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Rouleaux M, Peters-Scheffer N, Lindauer R, Mevissen L, Didden R. Stressful life events, post-traumatic stress disorder symptoms and mental health in individuals with intellectual disabilities: a scoping review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 39129191 DOI: 10.1111/jir.13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 07/10/2024] [Accepted: 07/19/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Stressful life events are events that do not fulfil the A criterion of PTSD in the DSM-5(TR) but are perceived as negative by the person. There is an ongoing debate about the usefulness of the A criterion as a gate criterion for PTSD, and especially regarding which events qualify as traumatic or stressful life events. This debate is particularly important for individuals with intellectual disabilities (ID) or borderline intellectual functioning (BIF), as they seem to be more likely to experience traumatic and stressful life events than their peers without ID-BIF and appear to be more susceptible to the disruptive effects of these events. As a result, people with ID-BIF are more likely to develop mental health and behavioural problems. There is insufficient knowledge about how the relationship between stressful life events and PTSD symptoms should be interpreted, how traumatic and stressful life events are defined and distinguished in people with ID, and whether the A criterion should be broadened for individuals with ID-BIF. The aim of this scoping review was to understand stressful life events and their relationship with PTSD symptoms, other mental health and/or behavioural problems in individuals with ID-BIF. METHODS The scoping review was conducted in accordance with the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). RESULTS Thirty-eight studies were included. Five studies focused on stressful life events and PTSD symptoms. The other studies examined associations between stressful life events and other mental health and/or behavioural problems. Most of the studies did not clearly differentiate between stressful and traumatic events according to the A criterion of PTSD in the DSM-IV (TR) or DSM-5(TR). Of the six studies in which stressful life events were specified and could be distinguished from traumatic events, one found a positive association between PTSD symptoms and stressful life events and five showed weak to strong positive associations with other mental health and/or behavioural problems. CONCLUSIONS PTSD symptoms following stressful life events in individuals with ID-BIF are underrepresented in the literature. The lack of a clear definition of stressful life events leads to a gap in the knowledge on whether and how stressful life events may lead to PTSD symptoms, other mental health and/or behavioural problems in individuals with ID-BIF. Therefore, no general conclusions or recommendations can be made regarding the appropriateness of the PTSD A criterion for individuals with ID-BIF. Further research is needed to establish the role of stressful life events in relation to PTSD symptoms and to inform the assessment and effective treatment in people with ID-BIF, as expert clinical experience studies suggest that broadening the PTSD A criterion should be considered for people with ID-BIF.
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Affiliation(s)
- M Rouleaux
- Department of Advisium, 's Heeren Loo Advisium, Amersfoort, The Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - N Peters-Scheffer
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Driestroom, Elst, The Netherlands
| | - R Lindauer
- Department Child and Adolescent Psychiatry, Levvel, Amsterdam, The Netherlands
- Department Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - L Mevissen
- Liesbeth Mevissen Psychotrauma Practice, Rha, The Netherlands
| | - R Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Department of Research and Development, Trajectum, Zwolle, The Netherlands
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Díaz-Faes DA, Codina M, Pereda N. Identifying victimization clusters across people with intellectual disabilities: A latent class analysis. Disabil Health J 2024; 17:101573. [PMID: 38072748 DOI: 10.1016/j.dhjo.2023.101573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND Research has shown high rates of victimization among people with intellectual disabilities (ID), but victimization clusters have been barely explored. OBJECTIVE We address the gap by examining how reported victimization experiences are grouped into different classes and identifying differences in the characteristics of the individuals in each class. METHODS We conducted a cross-sectional self-report study with a sample of adults with an ID diagnosis (n = 260). We gathered data about the participants' victimization experiences and socio-demographics, and then subjected the data to latent class analysis (LCA). RESULTS Three different classes were detected: High victimization (n = 27, 10.4 %); medium victimization, low sexual (n = 97, 37.3 %); and low victimization (n = 136, 52.3 %). The results highlight the experiences of sexual and physical victimization among the high-victimization class, in which women are overrepresented, and physical victimization among the medium-victimization class. The study also found that experiences of assault and bias attacks occur to a varying extent across all three classes. The LCA and poly-victimization methods showed substantial agreement but also differences when identifying the most victimized participants. In addition, we detected significant differences between classes in gender, type of school attended, place of residence, legal incapacity, type of support needed, secondary disability and poly-victimization status. CONCLUSION We identified distinct underlying ingroup patterns of victimization and sociodemographic inter-class differences that contribute to a better understanding of victimization within the population in question. The results have prevention and intervention implications for caregivers and providers of services for people with ID.
