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Langdon PE, Apanasionok MM, Scripps E, Barrowcliff A, Biswas A, Bunning K, Burbidge C, Byron-Daniel K, Cookson A, Croom S, Filipczuk M, Gillespie D, Hastings RP, Jahoda A, McNamara R, Patterson L, Rai D, Steward R, Gray KM. Behavioural interventions to treat anxiety in adults with autism and moderate to severe intellectual disabilities: The BEAMS-ID feasibility study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13282. [PMID: 39074852 DOI: 10.1111/jar.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/21/2024] [Accepted: 07/09/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. METHOD Twenty-eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single-group non-randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. RESULTS The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5-week enrolment delay. CONCLUSION The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial.
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Affiliation(s)
- Peter E Langdon
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
- Herefordshire and Worcestershire Health and Care NHS Trust, Worcester, UK
| | - Magdalena M Apanasionok
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
| | - Emma Scripps
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
| | | | - Asit Biswas
- Leicestershire Partnership NHS Trust, Leicester, UK
| | - Karen Bunning
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Cheryl Burbidge
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | | | | | - Sarah Croom
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
- Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Malwina Filipczuk
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
| | - David Gillespie
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Richard P Hastings
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
| | - Andrew Jahoda
- Psychological Medicine, University of Glasgow, Glasgow, UK
| | - Rachel McNamara
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | | | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Robyn Steward
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
| | - Kylie M Gray
- Centre for Research in Intellectual and Developmental Disabilities (CIDD), University of Warwick, Coventry, UK
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Royston R, Absoud M, Ambler G, Barnes J, Hunter R, Kyriakopoulos M, Ondruskova T, Oulton K, Paliokosta E, Panca M, Sharma A, Slonim V, Summerson U, Sutcliffe A, Thomas M, Qu C, Hassiotis A. Evaluation of adapted parent training for challenging behaviour in pre-school children with moderate to severe intellectual developmental disabilities: A randomised controlled trial. PLoS One 2024; 19:e0306182. [PMID: 39137195 PMCID: PMC11321573 DOI: 10.1371/journal.pone.0306182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 06/10/2024] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVES There is limited evidence on the effectiveness of parenting interventions to improve disruptive behaviour in children with intellectual developmental disabilities. This clinical trial evaluated whether an adapted group parenting intervention for preschool children with intellectual developmental disabilities who display challenging behaviour is superior to treatment as usual in England. STUDY DESIGN 261 children aged 30-59 months with moderate to severe intellectual developmental disabilities and challenging behaviour were randomised to either the intervention (Stepping Stones Triple P) and treatment as usual or treatment as usual alone. The primary outcome was the parent-rated Child Behaviour Checklist at 52 weeks after randomisation. A health economic evaluation was also completed. RESULTS We found no significant difference between arms on the primary outcome (mean difference -4.23; 95% CI: -9.99 to 1.53; p = 0.147). However, a subgroup analysis suggests the intervention was effective for participants randomised before the COVID-19 pandemic (mean difference -7.12; 95% CI: -13.44 to -0.81; p = 0.046). Furthermore, a complier average causal effects analysis (mean difference -11.53; 95% CI: -26.97 to 3.91; p = 0.143) suggests the intervention requires participants to receive a sufficient intervention dose. The intervention generated statistically significant cost savings (-£1,057.88; 95% CI -£3,218.6 to -£46.67) but the mean point estimate in Quality Adjusted Life Years was similar in both groups. CONCLUSION This study did not find an effect of the intervention on reducing challenging behaviour, but this may have been influenced by problems with engagement. The intervention could be considered by services as an early intervention if families are supported to attend, especially given its low cost.
