Affiliation(s)
- N Vlissides
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - N Beail
- Barnsley Adult Specialist Learning Disability Health Service, South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - T Jackson
- Barnsley Adult Specialist Learning Disability Health Service, South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK
| | - K Williams
- Barnsley Adult Specialist Learning Disability Health Service, South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK
| | - L Golding
- Department of Psychology, University of Liverpool, Liverpool, UK
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Lee AH, DiGiuseppe R. Anger and aggression treatments: a review of meta-analyses. Curr Opin Psychol 2017; 19:65-74. [PMID: 29279226 DOI: 10.1016/j.copsyc.2017.04.004] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 04/07/2017] [Indexed: 11/13/2022]
Abstract
In the last several decades, researchers have begun to recognize dysregulated anger as a common and debilitating psychological problem among various psychiatric populations. Accordingly, the treatment of anger and aggression has received increasing attention in the literature. The current article reviews existing meta-analyses of psychosocial intervention for anger and aggression with the aims of (1) synthesizing current research evidence for these interventions, and (2) identifying interventions characteristics associated with effectiveness in specific populations of interest. Results demonstrate that cognitive behavioral treatments are the most commonly disseminated intervention for both anger and aggression. Anger treatments have consistently demonstrated at least moderate effectiveness among both non-clinical and psychiatric populations, whereas aggression treatment results have been less consistent. We discuss the implication of these findings and provide directions for future research in the treatment of anger and aggression.
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Affiliation(s)
- Amy Hyoeun Lee
- Department of Psychology, St. John's University, 8000 Utopia Pkwy, Queens, NY 11439, United States
| | - Raymond DiGiuseppe
- Department of Psychology, St. John's University, 8000 Utopia Pkwy, Queens, NY 11439, United States.
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Hronis A, Roberts L, Kneebone II. A review of cognitive impairments in children with intellectual disabilities: Implications for cognitive behaviour therapy. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2017; 56:189-207. [DOI: 10.1111/bjc.12133] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 02/28/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Anastasia Hronis
- Discipline of Clinical Psychology; Graduate School of Health; University of Technology Sydney; New South Wales Australia
| | - Lynette Roberts
- Discipline of Clinical Psychology; Graduate School of Health; University of Technology Sydney; New South Wales Australia
| | - Ian I. Kneebone
- Discipline of Clinical Psychology; Graduate School of Health; University of Technology Sydney; New South Wales Australia
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Shepherd C, Beail N. A systematic review of the effectiveness of psychoanalysis, psychoanalytic and psychodynamic psychotherapy with adults with intellectual and developmental disabilities: progress and challenges. PSYCHOANALYTIC PSYCHOTHERAPY 2017. [DOI: 10.1080/02668734.2017.1286610] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Caroline Shepherd
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Nigel Beail
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
- South West Yorkshire Partnership NHS Foundation Trust, Adult Learning Disabilities Specialist Health Services, The Keresforth Centre, Barnsley, UK
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McNair L, Woodrow C, Hare D. Dialectical Behaviour Therapy [DBT] with People with Intellectual Disabilities: A Systematic Review and Narrative Analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2016; 30:787-804. [PMID: 27456814 DOI: 10.1111/jar.12277] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is mixed evidence regarding the effectiveness of psychological therapies for people with intellectual and developmental disorders. Although systematic reviews have supported the use of dialectical behaviour therapy with people with borderline personality disorder, there are no comparable reviews regarding DBT with people with intellectual and development disabilities. METHODS Studies were identified using a systematic approach and were selected if they reported an intervention that included a DBT skills group and then assessed using the Evaluative Method for Determining Evidence Based Practice. RESULTS Seven studies reported adaptations and outcomes of DBT for people with intellectual and development disabilities, four of which delivered full DBT programmes with three describing DBT skills groups. All studies were appraised with regard to methodological quality and the adaptations and results examined. CONCLUSIONS The findings indicate that DBT and DBT skills groups can be adapted for people with intellectual and development disabilities, but further high-quality research is needed to make conclusions about efficacy and effectiveness.