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Affiliation(s)
- Diego A Díaz-Faes
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, Universitat de Barcelona, Spain.
| | - Marta Codina
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, Universitat de Barcelona, Spain
| | - Noemí Pereda
- Department of Clinical Psychology and Psychobiology, Institute of Neurosciences, Universitat de Barcelona, Spain
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Sudnawa KK, Calamia S, Geltzeiler A, Chung WK. Clinical phenotypes of individuals with Chung-Jansen syndrome across age groups. Am J Med Genet A 2024; 194:e63471. [PMID: 37961033 DOI: 10.1002/ajmg.a.63471] [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: 04/18/2023] [Revised: 09/06/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
Pathogenic variants in pleckstrin homology domain interacting protein (PHIP) are associated with Chung-Jansen syndrome characterized by developmental delay, intellectual disability, behavioral challenges, hypotonia, obesity, and dysmorphic features. We report phenotypes and genotypes of 47 individuals with likely pathogenic/pathogenic PHIP variants. Variants were de novo in 61.7%, unknown inheritance in 29.8%, and inherited in 8.5%. The median age of the individuals was 10.9 years, approximately equally divided by sex. Individuals in this cohort frequently had a history of developmental delay (85.1%), attention-deficit/hyperactivity disorder (51.1%), anxiety (46.8%), depression (27.7%), and sleep difficulties (42.6%). Depression was significantly higher in the older age group (>12 years old). Most individuals had moderately low adaptive functioning based on the Vineland-3 (mean = 76.8, standard deviation = 12.0). Overall, 55.8% of individuals were obese/overweight. The percentage of obese individuals was greater in the older age group (>12 years old) and evolves over time. Other common symptoms were hypotonia (78.7%), constipation (48.9%), visual problems (66%), and cryptorchidism (39.1% of males). Our findings provide additional natural history data for Chung-Jansen syndrome and provide opportunities for early intervention of healthy eating habits and awareness of developing mood and behavioral challenges over the life course.
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Affiliation(s)
- Khemika K Sudnawa
- Department of Pediatrics, Columbia University, New York, New York, USA
- Department of Pediatrics, Pramongkutklao Hospital and Pramongkutklao College of Medicine, Bangkok, Thailand
| | - Sean Calamia
- Department of Pediatrics, Columbia University, New York, New York, USA
| | - Alexa Geltzeiler
- Department of Pediatrics, Columbia University, New York, New York, USA
| | - Wendy K Chung
- Department of Pediatrics, Columbia University, New York, New York, USA
- Department of Medicine, Columbia University, New York, New York, USA
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Berger I, Bruineberg A, van Ewijk M, de Jong L, van der Hout M, van Weeghel J, van der Meer L. Developing a recovery-oriented intervention for people with severe mental illness and an intellectual disability: design-oriented action research. Front Psychiatry 2023; 14:1184798. [PMID: 37539326 PMCID: PMC10395094 DOI: 10.3389/fpsyt.2023.1184798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/22/2023] [Indexed: 08/05/2023] Open
Abstract
Introduction Mild intellectual disability or borderline intellectual functioning (MID/BIF) are common in people with severe mental health problems (SMHP). Despite this, there is a lack of treatments adapted for this group of clients. Methods This qualitative study describes the development of a new intervention, guided by the principles of action research, for people with SMHP and MID/BIF and mental health professionals to help them talk about all aspects of the process of recovery. The intervention was developed in four cycles and in close cooperation with mental health professionals, experts by experience, other experts in the field of SMHP or MID/BIF, and clients. During all cycles there was a strong focus on the content of the intervention, exercises, understandable language, and drawings for visual support. Results This resulted in the intervention "Routes to Recovery," which covers both complaints and strengths, coping strategies, helpful (social) activities, and how to determine future steps in a recovery plan. Discussion Routes to Recovery is a first step in helping professionals and their clients with SMHP and MID/BIF to have a conversation about personal strengths and what the client needs to recover. Future research should investigate the effects of this intervention.
