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Frielink N, Schuengel C, van der Ven SHG, Embregts PJCM. The prospective associations between autonomy support, basic psychological needs, motivation and well-being among people with a mild to borderline intellectual disability: a two-wave study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 38886881 DOI: 10.1111/jir.13163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/20/2024] [Accepted: 05/19/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND This study, grounded in self-determination theory, examined how satisfaction of the needs for autonomy, relatedness and competence in people with mild to borderline intellectual disability (MBID) changed over a 4.5-year period. Additionally, it explored the association between life events across various domains (i.e. health, support and living situation, crime, relationships and freedom and finance) and these changes and explored the prospective associations between these needs, perceptions of support from direct support staff and the well-being and ill-being of people with MBID. METHODS Based on a sample of 117 adults with MBID, multiple regression analyses were conducted to determine correlations between constructs at both time points and the impact of autonomy support on need satisfaction and motivation, taking into account life events. RESULTS The analyses showed that, at both time points, most constructs were statistically significantly correlated and remained so despite a time lag of 4.5 years. Autonomy support emerged as a significant positive predictor, of medium size, for satisfying autonomy and relatedness needs. Its association with competence need satisfaction was not statistically significant after Bonferroni correction. For type of motivation, autonomy support statistically predicted increased autonomous motivation, irrespective of life events. CONCLUSIONS Findings underline the potential of autonomy supportive direct support in the lives of individuals with MBID. Some unexpected null findings underscore the need for further study into the interplay between autonomy support, life events and the well-being of people with MBID.
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Affiliation(s)
- N Frielink
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - C Schuengel
- Section of Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S H G van der Ven
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - P J C M Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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2
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Haehner P, Würtz F, Kritzler S, Kunna M, Luhmann M, Woud ML. The relationship between the perception of major life events and depression: A systematic scoping review and meta-analysis. J Affect Disord 2024; 349:145-157. [PMID: 38190863 DOI: 10.1016/j.jad.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND Major life events can lead to depression in adulthood. However, as predicted by several depression theories, not only the mere occurrence of major life events but also the way people perceive them determines the onset of a depression. METHODS Based on a systematic literature search, we identified 276 studies (Ntotal = 89,600) that examined the relationship between the perception of major life events and depression. We provide an overview of how this relationship has been examined. Furthermore, we meta-analytically integrated 420 effect sizes (172 studies) on the association between the perception of major life events and depression. RESULTS Most studies relied on college student samples, were cross-sectional, and were conducted in the United States. A more negative perception of events was significantly associated with higher levels of depressive symptoms (r = 0.28). This association was robust across several design and sample characteristics. Furthermore, the perception of major life events and depression were also longitudinally associated with each other (event perception predicting later depressive symptoms: r = 0.26; depressive symptoms predicting later event perception: r = 0.17). LIMITATIONS Longitudinal research on the relationship between depression and the perception of major life events was relatively rare impairing definite conclusions on whether the perception of life events can predict changes in depressive symptoms over time. CONCLUSION The perception of major life events is related to depression. However, further longitudinal research considering a range of different perceived event characteristics and using non-Western heterogeneous samples is needed to better understand their relationship.
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Affiliation(s)
- Peter Haehner
- Psychological Methods Lab, Department of Psychology, Ruhr University Bochum, Germany; Individual Differences Lab, Department of Psychology, University of Zurich, Switzerland.
| | - Felix Würtz
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr University Bochum, Germany
| | - Sarah Kritzler
- Psychological Methods Lab, Department of Psychology, Ruhr University Bochum, Germany
| | - Marius Kunna
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr University Bochum, Germany
| | - Maike Luhmann
- Psychological Methods Lab, Department of Psychology, Ruhr University Bochum, Germany
| | - Marcella L Woud
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr University Bochum, Germany; Clinical Psychology and Experimental Psychopathology, Georg-Elias-Mueller-Institute of Psychology, Georg-August-University Göttingen, Germany
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3
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Fisher MH, Sung C, Kammes RR, Okyere C, Park J. Social support as a mediator of stress and life satisfaction for people with intellectual or developmental disabilities during the COVID-19 pandemic. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:243-251. [PMID: 34633129 PMCID: PMC8646736 DOI: 10.1111/jar.12943] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/04/2021] [Accepted: 09/16/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This study examined factors that predict stress level and life satisfaction among adults with intellectual or developmental disabilities during the COVID-19 pandemic and the role of social support. METHOD From a larger study about the experiences during the pandemic of 2028 individuals with and without disabilities, 181 adults with intellectual or developmental disabilities (or proxy) responded. RESULTS Most respondents with intellectual or developmental disabilities (92.8%) reported negative impacts from the pandemic, with 55.2% of the 96 employed pre-pandemic reporting impacted employment, including job loss. The negative impact of the pandemic was a significant predictor of stress level; social support was related to reduced stress. Stress level and the negative impact of the pandemic were inversely related to life satisfaction; social support was positively related to life satisfaction. Social support partially mediated the association between stress level and life satisfaction. DISCUSSION Comprehensive services and social support systems are needed to combat the impact of the pandemic.
