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Gosens LCF, Poelen EAP, Didden R, de Jonge JM, Schellekens AFA, VanDerNagel JEL, Onghena P, Otten R. Evaluating the Effectiveness of Take it Personal!+ in People With Mild Intellectual Disability or Borderline Intellectual Functioning and Substance Use Disorder: A Multiple Baseline Single-Case Experimental Study. Behav Ther 2024; 55:331-346. [PMID: 38418044 DOI: 10.1016/j.beth.2023.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 06/07/2023] [Accepted: 07/11/2023] [Indexed: 03/01/2024]
Abstract
Individuals with mild intellectual disabilities or borderline intellectual functioning are at increased risk to develop a substance use disorder-however, effective treatment programs adapted to this target group are scarce. This study evaluated the effectiveness of Take it Personal!+ in individuals with mild intellectual disabilities or borderline intellectual functioning and substance use disorder. Take it Personal!+ is a personalized treatment based on motivational interviewing and cognitive-behavioral therapy supported by an mHealth application. Data were collected in a nonconcurrent multiple baseline single-case experimental design across individuals with four phases (i.e., baseline, treatment, posttreatment, and follow-up). Twelve participants were randomly allocated to baseline lengths varying between 7 and 11 days. Substance use quantity was assessed during baseline, treatment, and posttreatment with a daily survey using a mobile application. Visual analysis was supported with statistical analysis of the daily surveys by calculating three effect size measures in 10 participants (two participants were excluded from this analysis due to a compliance rate below 50%). Secondary, substance use severity was assessed with standardized questionnaires at baseline, posttreatment, and follow-up and analyzed by calculating the Reliable Change Index. Based on visual analysis of the daily surveys, 10 out of 12 participants showed a decrease in mean substance use quantity from baseline to treatment and, if posttreatment data were available, to posttreatment. Statistical analysis showed an effect of Take it Personal!+ in terms of a decrease in daily substance use in 8 of 10 participants from baseline to treatment and if posttreatment data were available, also to posttreatment. In addition, data of the standardized questionnaires showed a decrease in substance use severity in 8 of 12 participants. These results support the effectiveness of Take it Personal!+ in decreasing substance use in individuals with mild intellectual disabilities or borderline intellectual functioning.
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Affiliation(s)
- Lotte C F Gosens
- Research and Development, Pluryn, and Behavioural Science Institute.
| | | | | | | | | | - Joanneke E L VanDerNagel
- Nijmegen Institute for Scientist-Practitioners in Addiction, Centre for Addiction and Intellectual Disability, University of Twente, and Aveleijn
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Vruwink FJ, VanDerNagel JEL, Noorthoorn EO, Nijman HLI, Mulder CL. "Disruptive Behavior" or "Expected Benefit" Are Rationales of Seclusion Without Prior Aggression. Front Psychiatry 2022; 13:871525. [PMID: 35492701 PMCID: PMC9051060 DOI: 10.3389/fpsyt.2022.871525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE In the Netherlands, seclusion of patients with a psychiatric disorder is a last-resort measure to be used only in the event of (imminent) severe danger or harm. Although aggressive behavior is often involved, seclusions not preceded by aggression also seem to occur. We sought insight into the non-aggressive reasons underlying seclusion and investigated the factors associated with it. METHOD We included all patients admitted to a Dutch psychiatric hospital in 2008 and 2009. Seclusions had been registered on Argus-forms, and aggression incidents had been registered on the Staff Observation Aggression Scale-Revised (SOAS-R), inspectorate forms and/or patient files. Determinants of seclusion with vs. without prior aggression were analyzed using logistic regression. Reasons for seclusion without prior aggression were evaluated qualitatively and grouped into main themes. RESULTS Of 1,106 admitted patients, 184 (17%) were secluded at some time during admission. Twenty-one (11.4%) were excluded because information on their seclusion was lacking. In 23 cases (14%), neither SOAS-R, inspectorate forms nor individual patient files indicated any aggression. Univariable and multivariable regression both showed seclusion without preceding aggression to be negatively associated with daytime and the first day of hospitalization. In other words, seclusion related to aggression occurred more on the first day, and during daytime, while seclusion for non-aggressive reasons occurred relatively more after the first day, and during nighttime. Our qualitative findings showed two main themes of non-aggressive reasons for seclusion: "disruptive behavior" and "beneficial to patient." CONCLUSION Awareness of the different reasons for seclusion may improve interventions on reducing its use. Thorough examination of different sources showed that few seclusions had not been preceded by aggression. The use of seclusion would be considerably reduced through interventions that prevent aggression or handle aggression incidents in other ways than seclusion. However, attention should also be paid to the remaining reasons for seclusion, such as handling disruptive behavior and focusing on the beneficial effects of reduced stimuli. Future research on interventions to reduce the use of seclusion should not only aim to reduce seclusion but should also establish whether seclusions preceded by aggression decrease different from seclusions that are not preceded by aggression.