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Affiliation(s)
- Ingeborg Berger
- Department for Outpatients Severe Mental Health Services, Antes Parnassia Group, Rotterdam, Netherlands
| | - Anne Bruineberg
- Department for Outpatients Severe Mental Health Services, Antes Parnassia Group, Rotterdam, Netherlands
| | - Margot van Ewijk
- Department for Outpatients Severe Mental Health Services, Antes Parnassia Group, Rotterdam, Netherlands
| | - Levi de Jong
- Creative Media and Game Technology at Hogeschool Rotterdam, Rotterdam, Netherlands
| | - Michiel van der Hout
- Department for Outpatients Severe Mental Health Services, Antes Parnassia Group, Rotterdam, Netherlands
| | - Jaap van Weeghel
- Department of TRANZO, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Phrenos Center of Expertise on Severe Mental Illness, Utrecht, Netherlands
| | - Lisette van der Meer
- Department of Rehabilitation, Lentis Center for Mental Health Care, Zuidlaren, Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
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Yamada M, Tanito K, Suzuki H, Nakato D, Miya F, Takenouchi T, Kosaki K. Café-au-lait Spots and Cleft Palate: Not a Chance Association. Cleft Palate Craniofac J 2023:10556656231188205. [PMID: 37448313 DOI: 10.1177/10556656231188205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
The recognition of syndromic forms of cleft palate is important for condition-specific management. Here, we report a patient with cleft palate, congenital heart disease, intellectual disability, and café-au-lait spots who had a deletion of chromosome 15q14. The identification of the precise breakpoints using a Nanopore-based long-read sequencer showed that the deletion spanned MEIS2 and SPRED1 loci. Cleft palate and café-au-lait spots can be ascribed to MEIS2 and SPRED1, respectively. Patients with cleft palate and café-au-lait spots should be encouraged to undergo a detailed genomic evaluation, including screening for a 15q14 deletion, to enable appropriate anticipatory medico-surgical management and genetic counseling.
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Affiliation(s)
- Mamiko Yamada
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | | | - Hisato Suzuki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Nakato
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Fuyuki Miya
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Toshiki Takenouchi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
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Kassee C, Lunsky Y, Patrikar A, Brown HK. Impact of social-, health-, and disability-related factors on pregnancy outcomes in women with intellectual and developmental disabilities: A population-based latent class analysis. Disabil Health J 2023; 16:101426. [PMID: 36621355 PMCID: PMC10073261 DOI: 10.1016/j.dhjo.2022.101426] [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: 09/22/2022] [Revised: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Studies have shown women with intellectual and developmental disabilities (IDD) have elevated risks of perinatal complications, but few studies have examined how social, health, and disability-related factors affect these risks. OBJECTIVES To identify and describe subgroups of pregnant women with IDD according to social, health, and disability-related factors and examine the risks of perinatal complications in these subgroups compared to women without IDD. METHODS We performed a population-based cohort study in Ontario, Canada, of women with (n = 1922) and without (n = 1,126,854) IDD, with a singleton birth in 2003-2018. We used latent class analysis (LCA) to identify subgroups of women according to social (e.g., age), health (e.g., chronic medical conditions), and disability-related (e.g., IDD type) characteristics. Modified Poisson regression was then used to compare the risks of hypertensive disorders of pregnancy, cesarean delivery, and preterm birth across identified subgroups to women without IDD. RESULTS The LCA identified 4 classes of women with IDD: (1) young women who were mostly healthy and had little primary care before pregnancy (n = 253); (2) older women who were mostly healthy (n = 795); (3) young to mid-aged women who had significant comorbidities (n = 181); and (4) young women, many of whom were autistic, who had some medical comorbidities and significant psychiatric comorbidities (n = 693). Class 3 consistently had the greatest risks of perinatal complications, across all IDD groups, compared to women without IDD. CONCLUSIONS These findings underscore the importance of multidisciplinary care approaches tailored to the needs of at-risk women with IDD, in the preconception and perinatal periods.
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Affiliation(s)
- Caroline Kassee
- ICES, ICES: 2075 Bayview Ave, Toronto, Ontario, Canada M4N 3M5; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, Canada M5T 3M7.
| | - Yona Lunsky
- ICES, ICES: 2075 Bayview Ave, Toronto, Ontario, Canada M4N 3M5; Azrieli Adult Neurodevelopmental Centre, Centre for Addiction & Mental Health, 1001 Queen St W, Toronto, Ontario, Canada M6J 1H4.
| | - Aditi Patrikar
- ICES, ICES: 2075 Bayview Ave, Toronto, Ontario, Canada M4N 3M5.
| | - Hilary K Brown
- ICES, ICES: 2075 Bayview Ave, Toronto, Ontario, Canada M4N 3M5; Department of Health & Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario, Canada, M1C 1A5.
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7
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Kataria K, Philip S. Reorienting to mild and borderline intellectual disability: an appeal from south Asia. Lancet Psychiatry 2022; 9:e26. [PMID: 35569507 DOI: 10.1016/s2215-0366(22)00136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Kanak Kataria
- Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Sharad Philip
- CBM India Trust, Delhi, India; The Leprosy Mission Trust India, Delhi 110001, India.
