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Bakken TL. The effects of lockdown of work and activities for adults with multiple, complex needs including sensory impairments during the pandemic in 2020. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:578-587. [PMID: 38305233 PMCID: PMC11059831 DOI: 10.1177/17446295241232030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
Sheltered work and leisure activities were locked down in at the Signo centre in March 2020 because of the COVID-19 pandemic. The Signo centre is a Norwegian national centre for adults with multiple, complex needs, including severe sensory loss/impairments. Tension and uncertainty rapidly spread among relatives and workers. To explore the impacts of the pandemic on residents, 24 adults living in Signo Vivo answered a semi-structured interview together with their primary worker. Additionally, reports on staff injuries and PRN medication between April and Aug of 2020 were compared to the period before the lockdown. The reports from the interviews included fewer stressful events for the participants, more rest and sleep, more time spent in their own apartments, and more time with smaller groups of workers. The reports on staff injuries and PRN medication showed decreased occurrence.
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Affiliation(s)
- Trine Lise Bakken
- National Advisory Unit for mental health in Intellectual Disability, Oslo University Hospital, Norway
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2
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Tudehope L, Harris N, Vorage L, Sofija E. What methods are used to examine representation of mental ill-health on social media? A systematic review. BMC Psychol 2024; 12:105. [PMID: 38424653 PMCID: PMC10905888 DOI: 10.1186/s40359-024-01603-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/18/2024] [Indexed: 03/02/2024] Open
Abstract
There has been an increasing number of papers which explore the representation of mental health on social media using various social media platforms and methodologies. It is timely to review methodologies employed in this growing body of research in order to understand their strengths and weaknesses. This systematic literature review provides a comprehensive overview and evaluation of the methods used to investigate the representation of mental ill-health on social media, shedding light on the current state of this field. Seven databases were searched with keywords related to social media, mental health, and aspects of representation (e.g., trivialisation or stigma). Of the 36 studies which met inclusion criteria, the most frequently selected social media platforms for data collection were Twitter (n = 22, 61.1%), Sina Weibo (n = 5, 13.9%) and YouTube (n = 4, 11.1%). The vast majority of studies analysed social media data using manual content analysis (n = 24, 66.7%), with limited studies employing more contemporary data analysis techniques, such as machine learning (n = 5, 13.9%). Few studies analysed visual data (n = 7, 19.4%). To enable a more complete understanding of mental ill-health representation on social media, further research is needed focussing on popular and influential image and video-based platforms, moving beyond text-based data like Twitter. Future research in this field should also employ a combination of both manual and computer-assisted approaches for analysis.
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Affiliation(s)
- Lucy Tudehope
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, 1 Parklands Drive, 4222, Southport, Gold Coast, QLD, Australia.
| | - Neil Harris
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, 1 Parklands Drive, 4222, Southport, Gold Coast, QLD, Australia
| | - Lieke Vorage
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, 1 Parklands Drive, 4222, Southport, Gold Coast, QLD, Australia
| | - Ernesta Sofija
- School of Medicine and Dentistry, Griffith University, Gold Coast Campus, 1 Parklands Drive, 4222, Southport, Gold Coast, QLD, Australia
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Charlot LR, Hodge SM, Holland AL, Frazier JA. Psychiatric diagnostic dilemmas among people with intellectual and developmental disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:805-816. [PMID: 35974452 DOI: 10.1111/jir.12972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Research regarding the accuracy of co-morbid psychiatric diagnoses in individuals with intellectual and developmental disabilities (IDD) is sparse. Yet correct diagnostic assignment is vital so that effective and appropriate treatment can be implemented, especially for the large numbers of individuals requiring expensive and restrictive behavioural health crisis services. METHOD A retrospective review of de-identified data from multidisciplinary specialty team assessments completed for 50 individuals with ID (IntellectualDisability) with and without ASD and unresolved behavioural health challenges was conducted. The accuracy and reliability of the psychiatric diagnoses upon referral were compared with the diagnoses after the comprehensive team evaluation, and within-individual diagnostic agreement was calculated. The agreement between the Mood and Anxiety Semi-Structured interview tool (MASS) and the full team evaluation was also calculated. The influence of demographic and clinical characteristics on diagnostic agreement was explored. RESULTS The most common chief complaints upon referral were aggression to others and self-injurious behaviour. Individuals were taking a median of six medications (interquartile range: 5 to 7); 80% were taking an antipsychotic medication. The most common medical conditions were constipation (70%) and gastroesophageal reflux disease (52%). Measures of interrater reliability of the referral diagnoses with the team assessment were below 0.5 (kappa range: -0.04 to 0.39), with the exception of ruling out dementia (kappa = 0.85). The interrater reliability estimates for the MASS evaluations for depression and anxiety were higher (kappa = 0.69 and 0.64) and reflected higher sensitivity and PPV. The odds of any referral diagnosis being confirmed by team evaluation were low: 0.25 (range: 0 to 0.67). The level of diagnostic agreement for each patient was not significantly attributable to demographic or clinical characteristics, although effect sizes indicate a possible positive relationship to age and the number of prescribed psychotropic medications at referral. CONCLUSION Individuals in the current study had serious psychiatric and behavioural problems despite psychiatric care in their communities. The majority of psychiatric diagnoses provided upon referral were not supported by the multidisciplinary specialty team's assessment. In addition to possible diagnostic inaccuracy, the group in the study suffered from multiple medical co-morbidities and were exposed to polypharmacy. Results emphasise the importance of multidisciplinary evaluation by clinicians with expertise in neurodevelopmental disabilities when people with ID with and without ASD have complex behavioural health needs that are unresponsive to usual care. In addition, based on agreement with the full team evaluation, the MASS shows promise as an assessment tool, especially with regards to identifying anxiety and depression.
