Psychological interventions for depression in children and young people with an intellectual disability and/or autism: systematic review

Prevalence of depression and protective factors in a population of children aged 8 to 10 years, suffering from specific learning disorders, in a special education and home care service (SESSAD)

OBJECTIVES

Evaluate the prevalence of depression in a population of children aged 8 to 10 years with learning disabilities treated in a Special Education and Home Care Service (SESSAD) and identify the protective factors that might preserve these children from depressive and affective problems.

METHODS

Twenty children, aged 8 to 10, with learning disabilities were evaluated prior to their admission in SESSAD. Depression had been assessed through the Multiscore Depression Inventory for Children (MDIC), adapted to the French population as well as their developmental position in relation with their perceptual maturity of their body schema, through the Draw your family drawing. The protective factors were assessed through the qualitative analysis of the stories told on the Draw your family projective drawing and card 4, 9, 20 of The Socialization Test for Children (TSEA). Quantitative data were computed through descriptive statistics and non-parametric tests (Spearman's correlation test) by the jamovi© statistic software (V.2.3.24), and the qualitative data were analyzed through thematic content analysis and lexical text analysis through the TROPES software (V.8.3).

RESULTS

Quantitative data showed for the entire group: (1) a perceptual maturity delay of the body schema in 75% of the sample; (2) a low incidence of depression in this population with, however, 40% of the sample, (aged 8 and 9) displaying a critical threshold for feelings of helplessness. The qualitative analysis of the Draw your family and TSEA stories allowed to underline some of the protective factors against depression and those which refer, in decreasing order, to the social support given by family members, peers, and the emotional substitutes (animals).

CONCLUSIONS

This research highlighted the precocity of the feelings of helplessness in this population and the importance given by these children to the social support. These findings and future research on the topic might be used to guide the design and implementation of adjusted interventions addressing both the development of their learning capability and psychological empowerment.

Mental health challenges faced by autistic people

Mental health challenges impede the well-being of autistic people. This Review outlines contributing neurodevelopmental and physical health conditions, rates and developmental trajectories of mental health challenges experienced by autistic people, as well as unique clinical presentations. A framework is proposed to consider four contributing themes to aid personalized formulation: social-contextual determinants, adverse life experiences, autistic cognitive features, and shared genetic and early environmental predispositions. Current evidence-based and clinical-knowledge-informed intervention guidance and ongoing development of support are highlighted for specific mental health areas. Tailored mental health support for autistic people should be neurodivergence-informed, which is fundamentally humanistic and compatible with the prevailing bio-psycho-social frameworks. The personalized formulation should be holistic, considering physical health and transdiagnostic neurodevelopmental factors, intellectual and communication abilities, and contextual-experiential determinants and their interplay with autistic cognition and biology, alongside resilience. Supporting family well-being is integral. Mutual empathic understanding is fundamental to creating societies in which people across neurotypes are all empowered to thrive.

[Psychotherapy in disorders of intellectual development-Current evidence and practical implementation]

People with a disorder of intellectual development (German draft of the ICD-11, which came into force on 1 January 2022) suffer more frequently from mental illnesses. According to the international treatment guidelines multimodal approaches should include not only psychopharmacological treatment, but also disorder-specific psychotherapeutic methods. These psychotherapeutic interventions have to be adapted to the communicative and cognitive abilities (performance diagnostics with IQ tests) as well as the emotional developmental stage (developmental diagnostics, e.g., with the scale of emotional development, short version, SED-S 2; [1]). To ensure this, the rules of simple language should be observed and when appropriate relatives or caregivers should be involved in the therapeutic process. The effectiveness of cognitive behavioral therapy has received most scientific attention, especially for affective disorders. Posttraumatic stress disorders can be validly treated with eye movement desensitization and reprocessing (EMDR). There is also good evidence for exposure therapy with reinforcement in the treatment of anxiety disorders.

Differences in emotional state and autistic symptoms before and during confinement due to the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has generated a global crisis that has affected the emotional health of both the general and the clinical population.

METHOD

The present study aimed to analyze the differences between the emotional states of a group of individuals with ASD and a neurotypical group both during and after the COVID-19 confinement. The study also examined the changes in autistic symptoms between a group of individuals with ASD who were confined during the COVID-19 pandemic and another group of individuals with ASD who were studied prior to the COVID-19 pandemic period.

RESULTS

Higher levels of aggression, irritability, hyperactivity and impulsivity, lack of attention and anxiety, among other symptoms, were found in individuals with ASD during confinement when compared to healthy controls (p < .05; p < .01). Higher levels of repetitive, restrictive, and stereotyped behaviors were also found in pandemic-era ASD individuals when compared to the group of individuals with ASD who were assessed prior to the pandemic (p < .01).

CONCLUSIONS

the confinement is related to an increase in symptomatology and dysfunctional behaviours characteristic of ASD, and therefore it is necessary to implement actions that help to reduce this impact now, as well as in future crisis events.

Adjusted Indirect and Mixed Comparisons of Interventions for the Patient-Reported Outcomes Measures (PROMs) of Disabled Adults: A Systematic Review and Network Meta-Analysis

This systematic review adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA) guidelines and used the method of network meta-analysis to compare the effects of different types of interventions from different perspectives which were abilities of daily life activity, psychological health, social functioning, and overall life quality. The eligibility criteria were: (1) Participants were adults above 18 years old with disabilities; (2) Interventions could be classified into active exercise, passive therapy, psychological education, psychosocial support program, multi-disciplinary program, and usual care; (3) Outcomes should be the patient-reported outcome measures (PROMs) that could be classified into abilities of daily life activity, psychological health, social functioning, and overall life quality; (4) Randomized designed and published in English. The keywords and their search field were: (1) “people with disabilities/disability”, “disabled”, “handicapped”, or “disable people” in titles or abstracts; (2) AND “randomized” or “randomised” in titles or abstracts; (3) NOT “design”, “protocol”, or “review” in titles. After searching in databases of Medline (EBSCO), PubMed, CINAHL, and Ovid, 16 studies were included. As a result, active exercise and passive therapy are most likely to be the best interventions for overall life quality, psychological education and passive therapy are most likely to be the best interventions for abilities of daily life activity, and psychosocial support programs are most likely to be the best intervention for psychological health and social functioning.