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Affiliation(s)
- Fleur J Vruwink
- Mediant Geestelijke Gezondheidszorg (GGZ), Enschede, Netherlands
| | - Joanneke E L VanDerNagel
- Tactus, Deventer, Netherlands.,Department of Human Media Interactions, University of Twente, Enschede, Netherlands.,Aveleijn, Borne, Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud Universiteit Nijmegen, Nijmegen, Netherlands
| | | | - Henk L I Nijman
- Clinical Psychology, Department of Social Sciences, Behavioural Science Institute (BSI), Radboud University, Nijmegen, Netherlands
| | - Cornelis L Mulder
- Department of Psychiatry, Epidemiologic and Social Psychiatry Research Institute (ESPRI), Erasmus MC, Rotterdam, Netherlands
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Schijven EP, Hulsmans DHG, VanDerNagel JEL, Lammers J, Otten R, Poelen EAP. The effectiveness of an indicated prevention programme for substance use in individuals with mild intellectual disabilities and borderline intellectual functioning: results of a quasi-experimental study. Addiction 2021; 116:373-381. [PMID: 32678489 PMCID: PMC7891383 DOI: 10.1111/add.15156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/20/2019] [Accepted: 06/05/2020] [Indexed: 01/30/2023]
Abstract
AIMS To assess the effectiveness of Take it personal!, a prevention programme for individuals with mild intellectual disabilities and borderline intellectual functioning (MID-BIF) and substance use (SU). The prevention programme aims to reduce SU (alcohol, cannabis and illicit drugs) among experimental to problematic substance users. DESIGN A quasi-experimental design with two arms and a 3-month follow-up. SETTING Adolescents were recruited from 14 treatment centres in the Netherlands specialized in offering intra- and extramural care for people with MID-BIF and behavioural problems. PARTICIPANTS Data were collected from 66 individuals with MID-BIF assigned either to the intervention condition (n = 34) or to the control condition (n = 32). INTERVENTIONS Take it personal! was designed to target four personality traits: sensation-seeking, impulsive behaviour, anxiety sensitivity and negative thinking. For each of these profiles, interventions were developed that were structurally the same but contained different personality-specific materials, games and exercises. The control group received care as usual. MEASUREMENTS Primary outcomes at 3-month follow-up were frequency of SU, severity of SU and binge drinking. RESULTS Results showed intervention effects for SU frequency (F(1, 50.43) = 9.27, P = 0.004) and binge drinking (F(1, 48.02) = 8.63, P = 0.005), but not for severity of SU (F(1, 42.09) = 2.20, P = 0.145). CONCLUSIONS A prevention programme to reduce substance use among experimental to problematic users with mild intellectual disabilities and borderline intellectual functioning helped participants to decrease substance use frequency and binge drinking.