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Affiliation(s)
- L R Charlot
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - S M Hodge
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - A L Holland
- Department of Pediatric psychiatry/neuropsychiatry, Mayo Clinic Health System/Mayo Clinic, Eau Claire, WI, USA
| | - J A Frazier
- Eunice Kennedy Shriver Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
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Song M, Ware RS, Doan TN, Harley D. Characteristics associated with frequent health system use by Australian adults with intellectual disability: A cohort study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1403-1417. [DOI: 10.1111/jar.13029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 02/23/2022] [Accepted: 07/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Menghuan Song
- Queensland Centre for Intellectual and Developmental Disability (QCIDD) Mater Research Institute‐University of Queensland (MRI‐UQ) South Brisbane Queensland Australia
| | - Robert S. Ware
- Queensland Centre for Intellectual and Developmental Disability (QCIDD) Mater Research Institute‐University of Queensland (MRI‐UQ) South Brisbane Queensland Australia
- Menzies Health Institute Queensland Griffith University Nathan Queensland Australia
| | - Tan N. Doan
- Department of Medicine at The Royal Melbourne Hospital University of Melbourne Melbourne Victoria Australia
| | - David Harley
- Centre for Clinical Research University of Queensland South Brisbane Queensland Australia
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van den Akker N, Kroezen M, Wieland J, Pasma A, Wolkorte R. Behavioural, psychiatric and psychosocial factors associated with aggressive behaviour in adults with intellectual disabilities: A systematic review and narrative analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:327-389. [PMID: 33073443 PMCID: PMC7894289 DOI: 10.1111/jar.12809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 08/07/2020] [Accepted: 08/30/2020] [Indexed: 12/28/2022]
Abstract
Background Aggressive behaviour is prevalent in people with intellectual disabilities. To understand the aetiology, it is important to recognize factors associated with the behaviour. Method A systematic review was conducted and included studies published between January 2002 and April 2017 on the association of behavioural, psychiatric and psychosocial factors with aggressive behaviour in adults with intellectual disabilities. Results Thirty‐eight studies were included that presented associations with 11 behavioural, psychiatric and psychosocial factors. Conflicting evidence was found on the association of these factors with aggressive behaviour. Conclusions The aetiology of aggressive behaviour is specific for a certain person in a certain context and may be multifactorial. Additional research is required to identify contributing factors, to understand causal relationships and to increase knowledge on possible interaction effects of different factors.
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Affiliation(s)
- Natalie van den Akker
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Marieke Kroezen
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Jannelien Wieland
- Cordaan, Center for Excellence on Mental Health and Mild Intellectual Disability, Amsterdam, The Netherlands
| | - Annelieke Pasma
- Department of Rheumatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Ria Wolkorte
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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Lange J. Intelligenzminderung und Schuldfähigkeit. FORENSISCHE PSYCHIATRIE PSYCHOLOGIE KRIMINOLOGIE 2020. [DOI: 10.1007/s11757-020-00628-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ZusammenfassungWer zur Frage der Schuldfähigkeitsbeurteilung bei Intelligenzminderung in forensisch-psychiatrischen Lehrbüchern nachschlägt, findet vielfach und teils sehr anschaulich in schematischer Aufbereitung eine Beurteilungsmaßgabe, dass bei schwerster und schwerer Intelligenzminderung die Einsichtsfähigkeit aufgehoben, bei mittelgradiger Intelligenzminderung teils die Einsichts- und teils die Steuerungsfähigkeit aufgehoben und bei leichter Intelligenzminderung entweder die Einsichtsfähigkeit oder die Steuerungsfähigkeit entweder vermindert oder aufgehoben seien. Eine psychopathologische Fundierung dieser Leitsätze oder eine Darlegung möglicher Begründungswege von Fähigkeitsbeeinträchtigungen entsprechend den §§ 20, 21 StGB wird jedoch in aller Regel nicht geboten. Nachfolgend soll versucht werden, unter Bezugnahme auf aktuelle diagnostische Kriterien und Konzeptionen der Intelligenzminderung, die über die isolierte Bestimmung eines IQ-Werts hinausweisen, weitere Orientierung bei der Schuldfähigkeitsbeurteilung von Straftätern mit Intelligenzminderung zu bieten.
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Edwards N, King J, Williams K, Hair S. Chemical restraint of adults with intellectual disability and challenging behaviour in Queensland, Australia: Views of statutory decision makers. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2020; 24:194-211. [PMID: 29929418 DOI: 10.1177/1744629518782064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Psychotropic medication is widely prescribed to treat mental illness. However, it is controversial when used as a chemical restraint (CR) to manage challenging behaviours (CBs) of adults with intellectual disability (ID). CR has potentially negative consequences and affects human rights. METHOD Qualitative research conducted between 2014 and 2015 explored the views of 'guardian' decision makers appointed under unique Queensland legislation oversighting the use of CR. RESULTS Findings included (1) negative conceptualization of CR, (2) concerning relationships with prescribers and disability sector staff, (3) challenges to information seeking about people with ID prescribed CR and (4) problematic implementation of positive behaviour support plans. CONCLUSION According to guardians, CR may be used in lieu of community supports, and prescribers sometimes diagnose mental illness to avoid CR legislative requirements. Guardians, prescribers and professionals would benefit from training that addresses the intersection between physical and mental health, CB and CR.
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Affiliation(s)
| | - Julie King
- Queensland University of Technology, Australia
| | | | - Sara Hair
- Queensland University of Technology, Australia
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Abstract
People with intellectual disability (ID) have a high vulnerability to develop mental health problems. The prevalence of mental disorders is higher than in the general population and, in addition, adults with ID often show behavioral problems that imply a need for psychiatric psychotherapeutic care. In view of the impairments of intellectual functioning, impaired adaptive behavioral skills and physical illnesses, the needs of this target group are usually complex and require particular expertise. A number of specific assessment instruments are available for target group-specific diagnostics to collate the cognitive performance and emotional development as well as for psychopathological symptoms and behavioral disorders. To improve the accuracy of diagnosis in the ID population, existing alternatives to DSM or ICD should be applied especially to adults with moderate or severe ID. Guidelines for psychopharmacotherapy and adapted user guides for psychotherapeutic treatment provide support in the context of target group-specific treatment.