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Affiliation(s)
- Rachel Royston
- Division of Psychiatry, University College London, London, United Kingdom
| | - Michael Absoud
- Evelina London Children's Hospital, St Thomas' Hospital, and King's College London, London, United Kingdom
| | - Gareth Ambler
- Department of Statistical Science, University College London, London, United Kingdom
| | - Jacqueline Barnes
- Department of Psychological Sciences, Birkbeck University of London, London, United Kingdom
| | - Rachael Hunter
- Research Department of Primary Care and Population Health, Royal Free Medical School, London, United Kingdom
| | - Marinos Kyriakopoulos
- 1st Department of Psychiatry National and Kapodistrian University of Athens, Greece and South London and Maudsley NHS Foundation Trust and Department of Child and Adolescent Psychiatry, King's College London, London, United Kingdom
| | - Tamara Ondruskova
- Division of Psychiatry, University College London, London, United Kingdom
| | - Kate Oulton
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Eleni Paliokosta
- The Tavistock and Portman NHS Foundation Trust, Kentish Town Health Centre, London, United Kingdom
| | - Monica Panca
- Research Department of Primary Care and Population Health, Royal Free Medical School, London, United Kingdom
| | - Aditya Sharma
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust & Newcastle University, Walkergate Park Centre for Neurorehabilitation and Neuropsychiatry, Newcastle, United Kingdom
| | - Vicky Slonim
- Evelina London Children's Hospital, St Thomas' Hospital, and King's College London, London, United Kingdom
| | | | - Alastair Sutcliffe
- Institute of Child Health, University College London, London, United Kingdom
| | - Megan Thomas
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom
| | - Chen Qu
- Department of Statistical Science, University College London, London, United Kingdom
| | - Angela Hassiotis
- Division of Psychiatry, University College London, London, United Kingdom
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Hughes J, Roberts R, Tarver J, Warters-Louth C, Zhang B, Southward E, Shaw R, Edwards G, Waite J, Pearson E. 'It wasn't the strategies on their own': Exploring caregivers' experiences of accessing services in the development of interventions for autistic people with intellectual disability. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1231-1244. [PMID: 37712611 PMCID: PMC11067391 DOI: 10.1177/13623613231196084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
LAY ABSTRACT Many autistic individuals with intellectual disability experience anxiety, and for those who use few or no words, anxiety may present as behaviour that challenges, such as self-injury and avoiding anxiety-provoking situations. Families report difficulty accessing support from services for autistic individuals experiencing anxiety. Moreover, once receiving support, effective interventions for autistic people with intellectual disability are limited. We completed individual and group discussions with 16 caregivers of autistic people with intellectual disability, to (a) explore their experiences of accessing services for anxiety and/or behaviour that challenges for their child; and (b) understand what matters to caregivers when developing interventions that have been designed for them and the autistic individual with intellectual disability that they support. Caregivers reported that services, in their experience, did not deliver the support that they expected, and that they often needed to 'fight' for support. Caregivers considered services and families working together, the inclusion of peer support, and families being offered interventions that are flexible to individual circumstances to be important. These considerations are valuable for clinicians and researchers developing interventions and aiming to improve outcomes for autistic people with intellectual disability and their families.
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Jahoda A, Dagnan D, Hastings R, Gillooly A, Miller J, Baines S, Hatton C. Adapting psychological interventions for people with severe and profound intellectual disabilities: A behavioural activation exemplar. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13199. [PMID: 38361369 DOI: 10.1111/jar.13199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 11/06/2023] [Accepted: 01/01/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND People with severe to profound intellectual disabilities experience similar or higher levels of depression than those with more mild intellectual disabilities. Yet, there is an absence of evidence about how to adapt existing psychological therapies for this population. METHOD A behavioural activation intervention (BeatIt) for people with mild to moderate intellectual disabilities was adapted for people with severe to profound intellectual disabilities and depression. Key considerations include: (i) beginning with a more in-depth assessment process; (ii) including the person in session activities and developing a relationship with them; (iii) formulation and the use of film to document the link between activity and mood; and (iv) addressing barriers to change at an individual and inter-personal level and considering how the carer could support the person's engagement in activity. RESULTS Successfully adapting BeatIt represents a first step towards gathering evidence about the effectiveness of behavioural activation for people with severe to profound intellectual disabilities.
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Affiliation(s)
- Andrew Jahoda
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Dave Dagnan
- Community Learning Disability Services, Cumbria Northumberland, Tyne and Wear NHS Foundation Trust, Workington, UK
| | - Richard Hastings
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - Amanda Gillooly
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jenny Miller
- Promoting A More Inclusive Society (PAMIS), Dundee, UK
| | - Susie Baines
- Division of Health Research, University of Lancaster, Lancaster, UK
| | - Chris Hatton
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
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Gillooly A, Dagnan D, Hastings R, Hatton C, McMeekin N, Baines S, Cooper SA, Crawford L, Gillespie D, Miller J, Jahoda A. Behavioural activation for depressive symptoms in adults with severe to profound intellectual disabilities: Modelling and initial feasibility study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13197. [PMID: 38356379 DOI: 10.1111/jar.13197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 11/06/2023] [Accepted: 01/01/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Almost no research has been published reporting on evaluations of the effectiveness of psychological interventions for people with severe to profound intellectual disabilities and depression. This paper describes the development and initial feasibility testing of an adapted Behavioural Activation therapy (BeatIt2) for this population. METHOD Phase 1 of the study examined participant recruitment and willingness to be randomised in the context of a planned Randomised Controlled Trial (RCT). Phase 2 examined the feasibility of delivering the intervention. RESULTS Twenty adults with a severe or profound intellectual disability and clinically significant depression were recruited to Phase 1 of the study. In Phase 2, there was 100% participant retention for those recruited to the study at 6-month follow-up. The BeatIt2 therapy was reported to be acceptable for participants. CONCLUSION COVID disruption meant that it was not possible to complete the planned feasibility RCT. The positive findings suggest that additional evaluation of BeatIt2 is warranted.