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Affiliation(s)
- Esmée P. Schijven
- Research and DevelopmentPlurynNijmegenthe Netherlands,Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands
| | - Daan H. G. Hulsmans
- Research and DevelopmentPlurynNijmegenthe Netherlands,Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands
| | - Joanneke E. L. VanDerNagel
- TactusCentre for Addiction and Intellectual Disability (CAID)Deventerthe Netherlands,Radboud University, Nijmegen Institute for Scientist‐Practitioners in AddictionNijmegenthe Netherlands,AveleijnBornethe Netherlands,Faculty of Electrical Engineering, Mathematics, and Computer Science, Human Media InteractionUniversity of TwenteEnschedethe Netherlands
| | - Jeroen Lammers
- Trimbos InstituteNetherlands Institute of Mental Health and AddictionUtrechtthe Netherlands
| | - Roy Otten
- Research and DevelopmentPlurynNijmegenthe Netherlands,Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands,REACH Institute, Department of PsychologyArizona State UniversityTempeAZUSA
| | - Evelien A. P. Poelen
- Research and DevelopmentPlurynNijmegenthe Netherlands,Behavioural Science Institute, Radboud UniversityNijmegenthe Netherlands
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Luteijn I, VanDerNagel JEL, van Duijvenbode N, de Haan HA, Poelen EAP, Didden R. Post-traumatic stress disorder and substance use disorder in individuals with mild intellectual disability or borderline intellectual functioning: A review of treatment studies. Res Dev Disabil 2020; 105:103753. [PMID: 32763655 DOI: 10.1016/j.ridd.2020.103753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/07/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
Individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF; IQ 50-85) are at high risk for developing post-traumatic stress disorder (PTSD) and substance use disorders (SUD). In individuals without MID-BIF, Seeking Safety (SeSa) is found to be effective in treating PTSD and SUD simultaneously. However, little is known about integrated treatment of PTSD and SUD in individuals with MID-BIF. This review aims to provide an overview of studies about this type of triple psychopathology, as well as PTSD or SUD in individuals with MID-BIF (i.e. dual diagnosis). No studies were found on integrated treatment of PTSD and SUD in individuals with MID-BIF. Thirty-two studies were found on treatment of either PTSD (mostly Eye Movement Desensitization and Reprocessing and cognitive behavior therapy) or SUD (mostly cognitive behavior therapy and mindfulness) in individuals with MID-BIF. Only 9.4 % of these studies mentioned the co-morbidity of PTSD and SUD. Suggestions for adapting treatment to individuals with MID-BIF were provided on communication, structure, non-verbal elements, network, coping skills, therapeutic relationship and use of suitable and reliable instruments to measure treatment progress. More research is needed on the effectivity of EMDR or Imaginary Exposure (IE) combined with SUD treatment (CBT and mindfulness), and on the adaption of SeSa tot individuals with MID-BIF, as well as on this type of triple psychopathology in general.
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Affiliation(s)
- Ilse Luteijn
- Tactus Verslavingszorg, P.O. Box 154, 7400 AD, Deventer, the Netherlands.
| | - Joanneke E L VanDerNagel
- Tactus Verslavingszorg, P.O. Box 154, 7400 AD, Deventer, the Netherlands; Radboud Universiteit Nijmegen, Nijmegen Institute for Scientist-Practitioners in Addiction, P.O Box 6909, 6503 GK Nijmegen, the Netherlands; Aveleijn, Grotestraat 260, 7622 GW Borne, the Netherlands; University of Twente, Faculty of Electrical Engineering, Mathematics, & Computer Science, Human Media Interaction, Drienerlolaan 5, 7522 NB Enschede, the Netherlands
| | - Neomi van Duijvenbode
- Tactus Verslavingszorg, P.O. Box 154, 7400 AD, Deventer, the Netherlands; Trajectum, Hanzeallee 2, 8017 KZ Zwolle, the Netherlands
| | - Hein A de Haan
- Tactus Verslavingszorg, P.O. Box 154, 7400 AD, Deventer, the Netherlands; Radboud Universiteit Nijmegen, Nijmegen Institute for Scientist-Practitioners in Addiction, P.O Box 6909, 6503 GK Nijmegen, the Netherlands
| | - Evelien A P Poelen
- Pluryn, Research & Development, Industrieweg 50, 6541 TW, Nijmegen, the Netherlands; Behavioral Science Institute, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands
| | - Robert Didden
- Trajectum, Hanzeallee 2, 8017 KZ Zwolle, the Netherlands; Behavioral Science Institute, Radboud University, P.O. Box 9104, 6500 HE, Nijmegen, the Netherlands
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Schijven EP, VanDerNagel JEL, Otten R, Lammers J, Poelen EAP. Take it personal! Development and modelling study of an indicated prevention programme for substance use in adolescents and young adults with mild intellectual disabilities and borderline intellectual functioning. J Appl Res Intellect Disabil 2020; 34:307-315. [PMID: 32990417 PMCID: PMC7820965 DOI: 10.1111/jar.12808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Abstract