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Affiliation(s)
- Louisa McNair
- Cheshire and Wirral Partnership NHS Foundation Trust, Cheshire, UK
| | - Ceri Woodrow
- Cheshire and Wirral Partnership NHS Foundation Trust, Cheshire, UK
| | - Dougal Hare
- School of Psychology, Cardiff University, Cardiff, UK
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Chinn D, Abraham E. Using 'candidacy' as a framework for understanding access to mainstream psychological treatment for people with intellectual disabilities and common mental health problems within the English Improving Access to Psychological Therapies service. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:571-582. [PMID: 27097932 DOI: 10.1111/jir.12274] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/09/2015] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The Improving Access to Psychological Therapies (IAPT) service was established to address common mental health problems among the English population in a timely manner in order to counter the social and economic disadvantage accompanying such difficulties. Using the concept of candidacy, we examined how the legitimacy of claims by people with intellectual disabilities to use this service is facilitated or impeded. METHOD We used a sequential mixed methods design. We completed 21 interviews with a range of stakeholders, including people with intellectual disabilities and their carers. Themes from the interviews were used to design an online survey questionnaire that was returned by 452 staff from IAPT and specialist intellectual disability services. RESULTS Using the candidacy framework, we noted that eligibility and access to IAPT were achieved through dynamic and iterative processes of negotiation involving people with intellectual disabilities and their supporters on one side and IAPT staff and service structures on the other. Barriers and facilitators were apparent throughout the seven dimensions of candidacy (identification, navigation, permeability of services, appearances, adjudications, offers and resistance and operating conditions) and were linked to discourses relating to the character and purpose of IAPT and specialist intellectual disability services. CONCLUSIONS Opportunities exist for some people with intellectual disabilities to assert their candidacy for IAPT input, although there are barriers at individual, professional, organisational and structural levels. More attention needs to be paid to how principles of inclusiveness are operationalised within IAPT teams and to the mental health facilitation role of specialist intellectual disability staff.
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Affiliation(s)
- D Chinn
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
| | - E Abraham
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK
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Unwin G, Tsimopoulou I, Kroese BS, Azmi S. Effectiveness of cognitive behavioural therapy (CBT) programmes for anxiety or depression in adults with intellectual disabilities: A review of the literature. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51-52:60-75. [PMID: 26803286 DOI: 10.1016/j.ridd.2015.12.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 12/08/2015] [Accepted: 12/14/2015] [Indexed: 05/20/2023]
Abstract
Relatively little is known about the application of cognitive behavioural therapy (CBT) to people with intellectual disabilities (ID). This review sought to synthesise available evidence on the effectiveness of CBT for anxiety or depression to assess the current level of evidence and make recommendations for future research. A comprehensive systematic literature search was conducted to identify qualitative and quantitative studies. Robust criteria were applied to select papers that were relevant to the review. Included papers were subject to quality appraisal. Eleven out of the 223 studies considered met our inclusion criteria and were included in the review in which CBT was used with participants with ID and anxiety (n=3), depression (n=4) or a mixed clinical presentation (n=4). There remains a paucity of evidence of effectiveness, however, the studies indicate that CBT is feasible and well-tolerated and may be effective in reducing symptoms of depression among adults with mild ID. Qualitative data reflect a positive perception of CBT amongst clients and carers. Further research is required to investigate the components of CBT, suitability for CBT, and requisite skills for CBT, which uses valid, sensitive and more holistic outcome measures.
