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Quinn S, Rhynas S, Gowland S, Cameron L, Braid N, O Connor S. Risk for intellectual disability populations in inpatient forensic settings in the United Kingdom: A literature review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1267-1280. [PMID: 35995572 PMCID: PMC10087896 DOI: 10.1111/jar.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND People with an intellectual disability who commit a criminal offence can be detained, by a court, in a forensic inpatient facility. There is limited understanding of how inpatients with an intellectual disability and their nurses navigate risk in U.K. forensic services. METHODS A traditional literature review design was followed to map evidence (2000-2021) around the forensic and health and wellbeing risks faced by inpatients with an intellectual disability, nurses' perceptions of managing risk, and patient experiences of informing risk assessment and management. Papers were analysed thematically. RESULTS Findings suggest that restrictive measures to mitigate forensic risks (e.g., violence) can exacerbate the risk of poor health and wellbeing outcomes. There was some limited evidence of direct patient involvement in risk assessment and management. CONCLUSION Further research is required to explore how forensic inpatients with an intellectual disability can have input in care planning, risk assessment and management.
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Affiliation(s)
- Sam Quinn
- The University of Edinburgh, Edinburgh, Scotland
| | - Sarah Rhynas
- The University of Edinburgh, Edinburgh, Scotland
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Copersino ML, Slayter E, McHugh RK, Shedlack KJ, Lukas SE, Weiss RD. Clinical utility of a hybrid secondary and relapse prevention program in adults with mild intellectual disability or borderline intellectual functioning in community residential and day habilitation settings. Disabil Health J 2022; 15:101293. [PMID: 35337784 DOI: 10.1016/j.dhjo.2022.101293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/17/2021] [Accepted: 11/02/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Despite evidence that standard substance use disorder (SUD) treatment may be less effective in people with intellectual disability (ID), there is an absence of appropriate clinical tools with which to support them. OBJECTIVES This study examined the clinical utility of an alcohol and other drug refusal skills intervention designed to be cognitively accessible to adults with ID METHODS: Thirty individuals at high risk for or in recovery from a SUD in developmental disability services (DDS) community residential and day habilitation settings participated in the two-week refusal skills group. Measures included pretest versus posttest improvement in refusal skill competency and baseline performance on a standardized verbal learning test. RESULTS There was a strong effect for refusal skill acquisition (p < .001); and the magnitude of skill acquisition was predicted by group attendance (p < .001) and not by individual differences in verbal learning ability (p = .074) or efficiency (p = .35). CONCLUSIONS The Refusal Skills Group is developmentally appropriate for people with mild ID in that: (1) they can learn and demonstrate refusal skills and (2) their skill acquisition is predicted more strongly by exposure to the intervention than by individual differences in learning characteristics. Delivering refusal skills in DDS settings familiar to clients increased their access to services and minimized disruption to their usual routines and schedules.
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Affiliation(s)
- Marc L Copersino
- McLean Hospital, Division of Alcohol, Drugs, and Addiction, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA.
| | - Elspeth Slayter
- Salem State University, School of Social Work, Salem, MA, USA
| | - R Kathryn McHugh
- McLean Hospital, Division of Alcohol, Drugs, and Addiction, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Karen J Shedlack
- McLean Hospital, Division of Alcohol, Drugs, and Addiction, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA; Commonwealth of Massachusetts, Department of Developmental Services, Boston, MA, USA
| | - Scott E Lukas
- McLean Hospital, Division of Alcohol, Drugs, and Addiction, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Roger D Weiss
- McLean Hospital, Division of Alcohol, Drugs, and Addiction, Belmont, MA, USA; Harvard Medical School, Department of Psychiatry, Boston, MA, USA
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Walker H, Mann H, Pitcairn J, Thomson L. A national census of forensic in‐patients with intellectual disability and five‐year follow‐up. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2021. [DOI: 10.1111/jppi.12407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Helen Walker
- Department of Health and Life Sciences University of the West of Scotland Hamilton UK
- Forensic Network The State Hospital Lanark UK
| | - Helen Mann
- University of the West of Scotland Lanarkshire UK
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Abstract
PURPOSE OF REVIEW To provide an overview of studies on substance use and substance use disorder (SUD) in individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF). RECENT FINDINGS Many individuals with MID-BIF use tobacco, alcohol, and drugs. On average, rates of substance use and SUD are similar to or even higher than those in peers with average intelligence. Individuals with MID-BIF are overrepresented in (forensic) addiction care. Several instruments are now available for the assessment of SUD and its risk factors in this target group. Prevention and intervention programs have been shown feasible and with promising outcomes, although the evidence base is still small. Professionals in addiction care and intellectual disability care facilities show deficiencies in skills in addressing SUD in clients with MID-BIF. SUMMARY Research in this area is still in its infancy, though an increasing number of studies show promising outcomes regarding case identification, assessment, and treatment of SUD in intellectual disability. Policy and practice should be adapted to the characteristics of individuals with MID-BIF.