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Affiliation(s)
- Amanda Gillooly
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Dave Dagnan
- Community Learning Disability Services, Cumbria, Northumberland Tyne and Wear NHS Foundation Trust, Workington, UK
| | - Richard Hastings
- Centre for Research in Intellectual and Developmental Disabilities, University of Warwick, Coventry, UK
| | - Chris Hatton
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - Nicola McMeekin
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Susie Baines
- Division of Health Reserach, University of Lancaster, Lancaster, UK
| | - S-A Cooper
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lucy Crawford
- Learning Disabilty Services, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | - Jenny Miller
- Promoting a More Inclusive Society (PAMIS), Dundee, UK
| | - Andrew Jahoda
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Saidinejad M, Duffy S, Wallin D, Hoffmann JA, Joseph M, Uhlenbrock JS, Brown K, Waseem M, Snow SK, Andrew M, Kuo AA, Sulton C, Chun T, Lee LK. The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies. J Emerg Nurs 2023; 49:703-713. [PMID: 37581617 DOI: 10.1016/j.jen.2023.07.005] [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: 08/16/2023]
Abstract
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure, challenges with timely access to a mental health professional, the nature of a busy ED environment, and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
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Saidinejad M, Duffy S, Wallin D, Hoffmann JA, Joseph M, Schieferle Uhlenbrock J, Brown K, Waseem M, Snow SK, Andrew M, Kuo AA, Sulton C, Chun T, Lee LK, Conners GP, Callahan J, Gross T, Joseph M, Lee L, Mack E, Marin J, Mazor S, Paul R, Timm N, Dietrich AM, Alade KH, Amato CS, Atanelov Z, Auerbach M, Barata IA, Benjamin LS, Berg KT, Brown K, Chang C, Chow J, Chumpitazi CE, Claudius IA, Easter J, Foster A, Fox SM, Gausche-Hill M, Gerardi MJ, Goodloe JM, Heniff M, Homme JJL, Ishimine PT, John SD, Joseph MM, Lam SHF, Lawson SL, Lee MO, Li J, Lin SD, Martini DI, Mellick LB, Mendez D, Petrack EM, Rice L, Rose EA, Ruttan T, Saidinejad M, Santillanes G, Simpson JN, Sivasankar SM, Slubowski D, Sorrentino A, Stoner MJ, Sulton CD, Valente JH, Vora S, Wall JJ, Wallin D, Walls TA, Waseem M, Woolridge DP, Brandt C, Kult KM, Milici JJ, Nelson NA, Redlo MA, Curtis Cooper MR, Redlo M, Kult K, Logee K, Bryant DE, Cooper MC, Cline K. The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies. Ann Emerg Med 2023; 82:e97-e105. [PMID: 37596031 DOI: 10.1016/j.annemergmed.2023.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 08/20/2023]
Abstract
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure, challenges with timely access to a mental health professional, the nature of a busy ED environment, and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affects patient care and ED operations. Strategies to improve care for MBH emergencies, including systems level coordination of care, is therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
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Saidinejad M, Duffy S, Wallin D, Hoffmann JA, Joseph MM, Uhlenbrock JS, Brown K, Waseem M, Snow S, Andrew M, Kuo AA, Sulton C, Chun T, Lee LK. The Management of Children and Youth With Pediatric Mental and Behavioral Health Emergencies. Pediatrics 2023; 152:e2023063255. [PMID: 37584147 DOI: 10.1542/peds.2023-063255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 08/17/2023] Open
Abstract
Mental and behavioral health (MBH) emergencies in children and youth continue to increasingly affect not only the emergency department (ED), but the entire spectrum of emergency medical services for children, from prehospital services to the community. Inadequate community and institutional infrastructure to care for children and youth with MBH conditions makes the ED an essential part of the health care safety net for these patients. As a result, an increasing number of children and youth are referred to the ED for evaluation of a broad spectrum of MBH emergencies, from depression and suicidality to disruptive and aggressive behavior. However, challenges in providing optimal care to these patients include lack of personnel, capacity, and infrastructure; challenges with timely access to a mental health professional; the nature of a busy ED environment; and paucity of outpatient post-ED discharge resources. These factors contribute to prolonged ED stays and boarding, which negatively affect patient care and ED operations. Strategies to improve care for MBH emergencies, including systems-level coordination of care, are therefore essential. The goal of this policy statement and its companion technical report is to highlight strategies, resources, and recommendations for improving emergency care delivery for pediatric MBH.