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Affiliation(s)
- Marisa H Fisher
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Connie Sung
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Rebecca R Kammes
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Christiana Okyere
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA
| | - Jiyoon Park
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, Michigan, USA.,Center for Research on Autism, Intellectual, and Neurodevelopmental Disabilities, Michigan State University, East Lansing, Michigan, USA.,Department of Special Education, Changwon National University, Changwon, South Korea
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4
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Oligophrenin-1 moderates behavioral responses to stress by regulating parvalbumin interneuron activity in the medial prefrontal cortex. Neuron 2021; 109:1636-1656.e8. [PMID: 33831348 DOI: 10.1016/j.neuron.2021.03.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 02/09/2021] [Accepted: 03/10/2021] [Indexed: 12/28/2022]
Abstract
Ample evidence indicates that individuals with intellectual disability (ID) are at increased risk of developing stress-related behavioral problems and mood disorders, yet a mechanistic explanation for such a link remains largely elusive. Here, we focused on characterizing the syndromic ID gene oligophrenin-1 (OPHN1). We find that Ophn1 deficiency in mice markedly enhances helpless/depressive-like behavior in the face of repeated/uncontrollable stress. Strikingly, Ophn1 deletion exclusively in parvalbumin (PV) interneurons in the prelimbic medial prefrontal cortex (PL-mPFC) is sufficient to induce helplessness. This behavioral phenotype is mediated by a diminished excitatory drive onto Ophn1-deficient PL-mPFC PV interneurons, leading to hyperactivity in this region. Importantly, suppressing neuronal activity or RhoA/Rho-kinase signaling in the PL-mPFC reverses helpless behavior. Our results identify OPHN1 as a critical regulator of adaptive behavioral responses to stress and shed light onto the mechanistic links among OPHN1 genetic deficits, mPFC circuit dysfunction, and abnormalities in stress-related behaviors.
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5
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van den Akker N, Kroezen M, Wieland J, Pasma A, Wolkorte R. Behavioural, psychiatric and psychosocial factors associated with aggressive behaviour in adults with intellectual disabilities: A systematic review and narrative analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:327-389. [PMID: 33073443 PMCID: PMC7894289 DOI: 10.1111/jar.12809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 08/07/2020] [Accepted: 08/30/2020] [Indexed: 12/28/2022]
Abstract
Background Aggressive behaviour is prevalent in people with intellectual disabilities. To understand the aetiology, it is important to recognize factors associated with the behaviour. Method A systematic review was conducted and included studies published between January 2002 and April 2017 on the association of behavioural, psychiatric and psychosocial factors with aggressive behaviour in adults with intellectual disabilities. Results Thirty‐eight studies were included that presented associations with 11 behavioural, psychiatric and psychosocial factors. Conflicting evidence was found on the association of these factors with aggressive behaviour. Conclusions The aetiology of aggressive behaviour is specific for a certain person in a certain context and may be multifactorial. Additional research is required to identify contributing factors, to understand causal relationships and to increase knowledge on possible interaction effects of different factors.
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Affiliation(s)
- Natalie van den Akker
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Marieke Kroezen
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Jannelien Wieland
- Cordaan, Center for Excellence on Mental Health and Mild Intellectual Disability, Amsterdam, The Netherlands
| | - Annelieke Pasma
- Department of Rheumatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - Ria Wolkorte
- Intellectual Disability Medicine, Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
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6
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Hsieh K, Scott HM, Murthy S. Associated Risk Factors for Depression and Anxiety in Adults With Intellectual and Developmental Disabilities: Five-Year Follow Up. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:49-63. [PMID: 31877262 PMCID: PMC7959169 DOI: 10.1352/1944-7558-125.1.49] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A better understanding of the factors associated with depression and anxiety in people with intellectual and developmental disabilities (IDD) is needed to provide guidelines for service providers, clinicians, and researchers as well as to improve the diagnostic process. The current study used a longitudinal dataset to explore demographic, health, and psychosocial risk factors of anxiety and depression in adults with IDD. Women were more likely to have depression while older adults, people with autism, and people with hearing impairments, were more likely to have anxiety. Chronic health conditions were associated with both anxiety and depression, while changes in stressful life events were associated with an increased risk of anxiety. Clinical and research contributions are discussed.