Background This paper describes the theory and development of Take it personal! an indicated prevention programme aimed at reducing substance use in individuals with mild intellectual disabilities and borderline intellectual functioning. Method The process of the development of Take it personal! followed the steps of the Intervention Mapping protocol. Take it personal! is based on the theory that personality traits are an important construct to understand substance use (14–30 years old). A small modelling study was conducted with six adolescents to examine the feasibility, user‐friendliness and potential effectiveness of the intervention. Results The results showed that the intervention has good feasibility and user‐friendliness. Post‐intervention evaluation of frequency, binge drinking and problematic use indicated that use was lower than at pre‐intervention. Conclusions Take it Personal! can be a promising preventive intervention designed to reduce substance use in individuals in this target group. A larger scale study is needed to draw further conclusions.
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Affiliation(s)
- Esmée P Schijven
- Research and Development, Pluryn, Nijmegen, The Netherlands.,Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Joanneke E L VanDerNagel
- Centre for Addiction and Intellectual Disability (CAID), Tactus, Deventer, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, Nijmegen, The Netherlands.,Aveleijn, Borne, The Netherlands.,Human Media Interaction, Faculty of Electrical Engineering, Mathematics, & Computer Science, University of Twente, Enschede, The Netherlands
| | - Roy Otten
- Research and Development, Pluryn, Nijmegen, The Netherlands.,Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.,REACH Institute, Arizona State University, Tempe, AZ, USA
| | - Jeroen Lammers
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Evelien A P Poelen
- Research and Development, Pluryn, Nijmegen, The Netherlands.,Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
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VanDerNagel JEL, Kiewik M, van Dijk M, Didden R, Korzilius HPLM, van der Palen J, Buitelaar JK, Uges DRA, Koster RA, de Jong CAJ. Substance use in individuals with mild to borderline intellectual disability: A comparison between self-report, collateral-report and biomarker analysis. Res Dev Disabil 2017; 63:151-159. [PMID: 27133469 DOI: 10.1016/j.ridd.2016.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 04/15/2016] [Accepted: 04/16/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND AIMS Individuals with mild or borderline intellectual disability (MBID) are at risk of substance use (SU). At present, it is unclear which strategy is the best for assessing SU in individuals with MBID. This study compares three strategies, namely self-report, collateral-report, and biomarker analysis. METHODS AND PROCEDURES In a sample of 112 participants with MBID from six Dutch facilities providing care to individuals with intellectual disabilities, willingness to participate, SU rates, and agreement between the three strategies were explored. The Substance use and misuse in Intellectual Disability - Questionnaire (SumID-Q; self-report) assesses lifetime use, use in the previous month, and recent use of tobacco, alcohol, cannabis, and stimulants. The Substance use and misuse in Intellectual Disability - Collateral-report questionnaire (SumID-CR; collateral-report) assesses staff members' report of participants' SU over the same reference periods as the SumID-Q. Biomarkers for SU, such as cotinine (metabolite of nicotine), ethanol, tetrahydrocannabinol (THC), and its metabolite THCCOOH, benzoylecgonine (metabolite of cocaine), and amphetamines were assessed in urine, hair, and sweat patches. RESULTS Willingness to provide biomarker samples was significantly lower compared to willingness to complete the SumID-Q (p<0.001). Most participants reported smoking, drinking alcohol, and using cannabis at least once in their lives, and about a fifth had ever used stimulants. Collateralreported lifetime use was significantly lower. However, self-reported past month and recent SU rates did not differ significantly from the rates from collateral-reports or biomarkers, with the exception of lower alcohol use rates found in biomarker analysis. The agreement between self-report and biomarker analysis was substantial (kappas 0.60-0.89), except for alcohol use (kappa 0.06). Disagreement between SumID-Q and biomarkers concerned mainly over-reporting of the SumID-Q. The agreement between SumID-CR and biomarker analysis was moderate to substantial (kappas 0.48 - 0.88), again with the exception of alcohol (kappa 0.02). CONCLUSIONS AND IMPLICATIONS In this study, the three strategies that were used to assess SU in individuals with MBID differed significantly in participation rates, but not in SU rates. Several explanations for the better-than-expected performance of self- and collateral-reports are presented. We conclude that for individuals with MBID, self-report combined with collateralreport can be used to assess current SU, and this combination may contribute to collaborative, early intervention efforts to reduce SU and its related harms in this vulnerable group.