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9
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Thompson B, Tickle A, Dillon G. Discovery awareness for staff supporting individuals with intellectual disabilities and challenging behaviour: is it helpful and does it increase self-efficacy? INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2019; 67:44-57. [PMID: 34141398 PMCID: PMC7942778 DOI: 10.1080/20473869.2019.1599605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 06/12/2023]
Abstract
Discovery awareness (DA) is an approach to using video within structured meetings to help staff become more mindful, aware and interested in a client they are supporting who has intellectual disabilities and challenging behaviour. The objective was to evaluate whether, and how, DA is helpful for staff in both inpatient and community settings, and whether it increases self-efficacy in working with people with challenging behaviour. A two-phase mixed method design was employed. For phase 1, forty staff who took part in one of seven single DA meetings completed the Challenging Behaviour Self-Efficacy Scale pre- and post-DA. In addition, post-DA, participants completed an Adapted Helpful Aspects of Therapy Scale (AHAT). For phase 2, six participants completed a follow-up Change Interview; 3-12 weeks after DA. Descriptive statistics reveal participants found events in the DA 'greatly helpful'. The changes identified varied in whether they were expected or not, but were unlikely to occur without DA and 'very important'. Statistical analysis showed no significant changes in self-efficacy following the DA. A thematic analysis on the qualitative data generated by the change interviews and AHAT identified three main themes: Impact on interaction; DA is unique and valuable; and the power of the process. The latter had three subthemes: a structure to facilitate change, making use of the content and reflective space to promote learning. Attendance at a single DA meeting does not increase staff perceptions of self-efficacy, however, staff find the process of DA helpful as it encourages reflection on their interactions with individuals with intellectual disability and challenging behaviour and attuning of their interactions, though further research is needed.
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Affiliation(s)
| | - Anna Tickle
- Nottinghamshire Healthcare NHS Trust and University of Nottingham, Nottingham, United Kingdom
| | - Gayle Dillon
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
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Tyrer F, Dunkley AJ, Singh J, Kristunas C, Khunti K, Bhaumik S, Davies MJ, Yates TE, Gray LJ. Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross-sectional analysis of a UK cohort. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:255-265. [PMID: 30485584 DOI: 10.1111/jir.12571] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 09/25/2018] [Accepted: 10/21/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Multimorbidity [two or more conditions in addition to intellectual disability (ID)] is known to be more common among people with ID. However, the relationship between multimorbidity and lifestyle factors is currently unknown. The aim of this study was to determine the prevalence of multimorbidity in a population of adults with ID. We also aimed to identify risk factors, including lifestyle factors, for multimorbidity in this population. METHODS This was a cross-sectional analysis using data from a diabetes screening study of 920 adults aged 18-74 years with ID living in Leicestershire, UK. We described comorbidities and the prevalence of multimorbidity in this population. We explored the relationship between multimorbidity and age, gender, ethnicity, severity of ID, socio-economic status, physical activity, sedentary behaviour, fruit and vegetable consumption and smoking status using multiple logistic regression. RESULTS The prevalence of multimorbidity was 61.2% (95% CI 57.7-64.7). Multimorbidity was independently associated with being female (P < 0.001) and severe/profound ID (P = 0.004). Increasing age was of borderline significance (P = 0.06). Individuals who were physically inactive or sedentary were more likely to be multimorbid, independent of ability to walk, age, gender, severity of ID, ethnicity and socio-economic status (adjusted OR = 1.91; 95% CI 1.23-2.97; P = 0.004 and OR = 1.98; 95% CI 1.42-2.77; P < 0.001). After excluding probable life-long conditions (autism spectrum conditions, attention deficit hyperactivity disorders, epilepsy, cerebral palsy and other paralytic syndromes) as contributing comorbidities, the effect of sedentary behaviour, but not physical activity, remained (P = 0.004). We did not observe a relationship between multimorbidity, fruit and vegetable consumption and smoking status. CONCLUSIONS Multimorbidity presents a significant burden to people with ID. Individuals who were physically inactive or sedentary were more likely to be multimorbid, but further work is recommended to explore the relationship between multimorbidity and lifestyle factors using standardised objective measures.
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Affiliation(s)
- F Tyrer
- Department of Health Sciences Centre for Medicine, University of Leicester, Leicester, UK
| | - A J Dunkley
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - J Singh
- Department of Health Sciences Centre for Medicine, University of Leicester, Leicester, UK
| | - C Kristunas
- Department of Health Sciences Centre for Medicine, University of Leicester, Leicester, UK
| | - K Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - S Bhaumik
- Learning Disability Service, Leicestershire Partnership NHS Trust, Leicester, UK
| | - M J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - T E Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - L J Gray
- Department of Health Sciences Centre for Medicine, University of Leicester, Leicester, UK
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Verberg FLM, Helmond P, Overbeek G. Study protocol: a randomized controlled trial testing the effectiveness of an online mindset intervention in adolescents with intellectual disabilities. BMC Psychiatry 2018; 18:377. [PMID: 30514245 PMCID: PMC6278007 DOI: 10.1186/s12888-018-1939-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents with intellectual disabilities have an increased risk of developing academic, social, and psychological problems compared with non-disabled peers. These difficulties might have an impact on the implicit theories-or so called mindset-of these youth. Youth with a fixed mindset believe that their attributes are static while youth with a growth mindset believe their attributes are malleable. A growth mindset can positively affect the academic and psychosocial development of youth and can be stimulated by so called 'mindset interventions'. Nevertheless, mindset interventions specifically adapted to adolescents with intellectual disabilities are non-existing. METHODS/DESIGN The aim of the present study is to conduct a randomized controlled trial (RCT) to test the effectiveness of the online mindset intervention "The Growth Factory" aimed to teach adolescents with intellectual disabilities a growth mindset and thereby positively impacting their psychosocial development. The RCT targets adolescents (12-23 years) with mild to borderline intellectual disabilities (IQ 50-85) admitted to residential care or special education. Participants will be individually randomized to the intervention (n = 60) or control (n = 60) group. The intervention group will individually participate in the six sessions of "The Growth Factory" and the control group will receive care as usual. Primary outcome will be mindset. Empowerment, behavior problems, self-esteem, treatment motivation, therapeutic alliance, challenge seeking, and the impact of social exclusion will be included as secondary outcome measures. Moreover, moderation (i.e., intervention satisfaction, IQ, age, baseline mindset, gender) and mediation effects will be investigated. Self-reported and mentor assessments will be administrated at baseline, post-test and at three (except mentor assessment) and six months follow-up. DISCUSSION This paper describes the design of a RCT examining the effectiveness of the online mindset intervention "The Growth Factory" aimed to empower adolescents with intellectual disabilities. If effective, "The Growth Factory" makes an important contribution to the treatment and psychosocial development of adolescents with intellectual disabilities in residential care and special education. Due to the online approach, implementation will be efficient and cost-effective and therefore the intervention "The Growth Factory" can be used on large scale. TRIAL REGISTRATION Dutch Trial Register NTR5460 . Registered 2 October 2015.