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Affiliation(s)
- Mohsen Saidinejad
- Department of Clinical Emergency Medicine & Pediatrics, David Geffen School of Medicine at UCLA, Institute for Health Services and Outcomes Research, The Lundquist Institute for Biomedical Innovation at Harbor UCLA, and Department of Emergency Medicine, Harbor UCLA Medical Center, Los Angeles, California
| | - Susan Duffy
- Department of Emergency Medicine, Brown University School of Medicine, Providence, Rhode Island
| | - Dina Wallin
- Department of Emergency Medicine, University of California San Francisco, UCSF Benioff Children's Hospital, San Francisco, California
| | - Jennifer A Hoffmann
- Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Evanston, Illinois
| | - Madeline M Joseph
- Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, University of Florida Health Sciences Center, Jacksonville, Jacksonville, Florida
| | | | - Kathleen Brown
- Emergency Medicine and Trauma Center, Children's National Hospital, Washington, District of Columbia
| | - Muhammad Waseem
- Department of Emergency Medicine, Lincoln Medical Center, Bronx, New York
| | - Sally Snow
- Independent Consultant, Pediatric Emergency and Trauma Nursing
| | | | - Alice A Kuo
- Departments of Medicine and Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Carmen Sulton
- Departments of Pediatrics and Emergency Medicine, Emory University School of Medicine, CPG Sedation Services, Children's Healthcare of Atlanta, Egleston, Atlanta, Georgia
| | - Thomas Chun
- Division of Pediatric Emergency Medicine, Departments of Emergency Medicine and Pediatrics, Hasbro Children's Hospital, Warren Alpert Medical School of Medicine at Brown University, Providence, Rhode Island
| | - Lois K Lee
- Division of Emergency Medicine, Boston Children's Hospital, Department of Pediatrics and Emergency Medicine, Harvard Medical School, Boston, Massachusetts
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Müssener U, Henriksson P, Gustavsson C, Henriksson H, Tyrberg MJ, Johansson S, Alfredsson Ågren K. Promoting Healthy Behaviors Among Adolescents and Young Adults With Intellectual Disability: Protocol for Developing a Digital Intervention With Co-Design Workshops. JMIR Res Protoc 2023; 12:e47877. [PMID: 37505807 PMCID: PMC10422167 DOI: 10.2196/47877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Intellectual disability (ID) is a neurodevelopmental disorder associated with a poorer health profile and higher mortality. Young people with ID have more sedentary lifestyles than their typically developing peers. Consequently, this group is at significant risk of developing lifestyle diseases (ie, noncommunicable diseases) later in life. Increasing physical activity and eating a healthier diet have been argued to be effective ways to improve the health of adolescents and young adults with ID. Digital interventions are a viable option for improving health behaviors. OBJECTIVE This research protocol describes a co-design approach using workshops to develop a digital intervention that promotes healthy behaviors, including increasing physical activity and eating a healthier diet, among adolescents and young adults with ID. METHODS A participatory design using a co-design approach will be applied as a strategy to include potential users of the digital intervention and other stakeholders in the research process, comprising research design, data collection, and data analysis. A total of 7 to 10 workshops will be conducted aimed at developing a digital intervention and will include procedures for assessing needs; facilitators and barriers to health promotion; physical, mental, and social well-being; participation; and relationships. The workshops will include 12 to 18 stakeholders with experience of clinical practice and research related to young people with ID, including relatives, as well as adolescents and young adults (aged 16-25 years) with mild to moderate ID. Participants will perform a mixture of individual and group work using whiteboards, sticky notes, felt-tip pens, cards, balls, stickers, and wireframe templates. Data analysis will take place concurrently with data collection as an iterative process. Transcribed data from the audio and video recordings of the groups' discussions will be analyzed following a qualitative methodological procedure. RESULTS This study protocol provides a systematic record of the scientific methodologies used when developing the digital intervention and provides insights into the potential practical solutions and challenges when following a co-design approach in which relatives and professionals, as well as adolescents and young adults with ID, are included as research partners. Recruitment of participants started in April 2023. Data collection, analysis, and reporting will be completed in December 2023. CONCLUSIONS This study will explore the effectiveness of workshops at gathering rich, reliable, and valid data in a co-design approach with participants. The results will provide increased knowledge in how to use technology to develop novel, evidence-based, and scalable interventions that adolescents and young adults with ID can and want to use to motivate physical activity and a healthier diet. The project will provide a simple and cognitively accessible digital solution for promoting lifestyle behaviors tailored to the needs of adolescents and young adults with ID. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/47877.
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Affiliation(s)
- Ulrika Müssener
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Catharina Gustavsson
- Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Hanna Henriksson
- Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mårten J Tyrberg
- Centre for Clinical Research, Uppsala University, Uppsala, Sweden
- Region Västmanland, Västmanland Hospital, Västerås, Sweden
| | - Stefan Johansson
- Division of Media Technology and Interaction Design, School of Electrical Engineering and Computer Science, Kungliga Tekniska Högskolan, Stockholm, Sweden
- Department of Design Sciences, Lund University, Lund, Sweden
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10
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Windsor C, Zhang T, Wilson NJ, Blyth K, Ballentine N, Speyer R. Psychosocial-behavioural interventions for school-aged children with intellectual disabilities: A systematic review of randomised control trials. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:458-485. [PMID: 36814060 DOI: 10.1111/jar.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 12/09/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Evidence-based interventions are essential for school-aged children with intellectual disabilities to facilitate development and promote future independence. METHODS Using a PRISMA approach, systematic screening of five databases was undertaken. Original randomised controlled studies with psychosocial-behavioural interventions were included where participants were school aged (5-18 yrs) with documented intellectual disability. Study methodology was assessed using the Cochrane RoB 2 tool. RESULTS Two thousand three hundred and three records were screened with 27 studies included. Studies mainly included primary school participants with mild intellectual disabilities. Most interventions focused on intellectual skills (e.g., memory, attention, literacy and mathematics) followed by adaptive skills (e.g., daily living, communication, social and education/vocation) and some focused on a combination of these. CONCLUSION This review highlights the gap in evidence-base for social, communication and education/vocation interventions with school-aged children with moderate and severe intellectual disability. Future RCTs that bridge this knowledge gap across ages and ability are required for best practice.