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Affiliation(s)
- Joanneke E L VanDerNagel
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands; Tactus Addiction Treatment, Raiffeisenstraat 75, 7514 AM Enschede, The Netherlands; Aveleijn, Grotestraat 260, 7622 GW Borne, The Netherlands.
| | - Marion Kiewik
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands; Aveleijn, Grotestraat 260, 7622 GW Borne, The Netherlands
| | - Marike van Dijk
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands; Tactus Addiction Treatment, Raiffeisenstraat 75, 7514 AM Enschede, The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands; Trajectum, P.O. Box 40012, 8004 DA Zwolle, The Netherlands
| | - Hubert P L M Korzilius
- Institute for Management Research, Radboud University, Thomas van Aquinostraat 5, 6525 GD Nijmegen, The Netherlands
| | - Job van der Palen
- Department of Research Methodology, Measurement and Data Analysis, Faculty of Behavioral Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Medical School Twente, Medisch Spectrum Twente, Ariënsplein 1, 7511 JX Enschede, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Centre, P.O. Box 9101 (204), 6500HB Nijmegen, The Netherlands
| | - Donald R A Uges
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Clinical Pharmaceutical and Toxicological Laboratory, P.O. Box 30.001, 9700 RB Groningen, University of Groningen, The Netherlands
| | - Remco A Koster
- University of Groningen, University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Clinical Pharmaceutical and Toxicological Laboratory, P.O. Box 30.001, 9700 RB Groningen, University of Groningen, The Netherlands
| | - Cor A J de Jong
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands; Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
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Swerts C, Vandevelde S, VanDerNagel JEL, Vanderplasschen W, Claes C, De Maeyer J. Substance use among individuals with intellectual disabilities living independently in Flanders. Res Dev Disabil 2017; 63:107-117. [PMID: 27061044 DOI: 10.1016/j.ridd.2016.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/29/2016] [Accepted: 03/30/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Over the past decades, there has been increased scientific and clinical interest in substance use among individuals with intellectual disabilities (ID). Despite raised interest and awareness in the topic, lack of supportive data on prevalence and risk factors highlights the need for ongoing research. The aims of this cross-sectional multicenter study were to examine the nature and extent of substance use in individuals with ID living independently, to investigate group differences in substance use and related problems, and to explore the role of substance-related knowledge and attitudes in substance use behaviors. METHOD Participants were 123 individuals with mild to moderate ID receiving support from independent living services. Data were gathered by means of a structured interview strategy (i.e. the Substance Use and Misuse in Intellectual Disability-Questionnaire; SumID-Q). RESULTS Findings revealed that rates of lifetime use of licit and illicit substances were higher than those found in earlier studies among individuals with ID and the general population. While cannabis use was the only illicit substance reported, current tobacco and alcohol use were shown to be highly prevalent (48%-45.5%). Rates for the latter were similar to earlier studies among community samples of individuals with ID. In contrast to our hypotheses, few group differences in substance use behaviors were observed. Male gender was associated with age of onset of alcohol and tobacco use and tobacco use-related problems, while younger age was found to be associated with lifetime use of cannabis. No evidence was found regarding the role of knowledge; however, smokers and alcohol users rated tobacco and alcohol use more positively. CONCLUSION This study demonstrated that individuals with ID living independently use a wide range of licit and illicit substances and present divergent levels and patterns of substance use. Notwithstanding the role of personal choice in substance use, more research is needed to better understand the nature and extent of substance use and related problems, as well as the role of substance-related knowledge and attitudes in individuals with ID.