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Affiliation(s)
- Kelly Hsieh
- Kelly Hsieh, Haleigh M. Scott, and Sumithra Murthy, University of Illinois at Chicago
| | - Haleigh M Scott
- Kelly Hsieh, Haleigh M. Scott, and Sumithra Murthy, University of Illinois at Chicago
| | - Sumithra Murthy
- Kelly Hsieh, Haleigh M. Scott, and Sumithra Murthy, University of Illinois at Chicago
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7
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Rittmannsberger D, Kocman A, Weber G, Lueger‐Schuster B. Trauma exposure and post‐traumatic stress disorder in people with intellectual disabilities: A Delphi expert rating. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:558-567. [DOI: 10.1111/jar.12549] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 10/11/2018] [Accepted: 10/11/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Doris Rittmannsberger
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology University of Vienna Vienna Austria
| | - Andreas Kocman
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology University of Vienna Vienna Austria
| | - Germain Weber
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology University of Vienna Vienna Austria
| | - Brigitte Lueger‐Schuster
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology University of Vienna Vienna Austria
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8
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Nevill RE, Benson BA. Risk factors for challenging behaviour and psychopathology in adults with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:941-951. [PMID: 30125044 DOI: 10.1111/jir.12541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 05/22/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND This study explored the role of demographic, psychosocial, stress and life event-related risk factors for psychopathology and challenging behaviour in a clinical sample of adults with Down syndrome. METHOD A convenience sample of adults with Down syndrome seen through a specialised clinic was assessed through interviews and questionnaires specifically designed for use in people with intellectual disabilities. RESULTS Recent negative life events and stressors were significantly correlated with mental and behavioural health, and significantly predicted irritability, lethargy and depressed mood. Social avoidance was predicted by stress related to anticipation and social-environmental stressors, and negatively predicted by verbal ability. Ritual-related stress predicted obsessive-compulsive behaviour. Participants who did not have a job or vocational placement were significantly more depressed than participants who did. CONCLUSIONS Adults with Down syndrome should be provided increased supports for coping with negative life events and stressors. Interventions should also emphasise community engagement, such as employment, and access to psychosocial supports that teach coping and self-regulation skills when faced with stressors and negative life events.
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Affiliation(s)
- R E Nevill
- Department of Psychology and Nisonger Center, UCEDD, The Ohio State University, Columbus, OH, USA
| | - B A Benson
- Department of Psychology and Nisonger Center, UCEDD, The Ohio State University, Columbus, OH, USA
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9
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Mason-Roberts S, Bradley A, Karatzias T, Brown M, Paterson D, Walley R, Truesdale M, Taggart L, Sirisena C. Multiple traumatisation and subsequent psychopathology in people with intellectual disabilities and DSM-5 PTSD: a preliminary study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:730-736. [PMID: 29856097 DOI: 10.1111/jir.12505] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 03/18/2018] [Accepted: 05/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Individuals with intellectual disability (ID) are at greater risk of exposure to traumatic life events compared with the non-ID population. Yet no study to date has examined the role of multiple traumatisation and subsequent psychopathology in people with ID. The aim of this study was to explore the association between multiple traumatisation and subsequent mental health. METHODS A preliminary cross-sectional study involving 33 participants with DSM-5 post-traumatic stress disorder completed self-report questionnaires on exposure to traumatic life events and post-traumatic stress disorder symptoms, anxiety, depression and general distress. RESULTS A proportion of 42.4% of the sample reported multiple traumatisation, including exposure to life events in both childhood and adulthood. Those who reported exposure to life events in childhood and adulthood reported significantly higher risk of harm, depression and general psychological distress compared with those who reported exposure to life events only in adulthood. CONCLUSIONS Preliminary results indicate that more severe psychopathology is associated with multiple traumatisation in childhood and adulthood compared with trauma experienced solely in adulthood.
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Affiliation(s)
- S Mason-Roberts
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - A Bradley
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - T Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - M Brown
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - D Paterson
- Learning Disability Service, NHS Ayrshire & Arran, Crosshouse, UK
| | - R Walley
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - M Truesdale
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - L Taggart
- Institute of Nursing and Health Research, Ulster University, Jordanstown, Newtownabbey, UK
| | - C Sirisena
- Learning Disability Service, NHS Borders, Newstead, UK
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10
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de Kuijper GM, Hoekstra PJ. An Open-Label Discontinuation Trial of Long-Term, Off-Label Antipsychotic Medication in People With Intellectual Disability: Determinants of Success and Failure. J Clin Pharmacol 2018; 58:1418-1426. [PMID: 29920689 DOI: 10.1002/jcph.1271] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/15/2018] [Indexed: 11/08/2022]
Abstract
Although physicians are aware of the risks of prescribing long-term off-label antipsychotics in people with intellectual disability, attempts to discontinue often fail. This study aimed to identify potential determinants of successful and failed discontinuation. Long-term off-label antipsychotics were tapered in 14 weeks, with 12.5% of baseline dose every 2 weeks. Participants living in facilities offered by intellectual disability service providers, ≥6 years, with an IQ <70 were eligible to discontinue antipsychotic use, as judged by their physicians. The primary outcome was achievement of complete discontinuation at 16 weeks; changes in the Aberrant Behavior Checklist (ABC) and its 5 subscales were secondary outcomes. Potential determinants of the success or failure in discontinuing antipsychotics were psychotropic drug use and participants' living circumstances, medical health conditions, and severity of behavioral symptoms and neurologic side effects. Of 499 eligible clients, 129 were recruited. Reasons for client non-participation were clinician concerns that discontinuation might increase challenging behaviors and changes in clients' environment. Of the 129 participants, 61% had completely discontinued antipsychotics at 16 weeks, 46% at 28 weeks, and 40% at 40 weeks. ABC total scores increased in 49% of participants with unsuccessful discontinuation at 16 weeks. Autism, higher dose of antipsychotic drug, higher ABC and akathisia scores, and more-frequent worsening of health during discontinuation were associated with a lower incidence of complete discontinuation. Thus, in a selected sample of participants whom responsible clinicians had deemed discontinuation of antipsychotics could be attempted, 40% had achieved and maintained discontinuation at end of follow-up. Physicians should try to address patients' conditions that may hamper discontinuation.