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Affiliation(s)
- Fenneke L. M. Verberg
- Pluryn Research & Development, P.O. Box 53, 6500 AB Nijmegen, The Netherlands
- Research Institute of Child Development and Education, Faculty of Social and Behavioural Sciences, University of Amsterdam, P.O. Box 15776, 1001 NG Amsterdam, The Netherlands
| | - Petra Helmond
- Pluryn Research & Development, P.O. Box 53, 6500 AB Nijmegen, The Netherlands
- Research Institute of Child Development and Education, Faculty of Social and Behavioural Sciences, University of Amsterdam, P.O. Box 15776, 1001 NG Amsterdam, The Netherlands
| | - Geertjan Overbeek
- Research Institute of Child Development and Education, Faculty of Social and Behavioural Sciences, University of Amsterdam, P.O. Box 15776, 1001 NG Amsterdam, The Netherlands
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Axmon A, Björne P, Nylander L, Ahlström G. Psychiatric diagnoses in relation to severity of intellectual disability and challenging behaviors: a register study among older people. Aging Ment Health 2018; 22:1344-1350. [PMID: 28825845 DOI: 10.1080/13607863.2017.1348483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the possible association between severity of intellectual disability (ID) and presence of challenging behavior, respectively, on diagnoses of psychiatric disorders among older people with ID. METHODS People with a diagnosis of ID in inpatient or specialist outpatient care in 2002-2012 were identified (n = 2147; 611 with mild ID, 285 with moderate ID, 255 with severe or profound ID, and 996 with other/unspecified ID). Moreover, using impairment of behavior as a proxy for challenging behavior, 627 people with, and 1514 without such behavior were identified. RESULTS Severe/profound ID was associated with lower odds of diagnoses of psychotic, affective, and anxiety disorders than was mild/moderate ID. People with moderate ID had higher odds than those with mild ID of having diagnoses of affective disorders. Diagnoses of psychotic, affective, and anxiety disorders, and dementia were more common among people with challenging behavior than among those without. CONCLUSIONS People with severe/profound ID had lower odds of receiving psychiatric diagnoses than those with mild and moderate ID. Whether this is a result of differences in prevalence of disorders or diagnostic difficulties is unknown. Further, challenging behaviors were associated with diagnoses of psychiatric disorders. However, the nature of this association remains unclear.
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Affiliation(s)
- A Axmon
- a Department of Occupational and Environmental Medicine , Lund University , Lund , Sweden
| | - P Björne
- b Research and Development Unit, City Office , City of Malmö , Malmö , Sweden
| | - L Nylander
- c Department of Clinical Sciences/Psychiatry , Lund University , Lund , Sweden , and Gillberg Neuropsychiatry Centre , University of Gothenburg , Gothenburg , Sweden
| | - G Ahlström
- d Department of Health Sciences, Faculty of Medicine , Lund University , Lund , Sweden
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Camp J, Joy K, Freestone M. Does "Enhanced Support" for Offenders Effectively Reduce Custodial Violence and Disruption? An Evaluation of the Enhanced Support Service Pilot. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:3928-3946. [PMID: 29325468 DOI: 10.1177/0306624x17752254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study aimed to examine the effectiveness of The Enhanced Support Service (ESS) pilot in reducing custodial violence and disruption, and the associated costs, by observing the behavioural change of the 35 service users who participated in ESS intervention within its first 22 months of operation. Frequencies of recorded incidents of aggressive behaviours, self-harming behaviours, noncompliance, and positive behaviours were counted from routine administrative systems using a coding structure developed in previous studies. The count data were analysed using nonparametric tests and Poisson regression models to derive an Incident Rate Ratio (IRR). Findings suggest the ESS is associated with a reduction in aggressive behaviours and noncompliance, with medium to large effect sizes ( r = .31-.53); however, it was not associated with a reduction in deliberate self-harm or increased positive behaviours. The Poisson models revealed that levels of pre-intervention behaviour, intervention length, intervention completion, and service location had varying effects on postintervention behaviour, with those who completed intervention demonstrating more favourable outcomes. The ESS service model was associated with a reduction in behaviour that challenges, which has implications for the reduction in associated social, economic, and political costs-as well as the commissioning of interventions and future research in this area.
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Affiliation(s)
- Jake Camp
- 1 Oxleas NHS Foundation Trust, Kent, UK
| | - Kerry Joy
- 1 Oxleas NHS Foundation Trust, Kent, UK
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Young People with Intellectual Disability Transitioning to Adulthood: Do Behaviour Trajectories Differ in Those with and without Down Syndrome? PLoS One 2016; 11:e0157667. [PMID: 27391326 PMCID: PMC4938609 DOI: 10.1371/journal.pone.0157667] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/02/2016] [Indexed: 01/16/2023] Open
Abstract
Background Young people with intellectual disability exhibit substantial and persistent problem behaviours compared with their non-disabled peers. The aim of this study was to compare changes in emotional and behavioural problems for young people with intellectual disability with and without Down syndrome as they transition into adulthood in two different Australian cohorts. Methods Emotional and behavioural problems were measured over three time points using the Developmental Behaviour Checklist (DBC) for those with Down syndrome (n = 323 at wave one) and compared to those with intellectual disability of another cause (n = 466 at wave one). Outcome scores were modelled using random effects regression as linear functions of age, Down syndrome status, ability to speak and gender. Results DBC scores of those with Down syndrome were lower than those of people without Down syndrome indicating fewer behavioural problems on all scales except communication disturbance. For both groups disruptive, communication disturbance, anxiety and self-absorbed DBC subscales all declined on average over time. There were two important differences between changes in behaviours for these two cohorts. Depressive symptoms did not significantly decline for those with Down syndrome compared to those without Down syndrome. The trajectory of the social relating behaviours subscale differed between these two cohorts, where those with Down syndrome remained relatively steady and, for those with intellectual disability from another cause, the behaviours increased over time. Conclusions These results have implications for needed supports and opportunities for engagement in society to buffer against these emotional and behavioural challenges.