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Affiliation(s)
- Chris Swerts
- University College Ghent, Faculty of Education, Health and Social Work, Department of Orthopedagogy-Special Education, Centre of Expertise E-QUAL, Valentin Vaerwyckweg 1, 9000 Ghent, Belgium.
| | - Stijn Vandevelde
- Ghent University, Department of Special Needs Education, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Joanneke E L VanDerNagel
- Tactus Addiction Treatment, Raiffeisenstraat 75, 7514 AM Enschede, The Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands; Aveleijn, Grotestraat 260, 7622 GW Borne, The Netherlands
| | - Wouter Vanderplasschen
- Ghent University, Department of Special Needs Education, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Claudia Claes
- University College Ghent, Faculty of Education, Health and Social Work, Department of Orthopedagogy-Special Education, Centre of Expertise E-QUAL, Valentin Vaerwyckweg 1, 9000 Ghent, Belgium; Ghent University, Department of Special Needs Education, Henri Dunantlaan 2, 9000 Ghent, Belgium
| | - Jessica De Maeyer
- University College Ghent, Faculty of Education, Health and Social Work, Department of Orthopedagogy-Special Education, Centre of Expertise E-QUAL, Valentin Vaerwyckweg 1, 9000 Ghent, Belgium
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Kiewik M, VanDerNagel JEL, Kemna LEM, Engels RCME, DeJong CAJ. Substance use prevention program for adolescents with intellectual disabilities on special education schools: a cluster randomised control trial. J Intellect Disabil Res 2016; 60:191-200. [PMID: 26631986 DOI: 10.1111/jir.12235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 08/28/2015] [Accepted: 09/08/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Students without intellectual disability (ID) start experimenting with tobacco and alcohol between 12 and 15 years of age. However, data for 12- to 15-year old students with ID are unavailable. Prevention programs, like 'PREPARED ON TIME' (based on the attitude-social influence-efficacy model), are successful, but their efficacy has not been studied in students with ID. The objectives of this study were (1) to undertake a cluster randomised control trial to test the efficacy of the e-learning program among 12- to 15-year old students with mild and borderline ID in secondary special-needs schools and (2) to examine the tobacco and alcohol use for this population. METHODS Five schools, randomly selected to be part of either the experimental group or the control group, participated in this study. Passive informed consent was used in which parents and their children can refuse to participate in the study, resulting in 111 students in the experimental group and 143 students in the control group. A total of 210 students completed both baseline and follow-up questionnaires. Primary outcome variables are the knowledge and attitude towards alcohol and tobacco use. This study is registered in the ISRCTN registry with number ISRCTN95279686. RESULTS Baseline findings showed that a large proportion of all respondents had initiated smoking (49%) and drinking (75%), well above the expected numbers based on national figures. 'PREPARED ON TIME' did not affect the behavioural determinants (i.e. attitude, subjective norm and self-efficacy), except modelling on smoking. Additionally, alcohol-related knowledge of students in the experimental group increased after the completion of the program. CONCLUSIONS To obtain effective results on behavioural outcomes from 'PREPARED ON TIME', a greater degree of flexibility (i.e. repetition, extension of the program, role playing, etc.) is required. Furthermore, prevention needs to be implemented at a younger age, as 6% of the students tried their first cigarette and 15% of the students drank alcohol at the age of 10 years or younger.