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Yamada M, Suzuki H, Futagawa H, Takenouchi T, Miya F, Yoshihashi H, Kosaki K. Phenotypic overlap between cardioacrofacial dysplasia-2 and oral-facial-digital syndrome. Eur J Med Genet 2022; 65:104512. [PMID: 35439611 DOI: 10.1016/j.ejmg.2022.104512] [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: 12/15/2021] [Revised: 04/04/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Oral-facial digital (OFD) syndrome is characterized by abnormalities of the face (hypertelorism and low set-ears), oral cavity (multiple frenula, lingual hamartoma, or lobulated tongue) and extremities (postaxial polydactyly). At least 19 genes have been implicated in the development of OFD syndrome. Herein, we report the case a 13-year-old patient with atrioventricular septal defect, moderate intellectual disability, epilepsy, and features of OFD, including multiple oral frenula, and postaxial polydactyly of the hands and feet. The patient had a de novo heterozygous variant in PRKACB: chr1(GRCh37):g.84700915T > C, c.1124T > C (NM_182948.4), p.(Phe375Ser). To date, four patients with pathogenic monoallelic variants in PRKACB have been reported, and the condition associated with these variants is referred to as Cardioacrofacial dysplasia-2 (CAFD2, MIM619143). Previously reported features of this condition include congenital heart disease (e.g., atrioventricular septal defect) and postaxial polydactyly, and two of the patients had multiple oral frenula. We suggest that a significant phenotypic overlap exists between CAFD2 and OFD syndrome, in that these patients especially share the features of postaxial polydactyly and multiple oral frenula. The phenotypic similarity between patients with CAFD2 and classic OFD syndrome with an OFD1 variant might be explained by the recent in vitro experimental finding that a protein kinase A subunit encoded by PRKACB directly phosphorylates the OFD1 protein. From the standpoint of genetic counseling, OFD syndrome type1, the prototypic form of OFD, exhibits an X-linked dominant inheritance pattern, whereas other forms of OFD syndrome exhibit an autosomal recessive inheritance pattern. Recognition of CAFD2 as a differential diagnosis or forme fruste of OFD syndrome suggests that an autosomal dominant pattern of inheritance should also be considered during genetic counseling.
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Affiliation(s)
- Mamiko Yamada
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Hisato Suzuki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Futagawa
- Department of Clinical Genetics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Toshiki Takenouchi
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Fuyuki Miya
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Yoshihashi
- Department of Clinical Genetics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan.
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Wagemaker E, van Hoorn J, Bexkens A. Susceptibility to peer influence on prosocial behavior in adolescents with Mild Intellectual Disability or Borderline Intellectual Functioning. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 120:104143. [PMID: 34875546 DOI: 10.1016/j.ridd.2021.104143] [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: 07/14/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Adolescents with Mild Intellectual Disability (MID) or Borderline Intellectual Functioning (BIF) are highly susceptible to negative peer influence. However, research in typically developing adolescents shows that peers can also promote prosocial behavior, which is an opportunity for positive development. AIMS The current study aimed to investigate the effect of peer influence on prosocial behavior in adolescents with MID or BIF. METHODS AND PROCEDURES In an experimental donation task, 40 adolescents with MID or BIF (Mage = 14.0, 40 % boys) were repeatedly asked how many of five coins they would like to donate to the group. The task had four consecutive within-subject conditions: alone, with virtual peers present, with virtual peer feedback, and alone again. OUTCOMES AND RESULTS Results showed that adolescents made larger donations with virtual peers present, and even larger with peer feedback. This increase in donations sustained for subsequent decisions made alone. Finally, adolescents with BIF made larger donations with peer feedback compared to adolescents with MID. CONCLUSIONS AND IMPLICATIONS Adolescents with MID or BIF are susceptible to peer influence on prosocial behavior, demonstrating the potential effect social context can have on promoting positive development.
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Affiliation(s)
- Eline Wagemaker
- University of Amsterdam, Department of Psychology, Nieuwe Achtergracht 129B, 1018 WS, Amsterdam, the Netherlands; Research Priority Area Yield, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS, Amsterdam, the Netherlands.
| | - Jorien van Hoorn
- Leiden University, Department of Psychology, Developmental and Educational Psychology, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands; Levvel, Academic Center of Child- and Adolescent Psychiatry, Fred. Roeskestraat 73, 1076 EC, Amsterdam, the Netherlands
| | - Anika Bexkens
- Leiden University, Department of Psychology, Developmental and Educational Psychology, Wassenaarseweg 52, 2333 AK, Leiden, the Netherlands; GGZ Delfland, Department of Child and Adolescent Psychiatry, de Laat de Kanterstraat 32, 2313 JV, Leiden, the Netherlands
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Shu C, Green Snyder L, Shen Y, Chung WK. Imputing cognitive impairment in SPARK, a large autism cohort. Autism Res 2021; 15:156-170. [PMID: 34636158 DOI: 10.1002/aur.2622] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/26/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022]
Abstract
Diverse large cohorts are necessary for dissecting subtypes of autism, and intellectual disability is one of the most robust endophenotypes for analysis. However, current cognitive assessment methods are not feasible at scale. We developed five commonly used machine learning models to predict cognitive impairment (FSIQ<80 and FSIQ<70) and FSIQ scores among 521 children with autism using parent-reported online surveys in SPARK, and evaluated them in an independent set (n = 1346) with a missing data rate up to 70%. We assessed accuracy, sensitivity, and specificity by comparing predicted cognitive levels against clinical IQ data. The elastic-net model has good performance (AUC = 0.876, sensitivity = 0.772, specificity = 0.803) using 129 predictive features to impute cognitive impairment (FSIQ<80). Top-ranked predictive features included parent-reported language and cognitive levels, age at autism diagnosis, and history of services. Prediction of FSIQ<70 and FSIQ scores also showed good performance. We show cognitive levels can be imputed with high accuracy for children with autism, using commonly collected parent-reported data and standardized surveys. The current model offers a method for large-scale autism studies seeking estimates of cognitive ability when standardized psychometric testing is not feasible. LAY SUMMARY: Children with autism who have more severe learning challenges or cognitive impairment have different needs that are important to consider in research studies. When children in our study were missing standardized cognitive testing scores, we were able to use machine learning with other information to correctly "guess" when they have cognitive impairment about 80% of the time. We can use this information in research in the future to develop more appropriate treatments for children with autism and cognitive impairment.