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Affiliation(s)
- Gerda M de Kuijper
- Centre for Intellectual Disabilities and Mental Health/GGZ Drenthe Mental Health Institute, the Netherlands.,University of Groningen, University Medical Centre Groningen, University of Groningen, Department of Psychiatry, the Netherlands
| | - Pieter J Hoekstra
- University of Groningen, University Medical Centre Groningen, University of Groningen, Department of Psychiatry, the Netherlands
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11
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Hove O, Assmus J, Braatveit K, Havik OE. Inter-rater reliability of professional-caregiver-reported life events in adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:697-706. [PMID: 28612474 DOI: 10.1111/jir.12386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 02/17/2017] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The inter-rater reliability (IRR) of the measure of life events in adults with intellectual disabilities was investigated. METHOD Two staff members for each of 79 adults with intellectual disabilities (ID) living in group homes used a checklist to report the adults' exposure to and intensity of life events over the previous 12 months. The IRR was estimated with intraclass correlation analysis (ICC). The factors of the level of ID, number of years the rater knew the rated person and quality of community care were investigated for possible associations with level of reliability. RESULTS The ICC values for the occurrence of life events were .44-.80 depending on the category of life events. In general, intensity measures showed lower ICC values. When the rater had known the person rated for 2 or more years or the quality of community care was high, the ICC values increased, whereas lower levels of ID were associated with lower ICC values. CONCLUSIONS Inter-rater reliability in general was found to be acceptable. Further development and research are needed to improve the reliability of life event measures for more severe ID.
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Affiliation(s)
- O Hove
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - J Assmus
- Center for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - K Braatveit
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - O E Havik
- Department of Clinical Psychology, Universitetet i Bergen, Bergen, Norway
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12
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Medina Gómez B, Gil Ibáñez R. Estrés y estrategias de afrontamiento en personas con discapacidad intelectual: revisión sistemática. ANSIEDAD Y ESTRÉS 2017. [DOI: 10.1016/j.anyes.2017.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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Hove O, Assmus J, Havik OE. Type and Intensity of Negative Life Events Are Associated With Depression in Adults With Intellectual Disabilities. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2016; 121:419-431. [PMID: 27611352 DOI: 10.1352/1944-7558-121.5.419] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study investigated the associations between types and intensity of life events and symptoms of depression among adults with intellectual disabilities. A community sample (N = 593) was screened for current depression and exposure to life events (i.e., loss, illness, change, and bullying) during the previous 12 months. Symptoms of depression were measured using the Psychopathology Checklists for Adults With Intellectual Disabilities. Exposure to three of the four types of life events studied (loss, illness, and bullying) and the intensity of the events were associated with depression, particularly in the cases of loss of relatives and bullying. Quality of care moderated the association between bullying and depression and may buffer the adverse consequences of bullying.
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Affiliation(s)
- Oddbjørn Hove
- Oddbjørn Hove, Department of Research and Innovation, Helse Fonna HF, and Department of Clinical Psychology, University of Bergen, Norway; Jörg Assmus, Center for Clinical Research, Haukeland University Hospital, Norway; and Odd E. Havik, Department of Clinical Psychology, University of Bergen, Norway
| | - Jörg Assmus
- Oddbjørn Hove, Department of Research and Innovation, Helse Fonna HF, and Department of Clinical Psychology, University of Bergen, Norway; Jörg Assmus, Center for Clinical Research, Haukeland University Hospital, Norway; and Odd E. Havik, Department of Clinical Psychology, University of Bergen, Norway
| | - Odd E Havik
- Oddbjørn Hove, Department of Research and Innovation, Helse Fonna HF, and Department of Clinical Psychology, University of Bergen, Norway; Jörg Assmus, Center for Clinical Research, Haukeland University Hospital, Norway; and Odd E. Havik, Department of Clinical Psychology, University of Bergen, Norway
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14
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Stancliffe RJ, Bigby C, Balandin S, Wilson NJ, Craig D. Transition to retirement and participation in mainstream community groups using active mentoring: a feasibility and outcomes evaluation with a matched comparison group. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:703-718. [PMID: 25496307 DOI: 10.1111/jir.12174] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND This paper reports on the feasibility and outcomes of a transition to retirement programme for older adults with disability. Without activities and social inclusion, retirees with disability are likely to face inactivity, isolation and loneliness. METHODS Matched intervention and comparison groups each consisted of 29 older individuals with disability. There were 42 men and 16 women with a mean age of 55.6 years While attending their individual mainstream community group 1 day per week, intervention group participants received support from community group members trained as mentors. We assessed participants' loneliness, social satisfaction, depression, life events, quality of life, community participation, social contacts, and work hours before and 6 months after joining a community group. RESULTS Twenty-five (86%) of the intervention group attended their community group weekly for at least 6 months. They increased their community participation, made an average of four new social contacts and decreased their work hours. Intervention participants were more socially satisfied post-intervention than comparison group members. CONCLUSIONS The results demonstrate that participation in mainstream community groups with support from trained mentors is a viable option for developing a retirement lifestyle for older individuals with disability.