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Affiliation(s)
- Catriona Windsor
- Department Special Needs Education, University of Oslo, Oslo, Norway
| | - Tingwei Zhang
- Department Special Needs Education, University of Oslo, Oslo, Norway
| | - Nathan J Wilson
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia
| | - Katrina Blyth
- Faculty of Medicine and Health, Discipline of Speech Pathology, University of Sydney, Sydney, New South Wales, Australia
| | - Natalie Ballentine
- Rehabilitation and Physical Medicine (Medicina Física y Rehabilitación), Clinica Alemana Santiago, Vitacura, Chile
| | - Renée Speyer
- Department Special Needs Education, University of Oslo, Oslo, Norway.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands.,Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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11
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Shubina I. Scientific Publication Patterns of Systematic Reviews on Psychosocial Interventions Improving Well-being: Bibliometric Analysis. Interact J Med Res 2022; 11:e41456. [DOI: 10.2196/41456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/01/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Despite numerous empirical studies and systematic reviews conducted on the effectiveness of interventions improving psychological well-being, there is no holistic overview of published systematic reviews in this field.
Objective
This bibliometric study explored the scientific patterns of the effectiveness of different psychosocial interventions improving well-being among various categories of individuals with mental and physical diseases, to synthesize well-being intervention studies, and to suggest gaps and further studies in this emerging field.
Methods
The bibliometric analysis included identifying the most productive authors, institutions, and countries; most explored fields and subjects of study; most active journals and publishers; and performing citation analysis and analyzing publication trends between 2014 and 2022. We focused on data retrieved from known databases, and the study was conducted with a proven bibliometric approach.
Results
In total, 156 studies were found concerning the research domains and retrieved using LENS software from high-ranking databases (Crossref, Microsoft Academic, PubMed, and Core). These papers were written in English by 100 authors from 24 countries, among which, the leading country was the United Kingdom. Descriptive characteristics of the publications involved an increased number of publications in 2017 (n=35) and 2019 (n=34) and a decreased number in 2021 (n=4). The top 2 leading authors by citation score are James Thomas (3 papers and 260 citations) and Chris Dickens (3 papers and 182 citations). However, the most cited study had 592 citations. BMJ Open (n=6 articles) is the leading journal in the field of medicine; Clinical Psychology Review (n=5), in psychology; and Frontiers in Psychology, in psychological intervention (n=5) and psychology (n=5). The top 2 publishers were Wiley (n=28) and Elsevier (n=25).
Conclusions
This study indicates an overall interest in the declared domains within the last decade. Our findings primarily indicate that psychosocial interventions (PIs) were evaluated as being effective in managing mental and physical problems and enhancing well-being. Cognitive behavioral therapy was assessed as being effective in treating anxiety, psychoeducation in relapse prevention, and gratitude interventions in improving overall health, and the mindfulness approach had a positive impact on decreasing distress and depression. Moreover, all these intervention types resulted in an overall increase in an individuals’ well-being and resilience. Integrating social and cultural factors while considering individual differences increases the efficiency of PIs. Furthermore, PIs were evaluated as being effective in managing symptoms of eating disorders, dementia, and cancer. Our findings could help provide researchers an overview of the publication trends on research domains of focus for further studies, since it shows current findings and potential research needs in these fields, and would also benefit practitioners working on increasing their own and their patients' well-being.
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12
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Brinkman AH, Rea-Sandin G, Lund EM, Fitzpatrick OM, Gusman MS, Boness CL. Shifting the discourse on disability: Moving to an inclusive, intersectional focus. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2022; 93:50-62. [PMID: 36265035 PMCID: PMC9951269 DOI: 10.1037/ort0000653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Individuals with disabilities comprise one of the largest marginalized groups in the United States and experience systemic barriers in health care. In Westernized communities, disability has historically been conceptualized via the medical model, which considers disability an individual-level deficit in need of correction. Although other models of disability (e.g., social model) have been developed to address the medical model's ableist shortcomings, these fail to consistently acknowledge intersectionality. Specifically, these models fail to consider that (a) a disabled individual may hold other marginalized or oppressed identities and (b) these intersecting oppressions may exacerbate health inequities. Intersectionality, which originates from Black feminist literature, describes the ways that systems of power and oppression (e.g., racism, sexism) interact to form an individual's unique experience. To date, the intersection of disability and other marginalized identities has been neglected in psychology and related fields, leaving little guidance for how scholars, clinicians, and other stakeholders can address disability via an intersectional lens. The present article discusses how a disability-affirmative, intersectional approach can serve as a strategy for challenging and reforming oppressive systems across the field of psychology. We assert that, ultimately, this approach has the potential to optimize and expand access to equitable, inclusive mental health care, and we propose actionable steps psychologists can take in research, practice, training, and policy in pursuit of this aim. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Emily M. Lund
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama
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13
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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; 19:13109. [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
| | - 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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Awan N, Pearson E, Shelley L, Greenhill C, Tarver J, Waite J. The behavioral phenotype of Rubinstein-Taybi syndrome: A scoping review of the literature. Am J Med Genet A 2022; 188:2536-2554. [PMID: 35730128 PMCID: PMC9542155 DOI: 10.1002/ajmg.a.62867] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 01/24/2023]
Abstract
Rubinstein-Taybi syndrome (RTS) is a rare genetic syndrome associated with growth delay, phenotypic facial characteristics, microcephaly, developmental delay, broad thumbs, and big toes. Most research on RTS has focused on the genotype and physical phenotype; however, several studies have described behavioral, cognitive, social, and emotional characteristics, elucidating the behavioral phenotype of RTS. The reporting of this review was informed by PRISMA guidelines. A systematic search of CINAHL, Medline, and PsychINFO was carried out in March 2021 to identify group studies describing behavioral, cognitive, emotional, psychiatric, and social characteristics in RTS. The studies were quality appraised. Characteristics reported include repetitive behavior, behaviors that challenge, intellectual disability, mental health difficulties, autism characteristics, and heightened sociability. Findings were largely consistent across studies, indicating that many characteristics are likely to form part of the behavioral phenotype of RTS. However, methodological limitations, such as a lack of appropriate comparison groups and inconsistency in measurement weaken these conclusions. There is a need for multi-disciplinary studies, combining genetic and psychological measurement expertise within single research studies. Recommendations are made for future research studies in RTS.