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Affiliation(s)
- M Kiewik
- Afdeling Zorgondersteuning en Behandeling, Aveleijn, Borne, Overijssel, The Netherlands
- Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Radbound University, Nijmegen, The Netherlands
| | - J E L VanDerNagel
- Afdeling Zorgondersteuning en Behandeling, Aveleijn, Borne, Overijssel, The Netherlands
- Onderzoek en Advies, Tactus, Enschede, The Netherlands
- Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Radbound University, Nijmegen, The Netherlands
| | - L E M Kemna
- Afdeling Zorgondersteuning en Behandeling, Aveleijn, Borne, Overijssel, The Netherlands
| | - R C M E Engels
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
- Trimbos Institute, Utrecht, The Netherlands
| | - C A J DeJong
- Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Radbound University, Nijmegen, The Netherlands
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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. Res Dev Disabil 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] [What about the content of this article? (0)] [Affiliation(s)] [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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VanDerNagel JEL, Kiewik M, Postel MG, van Dijk M, Didden R, Buitelaar JK, de Jong CAJ. Capture recapture estimation of the prevalence of mild intellectual disability and substance use disorder. Res Dev Disabil 2014; 35:808-813. [PMID: 24530089 DOI: 10.1016/j.ridd.2014.01.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 01/14/2014] [Accepted: 01/20/2014] [Indexed: 06/03/2023]
Abstract
Persons with mild to borderline intellectual disability (MID) have been identified as a group at risk for substance use disorder (SUD). However, prevalence estimates of co-occurring SUD and MID rely largely on single source studies performed in selected samples. To obtain more reliable population estimates of SUD and MID, this study combines data from an Intellectual Disability Facility (IDF), and an Addiction Treatment Centre (ATC) in a semi-rural area in the Netherlands. Capture-recapture analysis was used to estimate the hidden population (i.e., the population not identified in the original samples). Further analyses were performed for age and gender stratified data. Staff members reported on 88 patients with SUD and MID in the IDF (4.0% of the IDF sample) and 114 in the ATC (5.2% of the ATC sample), with 12 patients in both groups. Only strata for males over 30 years provided reliable population estimates. Based on 97 patients in these strata, the hidden population was estimated at 215. Hence the estimated total population of males over 30 years old with MID and SUD was 312 (95% CI 143-481), approximately 0.16% (0.05-0.25%) of the total population of this age and gender group. This illustrates that while patients with co-occurring SUD and MID often receive professional help from only one service provider, single source data underestimate its prevalence, and thus underestimate treatment and service needs. Therefore, population prevalence estimations of co-occurring SUD and MID should be based on combined multiple source data.
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Affiliation(s)
- Joanneke E L VanDerNagel
- Tactus Addiction Treatment, Raiffeisenstraat 75, 7514 AM Enschede, The Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands; Aveleijn, Grotestraat 260, 7622 GW Borne, The Netherlands.
| | - Marion Kiewik
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands; Aveleijn, Grotestraat 260, 7622 GW Borne, The Netherlands.
| | - Marloes G Postel
- Tactus Addiction Treatment, Raiffeisenstraat 75, 7514 AM Enschede, The Netherlands; Department of Psychology, Health & Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | - Marike van Dijk
- Tactus Addiction Treatment, Raiffeisenstraat 75, 7514 AM Enschede, The Netherlands; Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands.
| | - Robert Didden
- Trajectum, P.O. Box 300, 7200 AH Zutphen, The Netherlands; Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, 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.
| | - Cor A J de Jong
- Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, P.O. Box 6909, 6503 GK Nijmegen, The Netherlands.
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Abstract
Knowledge of how nurses experience the process of secluding a patient can be useful in improving the quality of patient care and in the prevention of work related stress in nurses. This study describes personal experiences of nurses throughout the seclusion process. The emotions which came to surface in semi-structured interviews with 8 nurses were categorized in three main themes (Tension, Trust and Power) and a stress response curve was identified in the seclusion process, with specific feelings in each phase. Feelings denied in former studies such as feeling superior, anger and disgust were found in the interviews in this study.
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