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Affiliation(s)
- R J Stancliffe
- Centre for Disability Research and Policy, University of Sydney, Lidcombe, New South Wales, Australia
| | - C Bigby
- School of Social Work and Social Policy, La Trobe University, Bundoora, Victoria, Australia
| | - S Balandin
- School of Health & Social Development, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - N J Wilson
- School of Nursing and Midwifery, University of Western Sydney, Richmond, New South Wales, Australia
| | - D Craig
- School of Social Work and Social Policy, La Trobe University, Bundoora, Victoria, Australia
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15
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Arévalo SP, Tucker KL, Falcón LM. Beyond cultural factors to understand immigrant mental health: Neighborhood ethnic density and the moderating role of pre-migration and post-migration factors. Soc Sci Med 2015; 138:91-100. [PMID: 26057720 DOI: 10.1016/j.socscimed.2015.05.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Pre-migration and post-migration factors may influence the health of immigrants. Using a cross-national framework that considers the effects of the sending and receiving social contexts, we examined the extent to which pre-migration and post-migration factors, including individual and neighborhood level factors, influence depressive symptoms at a 2-year follow-up time point. Data come from the Boston Puerto Rican Health Study, a population-based prospective cohort of Puerto Ricans between the ages of 45 and 75 y. The association of neighborhood ethnic density with depressive symptomatology at follow-up was significantly modified by sex and level of language acculturation. Men, but not women, experienced protective effects of ethnic density. The interaction of neighborhood ethnic density with language acculturation had a non-linear effect on depressive symptomatology, with lowest depressive symptomatology in the second highest quartile of language acculturation, relative to the lowest and top two quartiles among residents of high ethnic density neighborhoods. Results from this study highlight the complexity, and interplay, of a number of factors that influence the health of immigrants, and emphasize the significance of moving beyond cultural variables to better understand why the health of some immigrant groups deteriorates at faster rates overtime.
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Affiliation(s)
- Sandra P Arévalo
- College of Health Sciences, Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, 3 Solomont Way, Suite 4, Weed Hall, Lowell, MA 01854, USA.
| | - Katherine L Tucker
- College of Health Sciences, Clinical Laboratory and Nutritional Sciences, University of Massachusetts at Lowell, 3 Solomont Way, Suite 4, Weed Hall, Lowell, MA 01854, USA
| | - Luis M Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts at Lowell, 150 Wilder St., Lowell, MA 01854, USA
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Belva BC, Matson JL. Examining the psychometrics of the Psychopathology Inventory for Mentally Retarded Adults-II for individuals with mild and moderate intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:291-302. [PMID: 25462489 DOI: 10.1016/j.ridd.2014.10.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 10/05/2014] [Accepted: 10/13/2014] [Indexed: 06/04/2023]
Abstract
With growing recognition of the occurrence of psychological disorders in individuals with intellectual disability (ID), researchers and clinicians alike have placed emphasis on developing measures to assess for psychopathologies in this population. Despite an increased interest in the topic, there is still a dearth of psychometrically robust measures available to assess for psychopathology in adults with mild and moderate ID. The purpose of this study was to examine the psychometric properties of a revised measure for psychopathology in individuals with mild and moderate ID, the Psychopathology Inventory for Mentally Retarded Adults - second edition (PIMRA-II). Internal consistency, inter-rater reliability, and test-retest reliability were investigated. Validity was studied via convergent validity by comparing the PIMRA-II to the Assessment of Dual Diagnosis (ADD) and via discriminate validity by comparing the PIMRA-II to the Social Performance Survey Schedule (SPSS) prosocial scores. Lastly, an exploratory factor analysis was conducted to determine the factor structure of the scale.
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Affiliation(s)
- Brian C Belva
- Louisiana State University, 2124 Cheshire Bridge Road NE, Atlanta, GA 30324, United States.
| | - Johnny L Matson
- Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, United States.
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Wigham S, Taylor JL, Hatton C. A prospective study of the relationship between adverse life events and trauma in adults with mild to moderate intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:1131-1140. [PMID: 24372838 DOI: 10.1111/jir.12107] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/15/2013] [Indexed: 06/03/2023]
Abstract
BACKGROUND Research has demonstrated a relationship between the experience of life events and psychopathology in people with intellectual disabilities (ID), however few studies have established causal links and to date no prospective studies have utilised a measure of trauma that has been developed specifically for this population group. METHOD This 6-month prospective study examined longitudinal relationships between adverse life events and trauma in 99 adults with mild to moderate ID. RESULTS Life events during the previous 6 months were significantly predictive of levels of trauma as measured by the self-report Lancaster and Northgate trauma scales (LANTS), and the informant LANTS behavioural changes, frequency and severity sub-scales. This prospective causal relationship was demonstrated while controlling for any prior life events or pre-existing trauma, though the relationship was not moderated by social support. CONCLUSIONS Evidence of a causal relationship between adverse life events and trauma symptoms is important for treatment planning and funding allocation.