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Affiliation(s)
- Gemma Unwin
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Ioanna Tsimopoulou
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Biza Stenfert Kroese
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Sabiha Azmi
- North East London NHS Foundation Trust, Good Mayes Hospital, Barley Lane, London, UK
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Abstract
BACKGROUND Interventions for anger represent the largest body of research on the adaptation of cognitive behavioural therapy (CBT) for people with intellectual disabilities. The extent to which the effectiveness of these interventions reflects the behavioural or cognitive components of CBT is uncertain. This arises in part because there are few measures of anger-related cognitions. METHOD The Profile of Anger-related Cognitions (PAC) is built around interpersonal scenarios that the participant identifies as personally anger-provoking, and was designed as an extension of the Profile of Anger Coping Skills (PACS). A conversational presentational style is used to approach ratings of anger experienced in those situations and of four relevant cognitive dimensions: attribution of hostile intent, unfairness, victimhood, and helplessness. The PAC, and other measures, including the PACS, was administered to (i) people with ID identified as having problems with anger control (n = 12) and (ii) university students (n = 23); its psychometric properties were investigated and content analyses were conducted of participants' verbal responses. In a third study, clinicians (n = 6) were surveyed for their impression of using the PAC in the assessment of clients referred for help with anger problems. RESULTS The PAC had good consistency and test-retest reliability, and the total score on the four cognitive dimensions correlated significantly with anger ratings but not with impersonal measures of anger disposition. The predominant cognitions reported were perceptions of unfairness and helplessness. People with ID and university students were in most respects very similar in both the psychometric analyses and the content analyses of their verbal responses. The PAC had high acceptability both to people with ID and to clinicians. CONCLUSIONS The PAC may be a useful instrument for both clinical and research purposes. Personal relevance and the conversational mode of administration are particular strengths.
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Taylor JL, Novaco RW, Brown T. Reductions in aggression and violence following cognitive behavioural anger treatment for detained patients with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:126-133. [PMID: 26294251 DOI: 10.1111/jir.12220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 07/31/2015] [Accepted: 07/31/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Aggression is a significant problem amongst people with intellectual disabilities (ID), particularly those residing in hospital settings. Anger is related to aggression in secure services working people with ID, and the effectiveness of psychological interventions in reducing anger has been demonstrated in this population. However, no studies have systematically examined whether levels of aggression reduce following anger treatment with people with ID detained in secure settings. METHOD This programme evaluation study concerns individually delivered cognitive anger treatment delivered to 50 patients (44 men and 6 women) with mild to borderline ID, delivered twice weekly for 18 sessions in a specialist forensic hospital service. Aggressive incidents and physical assault data were obtained from records 12 months pre-treatment and 12 months post-treatment. RESULTS Following completion of treatment, the total number of aggressive incidents recorded in patients' files fell by 34.5%, and the post-treatment reduction in the number of physical assaults was 55.9%. Analysis of the data partitioned into 6-month blocks over the 24-month study period showed that significant reductions in aggressive and violent incidents occurred in the assessment intervals following anger treatment. CONCLUSIONS These findings reinforce the efficacy of cognitive behavioural anger treatment for detained patients with ID and histories of aggression; and despite its methodical limitations the study indicates the ecological validity of this treatment approach.
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Affiliation(s)
- J L Taylor
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
- Psychological Services, Northumberland, Tyne & Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - R W Novaco
- Psychology and Social Behavior, University of California, Irvine, CA, USA
| | - T Brown
- Psychological Services, Northumberland, Tyne & Wear NHS Foundation Trust, Newcastle upon Tyne, UK