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Affiliation(s)
- Chang Shu
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.,Department of Systems Biology, Columbia University Irving Medical Center, New York, New York, USA
| | - LeeAnne Green Snyder
- Simons Foundation Autism Research Initiative, Simons Foundation, New York, New York, USA
| | - Yufeng Shen
- Department of Systems Biology, Columbia University Irving Medical Center, New York, New York, USA.,Department of Biomedical Informatics, Columbia University Irving Medical Center, New York, New York, USA
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.,Simons Foundation Autism Research Initiative, Simons Foundation, New York, New York, USA.,Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
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Children and adolescents with neurodevelopmental disorders show cognitive heterogeneity and require a person-centered approach. Sci Rep 2021; 11:18463. [PMID: 34531454 PMCID: PMC8445997 DOI: 10.1038/s41598-021-97551-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/09/2021] [Indexed: 11/15/2022] Open
Abstract
We aimed to identify patterns of cognitive differences and characterize subgroups of Mexican children and adolescents with three neurodevelopmental disorders (NDD): intellectual disability (ID), autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD). The sample included 74 children and adolescents 6–15 years; 34% had ID, ASD or ADHD, 47% had ID in comorbidity with ASD, ADHD or both, 11% had ASD + ADHD, 8% were children without NDD. We applied WISC-IV, Autism Diagnostic Interview-Revised, Mini-International Neuropsychiatric Structured Interview, Child Behavior Checklist, and UNICEF Child Functioning Module. We evaluated the normality of the WISC-IV sub-scales using the Shapiro-Francia test, then conducted a latent class analysis and assessed inter-class differences in terms of household, parent and child characteristics. The following four-class solution best fit the data: “Lower Cognitive Profile” (LCP), “Lower Working Memory” (LWM), “Higher Working Memory” (HWM), “Higher Cognitive Profile” (HCP). LCP included most of the children with ID, who had a low Working Memory (WM) index score. LWM included mainly children with ASD or ID + ADHD; their Perceptual Reasoning (PR) and Processing Speed (PS) index scores were much higher than those for Verbal Comprehension (VC) and WM. HWM included children with ASD or ADHD; their scores for PR, PS and VC were high with lower WM (although higher than for LWM). HCP included children without NDD and with ASD or ADHD or both and had the highest scores on all indices. Children with NDD show cognitive heterogeneity and thus require individualized treatment plans.
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Bourne J, Harrison TL, Wigham S, Morison CJ, Hackett S. A systematic review of community psychosocial group interventions for adults with intellectual disabilities and mental health conditions. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:3-23. [PMID: 34337837 DOI: 10.1111/jar.12919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND People with intellectual disabilities have a high risk of developing mental ill-health. Treatment is often neglected and diagnosis is misattributed to a person's disability. Standard psychosocial interventions can improve a person's well-being. This review aimed to understand what interventions are being delivered, any benefits, and future recommendations. METHODS Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed, and the review registered with PROSPERO-CRD42020160254. Databases searched included: MEDLINE, Embase, and PsycINFO. A framework synthesis approach was used to present the findings. RESULTS There are limited psychosocial interventions offered for this population. When groups are delivered having a creative element, multiple activities over a short period of time, with breaks and group rules outcomes can be improved. CONCLUSIONS Adaptations and reasonable adjustments should be used specifically to a person's ability. A mixed-method design allows people to share their experiences alongside quantitative data that provides clinical information.