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Affiliation(s)
- S Wigham
- Institute of Health and Society, Sir James Spence Institute, Newcastle University, Newcastle, UK
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18
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Scott HM, Havercamp SM. Mental health for people with intellectual disability: the impact of stress and social support. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 119:552-64. [PMID: 25354124 DOI: 10.1352/1944-7558-119.6.552] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A large, nationally representative sample from a preexisting dataset, the National Core Indicators, was used to examine the impact of stress and social support on the mental health of adults with intellectual disability (ID). Stress was significantly correlated with both mental illness and severity of behavior problems, with each additional stressor increasing the odds of poor mental health by 20%. This relationship held, even after controlling for level of ID, gender, and place of residence. Lack of social support was associated with having a mental illness; individuals who lacked social support were twice as likely to have a mental illness. The importance of considering these factors in the prevention, diagnosis, and treatment of mental health in this population is discussed.
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19
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Benen Demchick B, Goldrich Eskow K, Crabtree LA. Autism and Transitioning Youth: A Pilot Study of Sensory Processing and Family Quality of Life. JOURNAL OF OCCUPATIONAL THERAPY SCHOOLS AND EARLY INTERVENTION 2014. [DOI: 10.1080/19411243.2014.898492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Jacola LM, Hickey F, Howe SR, Esbensen A, Shear PK. Behavior and adaptive functioning in adolescents with Down syndrome: specifying targets for intervention. JOURNAL OF MENTAL HEALTH RESEARCH IN INTELLECTUAL DISABILITIES 2014; 7:287-305. [PMID: 28539987 PMCID: PMC5440084 DOI: 10.1080/19315864.2014.920941] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Research suggests that adolescents with Down syndrome experience increased behavior problems as compared to age matched peers; however, few studies have examined how these problems relate to adaptive functioning. The primary aim of this study was to characterize behavior in a sample of adolescents with Down syndrome using two widely-used caregiver reports: the Behavioral Assessment System for Children, 2nd Edition (BASC-2) and Child Behavioral Checklist (CBCL). The clinical utility of the BASC-2 as a measure of behavior and adaptive functioning in adolescents with Down syndrome was also examined. METHODS Fifty-two adolescents with Down syndrome between the ages of 12 and 18 (24 males) completed the Peabody Picture Vocabulary Test, 4th Edition (PPVT-IV) as an estimate of cognitive ability. Caregivers completed the BASC-2 and the CBCL for each participant. RESULTS A significant proportion of the sample was reported to demonstrate behavior problems, particularly related to attention and social participation. The profile of adaptive function was variable, with caregivers most frequently rating impairment in skills related to activities of daily living and functional communication. Caregiver ratings did not differ by gender and were not related to age or estimated cognitive ability. Caregiver ratings of attention problems on the BASC-2 accounted for a significant proportion of variance in Activities of Daily Living (Adj R2 = 0.30), Leadership (Adj R2 = 0.30) Functional Communication (Adj R2 = 0.28, Adaptability (Adj R2 = 0.29), and Social Skills (Adj R2 = 0.17). Higher frequencies of symptoms related to social withdrawal added incremental predictive validity for Functional Communication, Leadership, and Social Skills. Convergent validity between the CBCL and BASC-2 was poor when compared with expectations based on the normative sample. CONCLUSION Our results confirm and extend previous findings by describing relationships between specific behavior problems and targeted areas of adaptive function. Findings are novel in that they provide information about the clinical utility of the BASC-2 as a measure of behavior and adaptive skills in adolescents with Down syndrome. The improved specification of behavior and adaptive functioning will facilitate the design of targeted intervention, thus improving functional outcomes and overall quality of life for individuals with Down syndrome and their families.
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Affiliation(s)
- Lisa M. Jacola
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Steven R. Howe
- Department of Psychology, University of Cincinnati, Cincinnati Ohio
| | - Anna Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Paula K. Shear
- Department of Psychology, University of Cincinnati, Cincinnati Ohio
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21
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Hulbert-Williams L, Hastings R, Owen DM, Burns L, Day J, Mulligan J, Noone SJ. Exposure to life events as a risk factor for psychological problems in adults with intellectual disabilities: a longitudinal design. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:48-60. [PMID: 23627774 DOI: 10.1111/jir.12050] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/04/2013] [Indexed: 05/07/2023]
Abstract
BACKGROUND Several cross-sectional studies have shown an association between exposure to life events and psychological problems in adults with intellectual disability (ID). To establish life events as a risk factor, prospective designs are needed. METHODS Support staff informants provided data on the psychological problems of 68 adults with ID and their recent exposure to life events. Using data collected on the same sample 3.5 to 4 years earlier, prospective analysis of the relationships between life events exposure and psychological problems over time was explored. RESULTS Hierarchical linear regression analyses demonstrated a contribution of life events to the prediction of later psychological problems after controlling for earlier psychological problems. Exploratory analyses showed that the relationship between life events and psychological problems might be unidirectional, and non-spurious; remaining present once the impact of other correlates of psychological problems was controlled. CONCLUSIONS These data offer support for the status of life events (with a negative valence) as a risk factor for psychological problems in adults with ID. To establish life events as a causal risk factor, research is needed to examine the mechanisms via which life events have their impact on psychological well-being.