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Murphy GH, Chiu P, Triantafyllopoulou P, Barnoux M, Blake E, Cooke J, Forrester-Jones RVE, Gore NJ, Beecham JK. Offenders with intellectual disabilities in prison: what happens when they leave? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:957-968. [PMID: 28573662 DOI: 10.1111/jir.12374] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/11/2017] [Accepted: 03/14/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with intellectual disabilities, if convicted of offences, may be sentenced to prison, but little is known about their life when they are released. METHOD This study followed up men with intellectual disabilities who were leaving prisons in England. RESULTS The men were hard to contact, but 38 men were interviewed, on average 10 weeks after leaving prison. The men were living in a variety of situations and often were very under-occupied, with limited social networks. A total of 70% were above the clinical cut-off for anxiety, and 59.5% were above the clinical cut-off for depression. The men were receiving little support in the community, and many had been reinterviewed by police. CONCLUSIONS Community teams need to provide better support to this very vulnerable group.
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Affiliation(s)
- G H Murphy
- Tizard Centre, University of Kent, Canterbury, UK
| | - P Chiu
- Tizard Centre, University of Kent, Canterbury, UK
| | | | - M Barnoux
- Tizard Centre, University of Kent, Canterbury, UK
| | - E Blake
- Tizard Centre, University of Kent, Canterbury, UK
| | - J Cooke
- Tizard Centre, University of Kent, Canterbury, UK
| | | | - N J Gore
- Tizard Centre, University of Kent, Canterbury, UK
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Didden R. Substance use and abuse in individuals with mild intellectual disability or borderline intellectual functioning: An introduction to the special section. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 63:95-98. [PMID: 28222960 DOI: 10.1016/j.ridd.2017.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Robert Didden
- Radboud University, Behavioural Science Institute, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands; Trajectum, Zwolle, The Netherlands.
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Kiewik M, VanDerNagel JEL, Engels RCME, DeJong CA. The efficacy of an e-learning prevention program for substance use among adolescents with intellectual disabilities: A pilot study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 63:160-166. [PMID: 27836581 DOI: 10.1016/j.ridd.2016.09.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 08/10/2016] [Accepted: 09/27/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND AIMS Adolescents with Intellectual Disability (ID) are at risk for tobacco and alcohol use, yet little or no prevention programs are available for this group. 'Prepared on time' is an e-learning program based on the attitude - social influence - efficacy model originally developed for fifth and sixth grades of mainstream primary schools. The goals of this study were (1) to examine the lifetime use of tobacco and alcohol among this target group and (2) to gain a first impression of the efficacy of 'Prepared on time' among 12-16-year old students with moderate or mild ID (MMID). METHODS AND PROCEDURES Students form three secondary special-needs schools were assigned to the experimental (e-learning) group (n=37) or the control group (n=36). Pre-intervention and follow-up data (3 weeks after completion) were gathered using semi-structured interviews inquiring about substance use among students with MMID and the behavioral determinants of attitude, subjective norm, modelling, intention, and knowledge. RESULTS The lifetime tobacco use and alcohol consumption rates in our sample were 25% and 59%, respectively. The e-learning program had a positive effect on the influence of modelling of classmates and friends. No significant effects were found on other behavioral determinants and knowledge. CONCLUSIONS AND IMPLICATIONS A substantial proportion of adolescents with MMID in secondary special-needs schools use tobacco or alcohol. This study showed that an e-learning prevention program can be feasible for adolescents with MMID.
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Affiliation(s)
- Marion Kiewik
- Aveleijn Intellectual Disability Services, Borne, The Netherlands; Nijmegen Institute for Scientists and Practitioners in Addiction, Nijmegen, The Netherlands.
| | - Joanne E L VanDerNagel
- Aveleijn Intellectual Disability Services, Borne, The Netherlands; Tactus Addiction Medicine, Enschede, The Netherlands; Nijmegen Institute for Scientists and Practitioners in Addiction, Nijmegen, The Netherlands
| | - Rutger C M E Engels
- Behavioral Science Institute, Nijmegen, The Netherlands; Monitoring and Epidemiology Department, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Cor A DeJong
- Behavioral Science Institute, Nijmegen, The Netherlands; Nijmegen Institute for Scientists and Practitioners in Addiction, Nijmegen, The Netherlands
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Abstract
Intellectual Disability (ID) can be caused by a variety of factors, which may lead to a variety of signs and symptoms. Individuals with ID are living in societies where during the past decade there is a steady increase in the amount of research focused on civil law, criminal law and mental health. In this chapter, there will be a theoretical presentation of the research on ID regarding criminal law and the different forms of aggressive behavior such as sexual violence, homicide, theft, arson and alcohol-drug abuse. There will be information on research regarding civil law and the most common problems for individuals with ID, such as financial capacity and capacity for medical consent. Finally, there will be a section for the most important issues regarding the trial and conviction for individuals with ID and a presentation of a recent research on attitudes toward ID and legal issues. The above will be examined through the prism of current neuropsychological data, while cross-cultural restrictions will be discussed.