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Affiliation(s)
- Jane Bourne
- Arts Therapies Department, Cumbria Northumberland Tyne & Wear NHS Foundation Trust, Northgate Hospital, Morpeth, UK
| | - Toni Leigh Harrison
- Arts Therapies Department, Cumbria Northumberland Tyne & Wear NHS Foundation Trust, Northgate Hospital, Morpeth, UK
| | - Sarah Wigham
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Cindy-Jo Morison
- Arts Therapies Department, Cumbria Northumberland Tyne & Wear NHS Foundation Trust, Northgate Hospital, Morpeth, UK
| | - Simon Hackett
- Arts Therapies Department, Cumbria Northumberland Tyne & Wear NHS Foundation Trust, Northgate Hospital, Morpeth, UK
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Brief Report: An Exploration of Cognitive Flexibility of Autistic Adolescents with Low Intelligence Using the Wisconsin Card Sorting Task. J Autism Dev Disord 2021; 53:1726-1732. [PMID: 34114127 DOI: 10.1007/s10803-021-05134-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2021] [Indexed: 10/21/2022]
Abstract
Cognitive flexibility (CF) is the ability to shift between concepts or rules. Difficulty with CF is associated with autism (i.e., ASD) as it contributes to repetitive behaviours. However, little is known about CF skills of autistic adolescents with low intelligence. This study uses the Wisconsin Card Sorting Task (WCST) to assess the CF of 36 adolescents, all with a Weschler full-scale IQ between 50 and 85, 14 of whom had an ASD diagnosis. The results indicated no statistically significant differences in WCST performance between those with and without ASD. It was also found that performance IQ significantly contributed to the WCST performance in the ASD group only, suggesting an autism-specific role of non-verbal cognitive functioning in CF.
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Yamada M, Yamaguchi Y, Uehara T, Yagihashi T, Kosaki K. Heterozygous nonsense variant of CHD8 in a patient with forme-fruste Marfan syndrome and intellectual disability. Congenit Anom (Kyoto) 2021; 61:30-32. [PMID: 32951261 DOI: 10.1111/cga.12393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/06/2020] [Accepted: 09/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Mamiko Yamada
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Yu Yamaguchi
- Department of Clinical Genetics, Gunma Children's Medical Center, Gunma, Japan
| | - Tomoko Uehara
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuhiko Yagihashi
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo, Japan
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Giesbers SAH, Hendriks AHC, Hastings RP, Jahoda A, Tournier T, Embregts PJCM. Family-based social capital of emerging adults with and without mild intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:757-769. [PMID: 32743943 PMCID: PMC7540391 DOI: 10.1111/jir.12764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/15/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Family is recognised as an important context for the self-development of young adults in emerging adulthood, although very little research has addressed the perspective of young people with intellectual disability about their families by using self-report. This study examined how emerging adults with mild intellectual disability define their family support networks, compared with definitions of students without intellectual disability, within a social capital theoretical framework. METHODS Fifty-three participants with mild intellectual disability and 53 students without intellectual disability were interviewed individually using the Family Network Method - Intellectual Disability (FNM-ID). Data from the FNM-ID relate to key social network measures on how individuals define their family groups, and how they perceive existing supportive relationships within their families. Participants with mild intellectual disability and students were compared on the FNM-ID social network measures. RESULTS Participants with mild intellectual disability reported fewer family members who they considered significant to them than students without intellectual disability. They were less likely to include peers (i.e. friends and partners) and siblings in their significant family networks, had fewer relationships with family members in which they received or gave support, had fewer reciprocal support relationships and had a less central position in their family network. DISCUSSION The family-based social capital of emerging adults with mild intellectual disability differed from that of students without intellectual disability. They may remain more dependent on their natural family for emotional support as their supportive networks have not necessarily made the transition to networks with emotionally close peer relationships.