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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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Ali A, Hall I, Blickwedel J, Hassiotis A. Behavioural and cognitive-behavioural interventions for outwardly-directed aggressive behaviour in people with intellectual disabilities. Cochrane Database Syst Rev 2015; 2015:CD003406. [PMID: 25847633 PMCID: PMC7170213 DOI: 10.1002/14651858.cd003406.pub4] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Outwardly-directed aggressive behaviour is a significant part of problem behaviours presented by people with intellectual disabilities. Prevalence rates of up to 50% have been reported in the literature, depending on the population sampled. Such behaviours often run a long-term course and are a major cause of social exclusion. This is an update of a previously published systematic review (see Hassiotis 2004; Hassiotis 2008). OBJECTIVES To evaluate the efficacy of behavioural and cognitive-behavioural interventions on outwardly-directed aggressive behaviour in people with intellectual disabilities when compared to standard intervention or wait-list controls. SEARCH METHODS In April 2014 we searched CENTRAL, Ovid MEDLINE, Embase, and eight other databases. We also searched two trials registers, checked reference lists, and handsearched relevant journals to identify any additional trials. SELECTION CRITERIA We included studies if more than four participants (children or adults) were allocated by random or quasi-random methods to either intervention, standard treatment, or wait-list control groups. DATA COLLECTION AND ANALYSIS Two review authors independently identified studies and extracted and assessed the quality of the data. MAIN RESULTS We deemed six studies (309 participants), based on adult populations with intellectual disabilities, suitable for inclusion in the current version of this review. These studies examined a range of cognitive-behavioural therapy (CBT) approaches: anger management (three studies (n = 235); one individual therapy and two group-based); relaxation (one study; n = 12), mindfulness based on meditation (one study; n = 34), problem solving and assertiveness training (one study; n = 28). We were unable to include any studies using behavioural interventions. There were no studies of children.Only one study reported moderate quality of evidence for outcomes of interest as assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach. We judged the evidence for the remaining studies to be of very low to low quality. Most studies were at risk of bias in two or more domains: one study did not randomly allocate participants and in two studies the process of randomisation was unclear; in one study there was no allocation concealment and in three studies this was unclear; blinding of assessors did not occur in three studies; incomplete outcome data were presented in one study and unclear in two studies; there was selective reporting in one study; and other biases were present in one study and unclear in four studies.Three of the six studies showed some benefit of the intervention on improving anger ratings. We did not conduct a meta-analysis, as we considered the studies too heterogeneous to combine (e.g. due to differences in the types of participants, sample size interventions, and outcome measures).Follow-up data for anger ratings for both the treatment and control groups were available for two studies. Only one of these studies (n = 161) had adequate long-term data (10 months), which found some benefit of treatment at follow-up (continued improvement in anger coping skills as rated by key workers; moderate-quality evidence).Two studies (n = 192) reported some evidence that the intervention reduces the number of incidents of aggression and one study (n = 28) reported evidence that the intervention improved mental health symptoms.One study investigated the effects of the intervention on quality of life and cost of health and social care utilisation. This study provided moderate-quality evidence, which suggests that compared to no treatment, behavioural or cognitive-behavioural interventions do not improve quality of life at 16 weeks (n = 129) or at 10 months follow-up (n = 140), or reduce the cost of health service utilisation (n = 133).Only one study (n = 28) assessed adaptive functioning. It reported evidence that assertiveness and problem-solving training improved adaptive behaviour.No studies reported data on adverse events. AUTHORS' CONCLUSIONS The existing evidence on the effectiveness of behavioural and cognitive-behavioural interventions on outwardly-directed aggression in children and adults with intellectual disabilities is limited. There is a paucity of methodologically sound clinical trials and a lack of long-term follow-up data. Given the impact of such behaviours on the individual and his or her support workers, effective interventions are essential. We recommend that randomised controlled trials of sufficient power are carried out using primary outcomes that include reduction in outward-directed aggressive behaviour, improvement in quality of life, and cost effectiveness.