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Weiss JA, Ting V, Perry A. Psychosocial correlates of psychiatric diagnoses and maladaptive behaviour in youth with severe developmental disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:583-593. [PMID: 27073035 DOI: 10.1111/jir.12278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND We know little about the correlates of mental health problems in youth with severe and profound intellectual disability (ID), as most research includes these youth within larger samples that include greater proportions of mild and moderate disability. The purpose of the current study was to identify the child, family and psychosocial characteristics that were associated with the presence of psychiatric diagnoses and maladaptive behaviour in youth with severe ID. METHODS Participants were 141 parents of youth with severe or profound levels of ID, 4 to 18 years of age. The mean age of children was 11.04 years (SD = 3.38), with 68% male and 39% with autism spectrum disorder (ASD). Parents completed a primarily online survey of child and family characteristics, negative life events, family quality of life and their own mental health. RESULTS Logistic regression analyses revealed that youth with a psychiatric diagnosis had higher levels of adaptive behaviour and experienced more negative life events than youth without psychiatric diagnosis, while the presence of clinically significant maladaptive behaviour was related to higher levels of adaptive behaviour, parents' mental health problems and lower family quality of life. Child age, gender, ASD status and financial hardship were not related to either outcome variable. CONCLUSIONS Youth with severe and profound ID who experience psychosocial stressors are more likely reported to have mental health problems than youth without such stressors. It is likely that a combination of child and family based interventions, along with with policies that address larger systemic issues of social adversity, are needed to promote mental health and treat psychopathology when it arises.
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Affiliation(s)
- J A Weiss
- York University, Department of Psychology, Toronto, ON, Canada
| | - V Ting
- York University, Department of Psychology, Toronto, ON, Canada
| | - A Perry
- York University, Department of Psychology, Toronto, ON, Canada
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Chitty KM, Evans E, Torr JJ, Iacono T, Brodaty H, Sachdev P, Trollor JN. Central nervous system medication use in older adults with intellectual disability: Results from the successful ageing in intellectual disability study. Aust N Z J Psychiatry 2016; 50:352-62. [PMID: 26019276 DOI: 10.1177/0004867415587951] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Information on the rates and predictors of polypharmacy of central nervous system medication in older people with intellectual disability is limited, despite the increased life expectancy of this group. This study examined central nervous system medication use in an older sample of people with intellectual disability. METHODS Data regarding demographics, psychiatric diagnoses and current medications were collected as part of a larger survey completed by carers of people with intellectual disability over the age of 40 years. Recruitment occurred predominantly via disability services across different urban and rural locations in New South Wales and Victoria. Medications were coded according to the Monthly Index of Medical Specialties central nervous system medication categories, including sedatives/hypnotics, anti-anxiety agents, antipsychotics, antidepressants, central nervous system stimulants, movement disorder medications and anticonvulsants. The Developmental Behaviour Checklist for Adults was used to assess behaviour. RESULTS Data were available for 114 people with intellectual disability. In all, 62.3% of the sample was prescribed a central nervous system medication, with 47.4% taking more than one. Of those who were medicated, 46.5% had a neurological diagnosis (a seizure disorder or Parkinson's disease) and 45.1% had a psychiatric diagnosis (an affective or psychotic disorder). Linear regression revealed that polypharmacy was predicted by the presence of neurological and psychiatric diagnosis, higher Developmental Behaviour Checklist for Adults scores and male gender. CONCLUSION This study is the first to focus on central nervous system medication in an older sample with intellectual disability. The findings are in line with the wider literature in younger people, showing a high degree of prescription and polypharmacy. Within the sample, there seems to be adequate rationale for central nervous system medication prescription. Although these data do not indicate non-adherence to guidelines for prescribing in intellectual disability, the high rate of polypharmacy and its relationship to Developmental Behaviour Checklist for Adults scores reiterate the importance of continued medication review in older people with intellectual disability.
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Affiliation(s)
- Kate M Chitty
- Department of Developmental Disability Neuropsychiatry, UNSW Australia, Sydney, NSW, Australia
| | - Elizabeth Evans
- Department of Developmental Disability Neuropsychiatry, UNSW Australia, Sydney, NSW, Australia
| | - Jennifer J Torr
- Centre for Developmental Disability Health, Monash University, Notting Hill, VIC, Australia
| | - Teresa Iacono
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia Dementia Collaborative Research Centre, UNSW Australia, Sydney, NSW, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Julian N Trollor
- Department of Developmental Disability Neuropsychiatry, UNSW Australia, Sydney, NSW, Australia Centre for Healthy Brain Ageing, UNSW Australia, Sydney, NSW, Australia
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Pruijssers A, van Meijel B, Maaskant M, Keeman N, Teerenstra S, van Achterberg T. The role of nurses/social workers in using a multidimensional guideline for diagnosis of anxiety and challenging behaviour in people with intellectual disabilities. J Clin Nurs 2015; 24:1955-65. [PMID: 25950585 DOI: 10.1111/jocn.12850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES This study seeks (1) to investigate the impact of the implementation of the 'Diagnostic Guideline for Anxiety and challenging behaviours in clients with intellectual disability' on nurses/social workers' knowledge and self-efficacy; and (2) to evaluate the role of nurses/social workers in the diagnostic process when applying the guideline. BACKGROUND Nurses/social workers have extensive contact with clients with intellectual disabilities. Despite this key position, the contribution of nurses/social workers to the diagnosis of mental health problems and challenging behaviours is rather limited. The authors developed the multidimensional 'Diagnostic Guideline for Anxiety and challenging behaviours'. In this article, the implementation of this guideline is evaluated concerning knowledge and self-efficacy of nurses/social workers, as well the role of nurses/social workers in the diagnostic process. DESIGN This study employed a comparative multiple case study design. METHODS Qualitative and quantitative research methods. RESULTS Working with the 'Diagnostic Guideline for Anxiety and challenging behaviours' led to a statistically significant increase in knowledge and self-efficacy among the nurses/social workers in the experimental condition, compared with nurses/social workers in the control condition. Nurses/social workers and psychologists appreciated the more active contribution of the nurses/social workers in the diagnostic process. CONCLUSIONS Working with the guideline increased the knowledge and self-efficacy of nurses/social workers, and led to more active participation of nurses/social workers in the diagnostic process. RELEVANCE TO CLINICAL PRACTICE After following a training programme, nurses/social workers can effectively contribute to the diagnostic process in clients with anxiety and related challenging behaviours.