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Affiliation(s)
- L Hulbert-Williams
- School of Applied Sciences, University of Wolverhampton, Wolverhampton, UK
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22
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Wheeler A, Raspa M, Bann C, Bishop E, Hessl D, Sacco P, Bailey DB. Anxiety, attention problems, hyperactivity, and the Aberrant Behavior Checklist in fragile X syndrome. Am J Med Genet A 2013; 164A:141-55. [PMID: 24352914 DOI: 10.1002/ajmg.a.36232] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 07/28/2013] [Indexed: 11/07/2022]
Abstract
Behavior problems are a common challenge for individuals with fragile X syndrome (FXS) and constitute the primary clinical outcome domain in trials testing new FXS medications. However, little is known about the relationship between caregiver-reported behavior problems and co-occurring conditions such as anxiety and attention problems. In this study, 350 caregivers, each with at least one son or daughter with full-mutation FXS, rated one of their children with FXS using the Aberrant Behavior Checklist-Community Version (ABC-C); the Anxiety subscale of the Anxiety, Depression, and Mood Scale; and the Attention/Hyperactivity Items from the Symptom Inventories. In addition to examining family consequences of these behaviors, this study also sought to replicate psychometric findings for the ABC-C in FXS, to provide greater confidence for its use in clinical trials with this population. Psychometric properties and baseline ratings of problem behavior were consistent with other recent studies, further establishing the profile of problem behavior in FXS. Cross-sectional analyses suggest that selected dimensions of problem behavior, anxiety, and hyperactivity are age related; thus, age should serve as an important control in any studies of problem behavior in FXS. Measures of anxiety, attention, and hyperactivity were highly associated with behavior problems, suggesting that these factors at least coincide with problem behavior. However, these problems generally did not add substantially to variance in caregiver burden predicted by elevated behavior problems. The results provide further evidence of the incidence of problem behaviors and co-occurring conditions in FXS and the impact of these behaviors on the family.
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Affiliation(s)
- Anne Wheeler
- Carolina Institute for Developmental Disabilities, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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23
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Rojahn J, Rowe EW, Kasdan S, Moore L, van Ingen DJ. Psychometric properties of the Aberrant Behavior Checklist, the Anxiety, Depression and Mood Scale, the Assessment of Dual Diagnosis and the Social Performance Survey Schedule in adults with intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:2309-2320. [PMID: 21889296 DOI: 10.1016/j.ridd.2011.07.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 07/20/2011] [Indexed: 05/31/2023]
Abstract
Progress in clinical research and in empirically supported interventions in the area of psychopathology in intellectual disabilities (ID) depends on high-quality assessment instruments. To this end, psychometric properties of four instruments were examined: the Aberrant Behavior Checklist (ABC), the Assessment of Dual Diagnosis (ADD), the Anxiety, Depression and Mood Scale (ADAMS), and the Social Performance Survey Schedule (SPSS). Data were collected in two community-based groups of adults with mild to profound ID (n = 263). Subscale reliability (internal consistency) ranged from fair to excellent for the ABC, the ADAMS, and the SPSS (mean coefficient α across ABC subscales was .87 (ranging from fair to excellent), the ADAMS subscales .83 (ranging from fair to good), and the SPSS subscales .91 (range from good to excellent). The ADD subscales had generally lower reliability scores with a mean of .59 (ranging from unacceptable to good). Convergent and discriminant validity was determined by bivariate Spearman ρ correlations between subscales of one instrument and the subscales of the other three instruments. For the most part, all four instruments showed solid convergent and discriminant validity. To examine the factorial validity, Confirmatory Factor Analyses (CFA) were attempted with the inter-item covariance matrix of each instrument. Generally, the data did not show good fits with the measurement models for the SPSS, ABC, or the ADAMS (CFA analyses with the ADD would not converge). However, most of the items on these three instruments had significant loadings on their respective factors.
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Affiliation(s)
- Johannes Rojahn
- Department of Psychology, George Mason University, 10340 Democracy Lane, Fairfax, VA 22033, United States.