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McGillivray JA, Gaskin CJ, Newton DC, Richardson BA. Substance Use, Offending, and Participation in Alcohol and Drug Treatment Programmes: A Comparison of Prisoners with and without Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2015; 29:289-94. [PMID: 25754684 DOI: 10.1111/jar.12175] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many offenders with intellectual disabilities have substance use issues. Offending behaviour may be associated with substance use. MATERIALS AND METHODS Prisoners with and without intellectual disabilities were compared in terms of their substance use prior to imprisonment, the influence of substance use on offending, and their participation in alcohol and drug treatment programmes. RESULTS Substance use was similar in prisoners with and without intellectual disabilities in the year prior to their current prison terms. Prisoners with intellectual disabilities were much less likely to report that substance use was an antecedent to the offences leading to their imprisonment. The completion rate of alcohol and drug treatment programmes was much lower for those with intellectual disabilities. CONCLUSIONS Substance use may be as common in prisoners with intellectual disabilities as those without this condition. Services may need to reflect on whether their treatment programmes are meeting the needs of all prisoners.
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Affiliation(s)
- Jane A McGillivray
- Centre for Mental Health and Wellbeing Research, Faculty of Health, Deakin University, Burwood, Vic., Australia.,School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - Cadeyrn J Gaskin
- Centre for Mental Health and Wellbeing Research, Faculty of Health, Deakin University, Burwood, Vic., Australia.,School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - Danielle C Newton
- School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - Ben A Richardson
- Centre for Mental Health and Wellbeing Research, Faculty of Health, Deakin University, Burwood, Vic., Australia.,School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
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van Duijvenbode N, VanDerNagel JEL, Didden R, Engels RCME, Buitelaar JK, Kiewik M, de Jong CAJ. Substance use disorders in individuals with mild to borderline intellectual disability: current status and future directions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:319-328. [PMID: 25577182 DOI: 10.1016/j.ridd.2014.12.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 12/19/2014] [Indexed: 06/04/2023]
Abstract
Knowledge regarding substance use (SU) and substance use disorder (SUD) in individuals with mild to borderline intellectual disabilities (ID) has increased over the last decade, but is still limited. Data on prevalence and risk factors are fragmented, and instruments for screening and assessment and effective treatment interventions are scarce. Also, scientific developments in other fields are insufficiently incorporated in the care for individuals with ID and SUD. In this selective and critical review, we provide an overview of the current status of SU(D) in ID and explore insights on the conceptualisation of SUD from other fields such as addiction medicine and general psychiatry. SU(D) turns out to be a chronic, multifaceted brain disease that is intertwined with other physical, psychiatric and social problems. These insights have implications for practices, policies and future research with regard to the prevalence, screening, assessment and treatment of SUD. We will therefore conclude with recommendations for future research and policy and practice, which may provide a step forward in the care for individuals with ID and SUD.
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Affiliation(s)
- Neomi van Duijvenbode
- Radboud University Nijmegen, Behavioural Science Institute, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
| | - Joanneke E L VanDerNagel
- Aveleijn, Grotestraat 260, 7622 GW Borne, The Netherlands; Tactus, Raiffeisenstraat 75, 7514 AM Enschede, The Netherlands; Radboud University Nijmegen, Nijmegen Institute for Scientist-Practitioners in Addiction, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands
| | - Robert Didden
- Radboud University Nijmegen, Behavioural Science Institute, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Trajectum, P.O. Box 40012, 8004 DA Zwolle, The Netherlands
| | - Rutger C M E Engels
- Radboud University Nijmegen, Behavioural Science Institute, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Trimbos Institute, P.O. Box 725, 3500 AS Utrecht, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Nijmegen Centre for Evidence-based Medicine, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Marion Kiewik
- Aveleijn, Grotestraat 260, 7622 GW Borne, The Netherlands; Radboud University Nijmegen, Nijmegen Institute for Scientist-Practitioners in Addiction, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands
| | - Cor A J de Jong
- Radboud University Nijmegen, Nijmegen Institute for Scientist-Practitioners in Addiction, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands
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