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Affiliation(s)
- Addy Pruijssers
- Department of Health, Sports & Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Esdégé-Reigersdaal, a service provider for people with (intellectual) disabilities, Broek op Langedijk, The Netherlands
| | - Berno van Meijel
- Department of Health, Sports & Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands
| | - Marian Maaskant
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Stichting Pergamijn is a service provider for people with intellectual disabilities, Echt, The Netherlands
| | - Noortje Keeman
- Esdégé-Reigersdaal, a service provider for people with (intellectual) disabilities, Broek op Langedijk, The Netherlands
| | - Steven Teerenstra
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Theo van Achterberg
- Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.,Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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Pruijssers A, van Meijel B, Maaskant M, Keeman N, van Achterberg T. Quality of Diagnosis and Treatment Plans After Using the 'Diagnostic Guideline for Anxiety and Challenging Behaviours' in People with Intellectual Disabilities: A Comparative Multiple Case Study Design. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:305-16. [PMID: 25727744 DOI: 10.1111/jar.12180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND People with intellectual disabilities often have a multitude of concurrent problems due to the combination of cognitive impairments, psychiatric disorders (particularly anxiety) and related challenging behaviours. Diagnoses in people with intellectual disabilities are complicated. This study evaluates the quality of the diagnoses and treatment plans after using a guideline that was developed to support professionals in their diagnostic tasks. MATERIALS AND METHODS A comparative multiple case study with an experimental and control condition, applying deductive analyses of diagnoses and treatment plans. RESULTS The analyses revealed that the number of diagnostic statements and planned treatment actions in the experimental group was significantly larger and more differentiated than in the control condition. In the control group, consequential harm and protective factors were hardly mentioned in diagnoses and treatment plans. CONCLUSIONS Working with the 'Diagnostic Guideline for Anxiety and CB' leads to improved diagnoses and treatment plans compared with care as usual.
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Affiliation(s)
- Addy Pruijssers
- Esdégé-Reigersdaal, Broek op Langedijk, The Netherlands.,Inholland University, Department of Health, Sports & Welfare / Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Berno van Meijel
- Inholland University, Department of Health, Sports & Welfare / Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands.,VU University Medical Center, Department of Psychiatry, EGO Institute for Health and Care Research Amsterdam, Amsterdam, The Netherlands.,Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands
| | - Marian Maaskant
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Stichting Pergamijn, Echt, The Netherlands
| | | | - Theo van Achterberg
- Centre for Health Services and Nursing Research, KU Leuven, Leuven, Belgium.,Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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Belva BC, Matson JL. Examining the psychometrics of the Psychopathology Inventory for Mentally Retarded Adults-II for individuals with mild and moderate intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:291-302. [PMID: 25462489 DOI: 10.1016/j.ridd.2014.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 10/05/2014] [Accepted: 10/13/2014] [Indexed: 06/04/2023]
Abstract
With growing recognition of the occurrence of psychological disorders in individuals with intellectual disability (ID), researchers and clinicians alike have placed emphasis on developing measures to assess for psychopathologies in this population. Despite an increased interest in the topic, there is still a dearth of psychometrically robust measures available to assess for psychopathology in adults with mild and moderate ID. The purpose of this study was to examine the psychometric properties of a revised measure for psychopathology in individuals with mild and moderate ID, the Psychopathology Inventory for Mentally Retarded Adults - second edition (PIMRA-II). Internal consistency, inter-rater reliability, and test-retest reliability were investigated. Validity was studied via convergent validity by comparing the PIMRA-II to the Assessment of Dual Diagnosis (ADD) and via discriminate validity by comparing the PIMRA-II to the Social Performance Survey Schedule (SPSS) prosocial scores. Lastly, an exploratory factor analysis was conducted to determine the factor structure of the scale.
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Affiliation(s)
- Brian C Belva
- Louisiana State University, 2124 Cheshire Bridge Road NE, Atlanta, GA 30324, United States.
| | - Johnny L Matson
- Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, United States.
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Crocker AG, Prokić A, Morin D, Reyes A. Intellectual disability and co-occurring mental health and physical disorders in aggressive behaviour. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:1032-1044. [PMID: 23952483 DOI: 10.1111/jir.12080] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/29/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Mental and physical health problems are more prevalent among individuals with an intellectual disability (ID) than in the general population. Studies suggest that there may be significant associations between these co-occurring disorders and aggressive behaviour, but few studies have taken into account multiple mental and physical problems, as well as their level of severity. OBJECTIVES The main goal of this study was to identify the associations between different types of aggressive behaviour and various types of physical and mental health problems. METHODS These associations were explored through a cross-sectional study of 296 adult men and women with mild or moderate ID living in the community and receiving ID services. Information was gathered through interviews with ID participants, case managers and file review. RESULTS The results show that individuals with ID who have more mental and physical health problems have higher odds of displaying aggressive behaviour than those with fewer and less severe physical health problems. DISCUSSION These results can help guide future prevention and intervention strategies for persons with ID who display aggressive behaviour or who are at risk of become aggressive.
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Affiliation(s)
- A G Crocker
- Department of Psychiatry, McGill University, Montréal, Québec, Canada; Douglas Mental Health University Institute Research Centre, Montréal, Québec, Canada
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21
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Kim MS, Blair KSC, Lim KW. Using tablet assisted Social Stories™ to improve classroom behavior for adolescents with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2241-2251. [PMID: 24927518 DOI: 10.1016/j.ridd.2014.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 05/07/2014] [Accepted: 05/16/2014] [Indexed: 06/03/2023]
Abstract
The present study examined the use of tablet assisted Social Stories™ intervention for three high school students with severe intellectual disabilities whose problem behavior interfered with their learning and caused classroom disruptions. A multiple probe design across participants was employed to test the impact of the tablet assisted SS on the participants' target behaviors. During intervention, the participants read the Social Stories that were created on Prezi and accessed via Quick Response (QR) codes using a Galaxy Tap smart tablet before participating in an academic period. Data indicated that the SS intervention decreased disruptive behavior and increased academic engagement in all three participants. All three demonstrated generalization of behaviors to a nontargeted academic period and maintenance of improved behaviors at the 2-week follow-up.