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Affiliation(s)
- S. A. H. Giesbers
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
- Dichterbij Innovation and ScienceGennepthe Netherlands
| | - A. H. C. Hendriks
- School of Pedagogical and Educational Science, Faculty of Social SciencesRadboud University NijmegenNijmegenthe Netherlands
| | - R. P. Hastings
- Centre for Educational Development, Appraisal and ResearchUniversity of WarwickCoventryUK
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash HealthMonash UniversityClaytonAustralia
| | - A. Jahoda
- Psychological MedicineUniversity of GlasgowGlasgowUK
| | - T. Tournier
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
- ASVZSliedrechtthe Netherlands
| | - P. J. C. M. Embregts
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
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Nouwens PJG, Smulders NBM, Embregts PJCM, van Nieuwenhuizen C. Differentiating care for persons with mild intellectual disability or borderline intellectual functioning: a Delphi study on the opinions of primary and professional caregivers and scientists. BMC Psychiatry 2020; 20:57. [PMID: 32039715 PMCID: PMC7008567 DOI: 10.1186/s12888-020-2437-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/10/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The demand for support for persons with mild intellectual disability or borderline intellectual functioning is growing rapidly. These persons often encounter individual and familial limitations that influence their human functioning, and often have difficulty coping with the demands of modern society. Although in the areas of policy, research and practice, people with mild intellectual disability or borderline intellectual functioning are generally approached as one group, important differences between them have been reported. Current support seems to be both suboptimal and insufficiently differentiated. METHODS In this Delphi study we aimed to explore the need for appropriate and differentiated support for individuals with mild intellectual disability or borderline intellectual functioning. The study was based on five unique profiles of persons with mild intellectual disability or borderline intellectual functioning that are associated with individual and environmental variables. The opinions of expert primary caregivers, professional caregivers and scientists were analysed for potentially appropriate types of support for each of the five profiles. RESULTS A total of 174 statements, divided over the five profiles, were presented to the participants. For 74 statements, consensus was reached between the expert groups. For each profile, these consensual statements represented specific items (e.g. concrete personal goals) and non-specific items (e.g. the attitude towards persons with mild intellectual disability or borderline intellectual functioning, and the coordination of health care) related to the support needs. CONCLUSION This Delphi-based study generated consensual opinions contributing to a more differentiated system of support for individuals with mild intellectual disability or borderline intellectual functioning. Although these findings need additional investigation, they address actions that might enhance the support programmes for these individuals into more personalized support.
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Affiliation(s)
- Peter J. G. Nouwens
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | | | - Petri J. C. M. Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Chijs van Nieuwenhuizen
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- GGzE Centre for Child & Adolescent Psychiatry, Eindhoven, the Netherlands
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17
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Not recognized enough: The effects and associations of trauma and intellectual disability in severely mentally ill outpatients. Eur Psychiatry 2019; 58:63-69. [DOI: 10.1016/j.eurpsy.2019.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/02/2019] [Accepted: 02/06/2019] [Indexed: 11/19/2022] Open
Abstract
AbstractBackground:Little is known about the association between trauma and intellectual disability in SMI patients.Aim:To establish the prevalence of trauma and its association with intellectual functioning in SMI outpatients.Methods:A cross-sectional study was conducted in two mental health trusts in the Netherlands. We used the Trauma Screening Questionnaire (TSQ) to screen for trauma and PTSD, and the Screener for Intelligence and Learning disabilities (SCIL) for suspected MID/BIF. Chi-square and t-tests were used to test differences in outcome over patient characteristics. Post-hoc analysis was used to investigate gender differences between patients with and without MID/BIF on trauma and sexual trauma.Results:Any trauma was found in 86% of 570 patients and 42% were suspected for PTSD. The SCIL suggested that 40% had Borderline Intellectual Functioning (BIF), half of whom were suspected of having Mild Intellectual Disability (MID). These patients had more traumatic experiences (1.89 in BIF, 1.75 in MID, against 1.41 in SCIL-negative patients). Female MID/BIF patients (61%) had experienced significantly more sexual abuse than male MID/BIF patients (23%).Conclusions:Significantly more SMI outpatients who screened positive for MID/BIF reported having experienced traumatic events than those who screened negative. Rates of all trauma categories were significantly higher in the screen-positive group, who were also more likely to have PTSD. Sexual abuse occurred more in all females but the SCIL positive women are even more often victim. Clinical practice has to pay more attention to all of these issues, especially when they occur together in a single patient.
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18
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van Duijvenbode N, VanDerNagel JE. A Systematic Review of Substance Use (Disorder) in Individuals with Mild to Borderline Intellectual Disability. Eur Addict Res 2019; 25:263-282. [PMID: 31330514 PMCID: PMC6888885 DOI: 10.1159/000501679] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/21/2019] [Indexed: 11/19/2022]
Abstract
Although the attention for substance use (SU) and SU disorders (SUD) among individuals with mild to borderline intellectual disability (MBID) has been growing exponentially, this form of dual diagnosis has largely been ignored by addiction medicine. In this article, we systematically review the research between January 2000 and June 2018 on the prevalence, assessment, and treatment of SU(D) among children, adolescents, and adults with MBID. A total of 138 articles were included. It is concluded that individuals with MBID are likely to be at a higher risk for developing SUD compared to those without MBID. Future research should focus on the detection of MBID among patients being treated in addiction medicine, the development and implementation of systematic assessment methods of SU(D) among individuals with MBID, and the development and evaluation of prevention and treatment interventions. System integration, interdisciplinary collaboration, and the development of tailored treatment for individuals with MBID are advised to improve treatment access and outcome for those who have developed SUD.