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Affiliation(s)
- Neelam Awan
- School of Life Sciences and EducationStaffordshire UniversityStoke‐on‐TrentUK
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
- Present address:
Royal Manchester Children's HospitalManchesterUK
| | - Effie Pearson
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Lauren Shelley
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Courtney Greenhill
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Joanne Tarver
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Jane Waite
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
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15
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Xu R. The Relationship Between Psychological Quality Education and Mental Health Level of College Students by Educational Psychology. Front Psychol 2022; 13:892143. [PMID: 35783715 PMCID: PMC9240100 DOI: 10.3389/fpsyg.2022.892143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
To enable all college students to have positive psychological quality and sound personalities, their potential should be fully realized, and their comprehensive ability should be improved to adapt to society. Empirical research is carried out by means of questionnaires, and the relationship between psychological quality education and the mental health level of college students is studied through correlation analysis and regression analysis. Firstly, the problems existing in college students’ psychological quality education are summarized from the perspective of educational psychology through questionnaires. Secondly, the data of college students’ psychological quality education and mental health level are collected, and the general situation and the relationship between college students’ psychological quality education and mental health level are analyzed and discussed by processing the existing data. The research results show that 51% of college students think that psychological quality education is only needed when there is a psychological problem; 47% of college students believe that the current educational content of the school’s psychological quality education focuses on the prevention and solution of students’ psychological problems; 83% of the students consider that the psychological quality education currently carried out by the college still adopts the more traditional teaching methods such as classroom lectures, psychological counseling and special lectures. In the process of predicting college students’ mental health level, psychological resilience plays a significant role, which can predict 21.1% of variables. Psychological resilience and optimism can jointly predict 26.4% of variables. These contents broaden the research field of college students’ psychological quality education, enrich the related research on it, and provide a reference for the intervention of college students’ psychological health in school situations.
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16
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Totsika V, Liew A, Absoud M, Adnams C, Emerson E. Mental health problems in children with intellectual disability. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:432-444. [PMID: 35421380 DOI: 10.1016/s2352-4642(22)00067-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 12/16/2022]
Abstract
Intellectual disability ranks in the top ten causes of disease burden globally and is the top cause in children younger than 5 years. 2-3% of children have an intellectual disability, and about 15% of children present with differences consistent with an intellectual disability (ie, global developmental delay and borderline intellectual functioning). In this Review, we discuss the prevalence of mental health problems, interventions to address these, and issues of access to treatment and services. Where possible, we take a global perspective, given most children with intellectual disability live in low-income and middle-income countries. Approximately 40% of children with intellectual disability present with a diagnosable mental disorder, a rate that is at least double that in children without intellectual disability. Most risk factors for poor mental health and barriers to accessing support are not unique to people with intellectual disability. With proportionate universalism as the guiding principle for reducing poor mental health at scale, we discuss four directions for addressing the mental health inequity in intellectual disability.
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Affiliation(s)
- Vasiliki Totsika
- Division of Psychiatry, University College London, London, UK; Department of Psychiatry, Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, VIC, Australia; Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; Tavistock & Portman NHS Foundation Trust, London, UK.