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22
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Pogge DL, Stokes J, Buccolo ML, Pappalardo S, Harvey PD. Discovery of previously undetected intellectual disability by psychological assessment: a study of consecutively referred child and adolescent psychiatric inpatients. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1705-1710. [PMID: 24679700 DOI: 10.1016/j.ridd.2014.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 03/02/2014] [Accepted: 03/06/2014] [Indexed: 06/03/2023]
Abstract
Intellectual disability is associated with an increased risk of behavioral disturbances and also complicates their treatment. Despite increases in the sophistication of medical detection of early risk for intellectual disability, there is remarkably little data about the detection of intellectual disability in cases referred for psychiatric treatment. In this study, we used a 10-year sample of 23,629 consecutive child and adolescent admissions (ages between 6 and 17) to inpatient psychiatric treatment. Eleven percent (n=2621) of these cases were referred for psychological assessment and were examined with a general measure of intellectual functioning (i.e., WISC-IV). Of these cases, 16% had Full Scale IQs below 70. Of the cases whose therapists then referred them for formal assessment of their adaptive functioning (i.e., ABAS-II) 81% were found to have composite scores below 70 as well. Only one of the cases whose Full Scale IQ was less than 70 had a referral diagnosis of intellectual disability. Cases with previously undetected intellectual disability were found to be significantly more likely to have a diagnosis of a psychotic disorder and less likely to have a diagnosis of mood disorder than cases with IQs over 70. Disruptive behavior disorder diagnoses did not differ as a function of intellectual performance. These data suggest a high rate of undetected intellectual disability in cases with a psychiatric condition serious enough to require hospitalization and this raises the possibility that many such cases may be misdiagnosed, the basis of their problems may be misconceptualized, and they may be receiving treatments that do not take into account their intellectual level.
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Affiliation(s)
- David L Pogge
- Four Winds Hospital, Katonah, NY, United States; Fairleigh Dickinson University, Teaneck, NJ, United States
| | - John Stokes
- Pace University, New York, NY, United States
| | | | - Stephen Pappalardo
- Four Winds Hospital, Katonah, NY, United States; Fairleigh Dickinson University, Teaneck, NJ, United States
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, United States.
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Pruijssers AC, van Meijel B, Maaskant M, Nijssen W, van Achterberg T. The relationship between challenging behaviour and anxiety in adults with intellectual disabilities: a literature review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:162-171. [PMID: 23336582 DOI: 10.1111/jir.12012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Anxiety and challenging behaviour (CB) often occur simultaneously in people with intellectual disabilities (ID). Understanding the associations between anxiety and CB may contribute to more accurate diagnoses and management of both anxiety and CB in this population. AIMS To examine the relationship between anxiety and CB. METHODS A literature review covering the period from January 2000 to January 2012. RESULTS Seven studies about the relationship between psychiatric disorders, including anxiety, and CB were identified. These studies confirm the relationship between anxiety and CB in people with ID, although the precise nature of this relationship remains unclear. CONCLUSIONS The study points toward the existence of a moderate association between anxiety and CB. Further research is needed to clarify the complex nature of the association between anxiety and CB.
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Affiliation(s)
- A C Pruijssers
- Inholland University for Applied Sciences, Amsterdam, The Netherlands; Esdégé-Reigersdaal, Broek op Langedijk, The Netherlands
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25
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Allen D, Langthorne P, Tonge B, Emerson E, McGill P, Fletcher R, Dosen A, Kennedy C. Towards the prevention of behavioural and psychiatric disorders in people with intellectual disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2013; 26:501-14. [PMID: 23712642 DOI: 10.1111/jar.12050] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2012] [Indexed: 11/30/2022]
Abstract
Intervention for behavioural and psychiatric disorders in people with intellectual disabilities often only takes place once these conditions are well established and more resistant to change. As an alternative, this paper promotes a public health prevention model and maps out opportunities for intervention at primary, secondary and tertiary levels. The resulting model is partly derived from generic research into these issues and partly on specific evidence on interventions for people with intellectual disabilities; it also contains more theoretical considerations. The additional research that is necessary to demonstrate the efficacy of the interventions identified is also considered. Central to this proposal is a greater integration of issues for people with intellectual disabilities within much broader policy and research agendas.
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Affiliation(s)
- David Allen
- Special Projects Team, Abertawe Bro Morgannwg Univerity Health Board, Cardiff, UK
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Fredheim T, Haavet OR, Danbolt LJ, Kjønsberg K, Lien L. Intellectual disability and mental health problems: a qualitative study of general practitioners' views. BMJ Open 2013; 3:bmjopen-2012-002283. [PMID: 23471607 PMCID: PMC3612780 DOI: 10.1136/bmjopen-2012-002283] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To investigate general practitioners' (GPs) experiences in managing patients with intellectual disabilities (ID) and mental and behavioural problems (MBP). DESIGN Qualitative study using in-depth interviews. SETTING General practice in Hedmark county, Norway. PARTICIPANTS 10 GPs were qualitatively interviewed about their professional experience regarding patients with ID and MBP. Data were analysed by all authors using systematic text condensation. RESULTS The participants' knowledge was primarily experience-based and collaboration with specialists seemed to be individual rather than systemic. The GPs provided divergent attitudes to referral, treatment, collaboration, regular health checks and home visits. CONCLUSIONS GPs are in a position to provide evidence-based and individual treatment for both psychological and somatic problems among patients with ID. However, they do not appear to be making use of evidence-based treatment decisions. The GPs feel that they are left alone in decision-making, and find it difficult to find trustworthy collaborative partners. The findings in this study provide useful information for further research in the field.