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Affiliation(s)
- Afia Ali
- University College LondonUCL Division of PsychiatryCharles Bell House67‐73 Riding House StreetLondonUKW1W 7EY
| | - Ian Hall
- Mile End HospitalCommunity Learning Disability ServiceBeaumont HouseBancroft RoadLondonUKE1 4DG
| | - Jessica Blickwedel
- University College LondonUCL Division of PsychiatryCharles Bell House67‐73 Riding House StreetLondonUKW1W 7EY
| | - Angela Hassiotis
- University College LondonUCL Division of PsychiatryCharles Bell House67‐73 Riding House StreetLondonUKW1W 7EY
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Robertson J, Hatton C, Baines S, Emerson E. Systematic Reviews of the Health or Health care of People with Intellectual Disabilities: A Systematic Review to Identify Gaps in the Evidence Base. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 28:455-523. [DOI: 10.1111/jar.12149] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Janet Robertson
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Chris Hatton
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Susannah Baines
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
| | - Eric Emerson
- Centre for Disability Research; Division of Health Research; Lancaster University; Lancaster UK
- Centre for Disability Research and Policy; University of Sydney; Sydney NSW Australia
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Reduction of assaultive behavior following anger treatment of forensic hospital patients with intellectual disabilities. Behav Res Ther 2015; 65:52-9. [DOI: 10.1016/j.brat.2014.12.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 10/05/2014] [Accepted: 12/01/2014] [Indexed: 11/21/2022]
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Bai X, Ho DWH, Fung K, Tang L, He M, Young KW, Ho F, Kwok T. Effectiveness of a life story work program on older adults with intellectual disabilities. Clin Interv Aging 2014; 9:1865-72. [PMID: 25382974 PMCID: PMC4222619 DOI: 10.2147/cia.s56617] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study examines the effectiveness of a life story work program (LSWp) in older adults with mild-to-moderate levels of intellectual disability (ID). METHODS Using a quasiexperimental design, this study assigned 60 older adults who were between 50-90 years old with mild-to-moderate levels of ID to receive either the LSWp (intervention group, N=32) or usual activities (control group, N=28) during a period of 6 months. Evaluation was made based on the outcomes assessed by the Mood Interest and Pleasure Questionnaire, the Vineland Adaptive Behavior Scales, and the Personal Wellbeing Index - ID. RESULTS AND CONCLUSION LSWp shows potential for improving the quality of life and preventing the loss of interest and pleasure in older adults with ID. It also shows promise in enhancing their socialization skills. Patients with better communication abilities seemed to benefit more from the LSWp.
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Affiliation(s)
- Xue Bai
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Jockey Club Centre for Positive Ageing, Shatin, Hong Kong
| | - Daniel WH Ho
- Jockey Club Centre for Positive Ageing, Shatin, Hong Kong
| | | | | | - Moon He
- Hong Chi Association, Hong Kong
| | - Kim Wan Young
- Department of Social Work, Hong Kong Baptist University, Hong Kong
| | - Florence Ho
- Jockey Club Centre for Positive Ageing, Shatin, Hong Kong
| | - Timothy Kwok
- Jockey Club Centre for Positive Ageing, Shatin, Hong Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
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McWilliams J, de Terte I, Leathem J, Malcolm S. An evaluation of an emotion regulation programme for people with an intellectual disability. THERAPEUTIC COMMUNITIES 2014. [DOI: 10.1108/tc-02-2014-0003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to examine the effectiveness of the Transformers programme on individual's use of appropriate emotion regulation strategies.
Design/methodology/approach
– Five people with an intellectual disability participated in the Transformers programme and took part in the current study. The intervention was evaluated using the Profile of Anger Coping Skills (PACS) and incident reports. The PACS was completed by participants and their caregivers.
Findings
– The majority of participants demonstrated increases in self- and caregiver-reported use of appropriate emotion regulation strategies following their involvement in the Transformers programme. However, treatment gains were not always maintained at follow-up. Three of the participants also exhibited fewer incidents of challenging behaviour after taking part in the programme.
Originality/value
– Overall, the results provide preliminary support for the continued use of the Transformers programme with people with an intellectual disability who have emotion regulation difficulties. It is recommended that further research be carried out with a larger sample size, a control group, and a longer follow-up period.
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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: 102] [Impact Index Per Article: 9.3] [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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Nicoll M, Beail N. A Comparison of Anger in Offenders and Non-Offenders Who have Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 26:466-70. [PMID: 23925968 DOI: 10.1111/jar.12035] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Matthew Nicoll
- Men's Personality Disorder Service; Rampton Hospital; Nottinghamshire Healthcare Trust; Retford UK
| | - Nigel Beail
- Barnsley Adult Specialist Learning Disability Health Service; South West Yorkshire Partnership NHS Foundation Trust & University of Sheffield; Sheffield UK
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