| | - Ashley Liew
- Centre for Educational Development Appraisal and Research (CEDAR), University of Warwick, Coventry, UK; National & Specialist CAMHS, South London and Maudsley NHS Foundation Trust, London, UK; Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK; Department of Women and Children's Health, Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK
| | - Colleen Adnams
- Division of Intellectual Disability, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Eric Emerson
- Centre for Disability Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK; Centre for Disability Research & Policy, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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17
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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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18
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Ballester P, Espadas C, Londoño AC, Almenara S, Aguilar V, Belda C, Pérez E, Muriel J, Peiró AM. The challenge of detecting adverse events in adults with autism spectrum disorder who have intellectual disability. Autism Res 2021; 15:192-202. [PMID: 34652075 DOI: 10.1002/aur.2624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/15/2021] [Accepted: 09/26/2021] [Indexed: 11/09/2022]
Abstract
Adults with autism spectrum disorder (ASD) and associated intellectual disability (ID) take a high number of different psychotropic drugs simultaneously. Nowadays, little is known about this multidrug pattern efficacy and safety. The present study has endeavored to fill this gap creating a local pharmacovigilance system. A 36-month, retrospective and prospective, observational, and multicenter pharmacovigilance study was carried out in adults with ASD and ID (n = 83). Information regarding ongoing medications (polypharmacy: taking simultaneously >4 drugs; safety profile: adverse events' number, adverse drug reactions' number, and affected system; and observed-to-expected [O/E] ratio using the summary of product characteristics), and current diagnoses were recorded. A median of four ongoing medications per participant was registered, half of the sample was under polypharmacy regimen. Regarding all ongoing medications, 50% were antipsychotic drugs, and 47% of participants had >1 antipsychotic prescribed. In contrast, only 64 adverse events were identified from electronic health records, mostly due to risperidone. Half of them were related either to nervous or metabolic systems, and almost a third were not previously described in the corresponding drug summary of products characteristics. Extrapyramidalism, gynecomastia, hypercholesterolemia, and urinary retention were some AEs that occurred more frequently than expected (O/E ratio > 6 times) according to our data. The highest O/E ratio scores (>120 times) were for hypercholesterolemia and rhabdomyolysis caused by valproic acid. According to the number of adverse events and adverse drug reactions reported in electronic health records locally and nationally by clinicians, we need to increase awareness about medications safety. LAY SUMMARY: A 36-month study in adults with autism, ID, and polypharmacy (>4 drugs) was done to investigate drug safety on everyone. A median of four medications per person was registered, half were antipsychotic drugs, and 47% of participants had >1 antipsychotic medication simultaneously. Only 64 adverse events were identified from electronic health records, mostly due to risperidone. Half of them were related to nervous or metabolic systems and a third were not previously described in the drug information sheet.
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Affiliation(s)
- Pura Ballester
- Clinical Pharmacology, Paediatrics and Organic Chemistry Department, Miguel Hernández University of Elche (UMH), Alicante, Spain.,Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Cristina Espadas
- Clinical Pharmacology, Paediatrics and Organic Chemistry Department, Miguel Hernández University of Elche (UMH), Alicante, Spain
| | - Ana C Londoño
- Clinical Psychiatry and Psychology Unit, Department of Health of Alicante, General Hospital, Alicante, Spain.,Clinical Pharmacology Unit, Department of Health of Alicante, General Hospital, Alicante, Spain
| | - Susana Almenara
- Clinical Pharmacology Unit, Department of Health of Alicante, General Hospital, Alicante, Spain
| | - Victor Aguilar
- San Rafael Centre - San Francisco De Borja Foundation, Residential Facility, Alicante, Spain
| | - Cesar Belda
- Infanta Leonor Center, Autism Parents Association Valencian Community Autism Association (APACV), Alicante, Spain
| | - Enrique Pérez
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.,Clinical Psychiatry and Psychology Unit, Department of Health of Alicante, General Hospital, Alicante, Spain
| | - Javier Muriel
- Clinical Pharmacology, Paediatrics and Organic Chemistry Department, Miguel Hernández University of Elche (UMH), Alicante, Spain.,Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Ana M Peiró
- Clinical Pharmacology, Paediatrics and Organic Chemistry Department, Miguel Hernández University of Elche (UMH), Alicante, Spain.,Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.,Clinical Pharmacology Unit, Department of Health of Alicante, General Hospital, Alicante, Spain
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19
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Oudshoorn CEM, Frielink N, Nijs SLP, Embregts PJCM. Psychological eHealth interventions for people with intellectual disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:950-972. [PMID: 33704872 PMCID: PMC8359285 DOI: 10.1111/jar.12877] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of eHealth, which has accelerated in the wake of the COVID-19 pandemic, could contribute to the access to tailor-made psychological interventions for people with intellectual disabilities. METHOD A scoping review was conducted on peer-reviewed studies between 1996-2019. RESULTS Thirty-three studies reported on the use of psychological eHealth interventions focused on mental health problems and/or challenging behaviour. The vast majority of these studies reported on interventions that were delivered at the individual level. The context in which these interventions were delivered varied, primarily ranging from the home setting to residential settings, as well as day or activity centres and schools. The studies described various types of interventions: telehealth interventions, computerized cognitive behavioural therapy, and interventions focused on (social) learning principles targeting challenging behaviour. CONCLUSIONS eHealth provides new opportunities for both therapists and lay-therapists to deliver psychological interventions. Future studies should focus on the effectiveness of psychological eHealth interventions.