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Affiliation(s)
- Neomi van Duijvenbode
- Tactus, Centre for Addiction and Intellectual Disability (CAID), Deventer, The Netherlands,Radboud University Nijmegen, Behavioural Science Institute, Nijmegen, The Netherlands,Radboud University Nijmegen, Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands,*Neomi van Duijvenbode, Tactus, Centre for Addiction and Intellectual Disability (CAID), P.O. Box 154, NL–7400 AD Deventer (The Netherlands), E-Mail
| | - Joanne E.L. VanDerNagel
- Tactus, Centre for Addiction and Intellectual Disability (CAID), Deventer, The Netherlands,Radboud University Nijmegen, Behavioural Science Institute, Nijmegen, The Netherlands,Radboud University Nijmegen, Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands,Aveleijn, Borne, The Netherlands,University of Twente, Faculty of Electrical Engineering, Mathematics, and Computer Science, Human Media Interaction, Enschede, The Netherlands
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Vervoort-Schel J, Mercera G, Wissink I, Mink E, van der Helm P, Lindauer R, Moonen X. Adverse Childhood Experiences in Children with Intellectual Disabilities: An Exploratory Case-File Study in Dutch Residential Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102136. [PMID: 30274163 PMCID: PMC6210466 DOI: 10.3390/ijerph15102136] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 09/11/2018] [Accepted: 09/26/2018] [Indexed: 01/11/2023]
Abstract
Adverse Childhood Experiences (ACEs) are negative childhood events occurring in a child’s family or social environment, that may cause harm or distress. Children with intellectual disabilities (ID) and their families are underrepresented in international ACEs research, while current insights can also contribute to the improvement of their health and well-being. Deficiencies in intellectual and adaptive functioning and living circumstances can increase their vulnerability to adversities. In the present exploratory study 69 case-files of children referred to a Dutch national center for residential youth care for children with ID were analyzed to assess the prevalence and associations of ACEs. It was found that almost half (49.3%) of the children experienced 2 ACEs from the original ACEs framework or more (M (mean) = 2.1; SD (standard deviation) = 1.8) and that the number of ACEs in children was related to the presence of ACEs in parents. Both child and parental ACEs were also related to attachment- and trauma- and stressor-related disorders. Finally, living circumstances and multiple ACEs from the expanded ACEs framework, especially related to parental characteristics, were found to be related to ACEs in children with ID. This implicates the importance of a transgenerational approach when further investigating the impact of ACEs on mental and physical health in children with ID (intellectual disabilities).
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Affiliation(s)
- Jessica Vervoort-Schel
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands.
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands.
| | - Gabriëlle Mercera
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands.
| | - Inge Wissink
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands.
| | - Emmelie Mink
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands.
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands.
| | - Peer van der Helm
- Expert Center Social Work and applied Psychology, Professional University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK Leiden, The Netherlands.
- Fier, National Expertise and Treatment Center, Holstmeerweg 1, 8936 AS Leeuwarden, The Netherlands.
| | - Ramón Lindauer
- Amsterdam UMC, University of Amsterdam, Department Child and Adolescent Psychiatry Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
- De Bascule, Academic Center for Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
| | - Xavier Moonen
- Koraal Center of Expertise, De Hondsberg, Hondsberg 5, 5062 JT Oisterwijk, The Netherlands.
- Department of Child Development and Education, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS Amsterdam, The Netherlands.
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20
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Zhang Z. Identification of three classes of acute respiratory distress syndrome using latent class analysis. PeerJ 2018; 6:e4592. [PMID: 29610712 PMCID: PMC5880177 DOI: 10.7717/peerj.4592] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/19/2018] [Indexed: 02/05/2023] Open
Abstract
Acute respiratory distress syndrome (ARDS) is a highly heterogeneous syndrome that can exhibit significant differences in the underlying causes, leading to different responses to treatment. It is required to identify subtypes of ARDS to guideline clinical treatment and trial design. The study aimed to identify subtypes of ARDS using latent class analysis (LCA). The study was a secondary analysis of the EDEN study, which was a randomized, controlled, multicenter trial conducted from January 2, 2008 to April 12, 2011. The primary study endpoint was death through 90-day follow up. LCA was performed incorporating variables on day 0 before randomization. The number of classes was chosen by a bootstrapped likelihood ratio test, Bayesian information criterion and the number of patients in each class. A total of 943 patients were enrolled in the study, including 219 (23.2%) non-survivors and 724 (76.8%) survivors. The LCA identified three classes of ARDS. Class 1 (hemodynamically unstable type) had significantly higher mortality rate (p = 0.003) than class 2 (intermediate type) and 3 (stable type) through 90 days follow up. There was significant interaction between cumulative fluid balance and the class (p = 0.02). While more fluid balance was beneficial for class 1, it was harmful for class 2 and 3. In conclusion, the study identified three classes of ARDS, which showed different clinical presentations, responses to fluid therapy and prognosis. The classification system used simple clinical variables and could help to design ARDS trials in the future.
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Affiliation(s)
- Zhongheng Zhang
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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