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Affiliation(s)
- Terje Fredheim
- Centre for Psychology of Religion, Innlandet Hospital Trust (SIHF), Hamar, Norway
- Department of General Practice, University of Oslo, Oslo, Norway
| | | | - Lars Johan Danbolt
- Centre for Psychology of Religion, Innlandet Hospital Trust (SIHF), Hamar, Norway
- Norwegian School of Theology, Oslo, Norway
| | - Kari Kjønsberg
- Centre for Psychology of Religion, Innlandet Hospital Trust (SIHF), Hamar, Norway
| | - Lars Lien
- Centre for Psychology of Religion, Innlandet Hospital Trust (SIHF), Hamar, Norway
- Faculty of Public Health, University College of Hedmark, Elverum, Norway
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Allen D, Lowe K, Matthews H, Anness V. Screening for Psychiatric Disorders in a Total Population of Adults with Intellectual Disability and Challenging Behaviour Using the PAS-ADD Checklist. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2012; 25:342-9. [DOI: 10.1111/j.1468-3148.2011.00670.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gerber F, Bessero S, Robbiani B, Courvoisier DS, Baud MA, Traoré MC, Blanco P, Giroud M, Galli Carminati G. Comparing residential programmes for adults with autism spectrum disorders and intellectual disability: outcomes of challenging behaviour and quality of life. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:918-932. [PMID: 21806693 DOI: 10.1111/j.1365-2788.2011.01455.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Owing to methodological issues, little research has been conducted to examine quality of life (QoL) as a treatment outcome in autism spectrum disorders (ASD) and intellectual disabilities (ID). This study was conducted to combine QoL measures and objective observations of challenging behaviours (CB) in order to evaluate changes over time in adults with ASD and ID who were treated in two different residential programmes; we hypothesised that a decrease in CB would be related to an improved QoL. METHOD In a longitudinal study (45 months), we followed 31 adults with ASD and ID who had been integrated into two residential programmes [Autism Programme with a Structured Method (PAMS) vs. traditional programme for ID (No-PAMS)] for 2-19 years. QoL [Quality of Life Inventory in a Residential Environment (IQVMR)] and severity of autistic features (Childhood Autism Rating Scales) were evaluated annually. CB, as measured by the Aberrant Behaviour Checklist (ABC), including stereotypic behaviour and inappropriate speech, were repeatedly assessed every 3 months. RESULTS Observed separately, the groups' results were different. In the PAMS programme, stereotypic behaviour and inappropriate speech (ABC scores) significantly decreased, and the IQVMR total score increased; in contrast, in the comparison group, ABC scores did not change and the IQVMR total score decreased. In all, three mixed-effect ANCOVAs partially confirmed that the PAMS programme had an effect on CB and that QoL improvement did not directly depend on the type of programme but on reducing CB as measured by the ABC. CONCLUSION The PAMS programme has a positive and indirect influence on QoL by reducing CB.
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Affiliation(s)
- F Gerber
- Psychiatric Unit of Mental Development (UPDM), Department of Psychiatry, University Hospitals of Geneva (HUG) - University of Geneva, Geneva, Switzerland.
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Tsiouris JA, Kim SY, Brown WT, Cohen IL. Association of aggressive behaviours with psychiatric disorders, age, sex and degree of intellectual disability: a large-scale survey. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:636-649. [PMID: 21492292 DOI: 10.1111/j.1365-2788.2011.01418.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND The link between aggression and mental disorders has been the focus of diverse studies in persons with and without intellectual disabilities (ID). Because of discrepancies in the finding of studies in persons with ID to date, and because of differences in research design, instruments used and the population studied, more research is needed. The purpose of this study was to delineate any significant association between certain psychiatric disorders and specific domains of aggressive behaviours in a large sample of persons with ID controlling for sex, age, autism and degree of ID. METHOD Data from the present study were obtained from 47% of all persons with ID receiving services from New York State agencies, using the Institute for Basic Research - Modified Overt Aggression Scale (IBR-MOAS between 2006 and 2007). The IBR-MOAS was completed by the chief psychologists of 14 agencies based on information from the participants' files. Demographic information obtained included the psychiatric diagnosis made by the treating psychiatrist as well as information on age, sex and degree of ID. Data from 4069 participants were analysed. RESULTS Impulse control disorder and bipolar disorder were strongly associated with all five domains of aggressive behaviour in the IBR-MOAS. Psychotic disorder was highly associated with four domains except for physical aggression against self (PASLF), which was of borderline significance. Anxiety was most associated with PASLF and verbal aggression against self (VASLF); depression with VASLF; obsessive compulsive disorder with physical aggression against objects (PAOBJ); personality disorders with verbal aggression against others (VAOTH), VASLF and PASLF; and autism with physical aggression against others (PAOTH), PAOBJ and PASLF. Mild to moderate ID was associated with VAOTH and VASLF and severe to profound ID with PAOBJ and PASLF. Female sex was most associated with VASLF. CONCLUSIONS Impulse control, mood dysregulation and perceived threat appear to underlie most of the aggressive behaviours reported. Psychosis and depression appeared to have been over-diagnosed in persons with mild to moderate ID and under-diagnosed in persons with severe and profound ID. These findings replicate and extend findings from previous studies. The pattern of associations reported can be used as helpful indicators by professionals involved in the treatment of aggressive behaviours in persons with ID.
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Affiliation(s)
- J A Tsiouris
- George A. Jervis Clinic, New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, USA
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Teixeira MCTV, Emerich DR, Orsati FT, Rimério RC, Gatto KR, Chappaz IO, Kim CA. A description of adaptive and maladaptive behaviour in children and adolescents with Cri-du-chat syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:132-137. [PMID: 21205041 DOI: 10.1111/j.1365-2788.2010.01377.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Psychological tests can be useful to record adaptive and maladaptive behaviours of children with intellectual disability. The objective of this study was to describe the adaptive and maladaptive behaviour of children and adolescents with Cri-du-chat syndrome. METHODS The sample consisted of 10 children and adolescents with Cri-du-chat syndrome (mean chronological age=11.3 years, mean mental age=18 months). The developmental quotient was calculated through the Psychoeducational Profile - Revised. An observational protocol was used to record adaptive and maladaptive behaviours. RESULTS The number of maladaptive behaviours observed was different among participants. However, all of them had high rates of adaptive behaviours, such as rule-following. CONCLUSIONS These results, though preliminary, justify that we continue to think about the need for psychoeducational interventions aimed at stimulating the repertoire of adaptive behaviours, in people with Cri-du-chat syndrome.
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Affiliation(s)
- M C T V Teixeira
- Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University, São Paulo, Brazil.
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Taggart L, McMillan R, Lawson A. Listening to women with intellectual disabilities and mental health problems: a focus on risk and resilient factors. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2009; 13:321-340. [PMID: 20048351 DOI: 10.1177/1744629509353239] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Women without intellectual disabilities are more likely to develop mental health problems as a result of physiological functioning and psychosocial risk factors. However, little is known about the mental health of women with intellectual disabilities. The aim of this study was to explore a small group of women's perceptions of the risk and protective factors pertaining to their mental health conditions. Twelve semi-structured interviews were conducted in 2007 in Northern Ireland. Thematic content analysis identified three risk factors and four protective/resilient factors. None of the women identified physiological functioning as a risk factor. Results suggest that women with intellectual disabilities experience psychosocial risk factors similar to those reported by women without intellectual disability. Additional risk factors place them at higher risk of developing mental health problems. However, more research is required.
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Affiliation(s)
- L Taggart
- University of Ulster, Coleraine, Antrim BT52 1SA, Northern Ireland.
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32
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Positive behavioural support as a service system for people with challenging behaviour. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.mppsy.2009.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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