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Affiliation(s)
- Cathelijn E. M. Oudshoorn
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
- ASVZSliedrechtThe Netherlands
| | - Noud Frielink
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Sara L. P. Nijs
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Petri J. C. M. Embregts
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
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20
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Cameron LA, Phillips K, Melvin GA, Hastings RP, Gray KM. Psychological interventions for depression in children and young people with an intellectual disability and/or autism: systematic review. Br J Psychiatry 2021; 218:305-314. [PMID: 33198825 DOI: 10.1192/bjp.2020.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Children and young people with intellectual disability and/or Autism Spectrum Disorder (autism) experience higher rates of mental health problems, including depression, than their typically developing peers. Although international guidelines suggest psychological therapies as first-line intervention for children and young people, there is limited evidence for psychological therapy for depression in children and young people with intellectual disability and/or autism. AIMS To evaluate the current evidence base for psychological interventions for depression in children and young people with intellectual disability and/or autism, and examine the experiences of children and young people with intellectual disability and/or autism, their families and therapists, in receiving and delivering psychological treatment for depression. METHOD Databases were searched up to 30 April 2020 using pre-defined search terms and criteria. Articles were independently screened and assessed for risk of bias. Data were synthesised and reported in a narrative review format. RESULTS A total of 10 studies met the inclusion criteria. Four identified studies were clinical case reports and six were quasi-experimental or experimental studies. All studies were assessed as being of moderate or high risk of bias. Participants with intellectual disability were included in four studies. There was limited data on the experiences of young people, their families or therapists in receiving or delivering psychological treatment for depression. CONCLUSIONS Well-designed, randomised controlled trials are critical to develop an evidence base for psychological treatment for young people with intellectual disability and/or autism with depression. Future research should evaluate the treatment experiences of young people, their families and therapists.
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Affiliation(s)
- Lauren A Cameron
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia
| | - Katelyn Phillips
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University; and Discipline of Paediatrics, School of Women's and Children's Health, University of New South Wales Medicine, The University of New South Wales, Australia
| | - Glenn A Melvin
- School of Psychology, Deakin University, Australia; and Centre for Education, Appraisal and Research, University of Warwick, UK
| | - Richard P Hastings
- Centre for Education, Appraisal and Research, University of Warwick, UK; and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia
| | - Kylie M Gray
- Centre for Education, Appraisal and Research, University of Warwick, UK; and Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Australia
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21
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Eaton C, Tarver J, Shirazi A, Pearson E, Walker L, Bird M, Oliver C, Waite J. A systematic review of the behaviours associated with depression in people with severe-profound intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:211-229. [PMID: 33426741 DOI: 10.1111/jir.12807] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/09/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
The assessment of depression in people with severe to profound intellectual disability (severe-profound ID) is challenging, primarily due to inability to report internal states such as mood, feelings of worthlessness and suicidal ideation. This group also commonly presents with challenging behaviours (e.g. aggression and self-injury) with debate about whether these behaviours should be considered 'depressive equivalents' or are sensitive for, but not specific to, depression in severe-profound ID. We conducted a systematic review exploring behaviours associated with depression and low mood in individuals with severe-profound ID. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2009) guidelines. Three electronic databases were searched (Embase, PsycINFO and Ovid MEDLINE), and 13 studies were included and rated for quality. Few studies were rated as having high methodological quality. Behaviours captured by standard diagnostic schemes for depression (e.g. Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases) showed a relationship with depression in severe-profound ID, including the two core symptoms (depressed affect and anhedonia), as well as irritability, sleep disturbance, psychomotor agitation, reduced appetite and fatigue. Challenging behaviours such as aggression, self-injury, temper tantrums, screaming and disruptive behaviour were associated with depression. Challenging behaviours show a robust relationship with depression. Whilst these behaviours may suggest an underlying depression, study limitations warrant caution in labelling them as 'depressive equivalents'. These limitations include not controlling for potential confounds (autism, other affective disorders and pain) and bias associated with comparing depressed/non-depressed groups on the same behavioural criteria used to initially diagnose and separate these groups. Future studies that use depressive measures designed for ID populations, which control for confounds and which explore low mood irrespective of psychiatric diagnosis, are warranted to better delineate the behaviours associated with depression in this population (PROSPERO 2018: CRD42018103244).
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Affiliation(s)
- C Eaton
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
- Department of Child Life and Health, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Tarver
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - A Shirazi
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - E Pearson
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - L Walker
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - M Bird
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - C Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - J Waite
- School of Life and Health Sciences, Aston University, Birmingham, UK
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22
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Byrne G, O'Mahony T. Acceptance and commitment therapy (ACT) for adults with intellectual disabilities and/or autism spectrum conditions (ASC): A systematic review". JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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23
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Family accommodation of anxiety in a community sample of children on the autism spectrum. J Anxiety Disord 2020; 70:102192. [PMID: 31972299 DOI: 10.1016/j.janxdis.2020.102192] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/22/2019] [Accepted: 01/15/2020] [Indexed: 12/28/2022]
Abstract
Anxiety is recognised as one of the most common co-occurring conditions for individuals with a diagnosis on the autism spectrum, with approximately 40 % of children on the spectrum receiving a clinical diagnosis of an anxiety disorder. To date, research has tended to focus upon understanding presentation and evaluating treatment, with little focus on assessing systemic factors, such as the way that family members accommodate the anxiety. This study aimed to investigate the relationship between parent and child anxiety levels and child autism characteristics on the four domains of family accommodation; Participation, Modification, Distress, and Consequence. A community sample (n = 132) of parents of children on the spectrum completed questionnaires on their child's autism characteristics and anxiety symptomatology as well as their own levels of anxiety and family accommodation behaviours. Regression models identified specific aspects of child anxiety as well as parent anxiety as predictive of family accommodation, with the child's difficulties with uncertainty being a consistent predictor of all four domains. Clinical and research implications of this study, including the importance of understanding similarities or differences in the nature and consequence of family accommodation in children on the autism spectrum, are discussed.
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24
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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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