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24
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Lunsky Y, Elserafi J. Life events and emergency department visits in response to crisis in individuals with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2011; 55:714-718. [PMID: 21492291 DOI: 10.1111/j.1365-2788.2011.01417.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Stressful life events have been linked to psychopathology in the general population, but few studies have considered the relationship between life events and psychopathology for people with intellectual disabilities (ID), and the link between particular life events and hospital use. METHODS Informants provided data on 746 adults with ID who had experienced at least one 'crisis'. Informants completed a checklist of recent life events from the Psychiatric Assessment for Adults with Developmental Disabilities Checklist (PAS ADD checklist) and also indicated whether the crisis resulted in a visit to the hospital emergency department. RESULTS Individuals experiencing life events in the past year were more likely to visit the emergency department in response to crisis than those who did not experience any life events. Individuals experiencing a move of house or residence, serious problem with family, friend or caregiver, problems with police or other authority, unemployed for more than 1 month, recent trauma/abuse, or a drug or alcohol problem were more likely to visit the emergency department. CONCLUSIONS Six specific life events were found to be associated with use of emergency departments in response to crisis. We suggest intervention efforts be targeted towards people who experience life events, particularly these events, as they may be a risk factor for hospital visits.
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Affiliation(s)
- Y Lunsky
- Dual Diagnosis Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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25
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Eskow K, Pineles L, Summers JA. Exploring the Effect of Autism Waiver Services on Family Outcomes. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1741-1130.2011.00284.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hulbert-Williams L, Hastings RP, Crowe R, Pemberton J. Self-Reported Life Events, Social Support and Psychological Problems in Adults with Intellectual Disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2011. [DOI: 10.1111/j.1468-3148.2011.00624.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taggart L, McMillan R, Lawson A. Staffs' knowledge and perceptions of working with women with intellectual disabilities and mental health problems. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2010; 54:90-100. [PMID: 19719516 DOI: 10.1111/j.1365-2788.2009.01211.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIM There is a growing evidence of the physical and mental health inequalities in people with intellectual disability (ID) although less has been written concerning the mental health of women with ID (International Association for the Scientific Study of Intellectual Disabilities). This is compared with the substantive literature published within mainstream psychiatry on gender. The aim of this study was to explore a range of health and social care staffs' knowledge and perceptions of caring for women with ID who have mental health problems focusing upon risk and resilient/protective factors. METHOD A qualitative methodology was used. Eight focus groups were conducted with hospital, community and residential staff across one region of the UK. The focus groups were audiotaped and the transcriptions were subjected to a thematic content analysis using Newell & Burnard's framework. FINDINGS Six inter-related risk factors were identified by the participants as potential causes for the women with ID to develop a mental illness and these were: having an ID and being female, unmet expectations, dysfunctional family upbringing, unstable relationships/loss of children, domestic violence and negative life experiences. Few of the participants acknowledged hormonal issues as a risk factor. Resilient/protective factors included being proactive, greater community participation, early recognition and mental health maintenance. CONCLUSION These results are discussed in light of current developments and policy within mainstream psychiatric gender approaches. Greater recognition of a proactive health approach for both staff and women with an ID is recommended.
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Affiliation(s)
- L Taggart
- Institute of Nursing Research, University of Ulster, Northern Ireland.
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28
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Stinton C, Elison S, Howlin P. Mental health problems in adults with Williams syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2010; 115:3-18. [PMID: 20025356 DOI: 10.1352/1944-7558-115.1.3] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Accepted: 06/23/2009] [Indexed: 05/28/2023]
Abstract
Although many researchers have investigated emotional and behavioral difficulties in individuals with Williams syndrome, few have used standardized diagnostic assessments. We examined mental health problems in 92 adults with Williams syndrome using the Psychiatric Assessment Schedule for Adults with Developmental Disabilities-PAS-ADD (Moss, Goldberg, et al., 1996). Factors potentially associated with mental health problems were also explored. The PAS-ADD identified mental health problems in 24% of the sample. The most common were anxiety (16.5%) and specific phobias (12%). Other diagnoses included depression, agoraphobia, and social phobia. No association was found between the presence of mental health problems and either individual (e.g., age, IQ, language level) or external (life events) variables.
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Affiliation(s)
- Chris Stinton
- University of Warwick, Warwick Medical School, Coventry, UK.
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A Comparison of Two Family Quality of Life Measures: An Australian Study. ENHANCING THE QUALITY OF LIFE OF PEOPLE WITH INTELLECTUAL DISABILITIES 2010. [DOI: 10.1007/978-90-481-9650-0_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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30
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Mevissen L, de Jongh A. PTSD and its treatment in people with intellectual disabilities: a review of the literature. Clin Psychol Rev 2009; 30:308-16. [PMID: 20056303 DOI: 10.1016/j.cpr.2009.12.005] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Revised: 12/03/2009] [Accepted: 12/08/2009] [Indexed: 11/16/2022]
Abstract
Although there is evidence to suggest that people with intellectual disabilities (ID) are likely to suffer from Post-Traumatic Stress Disorder (PTSD), reviews of the evidence base, and the potential consequences of this contention are absent. The purpose of this article is to present a comprehensive account of the literature on prevalence, assessment, and treatment of PTSD in people with ID. Some support was found for the notion that people with ID have a predisposition to the development of PTSD. Differences in comparison with the general population may consist of the expression of symptoms, and the interpretation of distressing experiences, as the manifestation of possible PTSD seems to vary with the level of ID. Since reliable and valid instruments for assessing PTSD in this population are completely lacking, there are no prevalence data on PTSD among people with ID. Nine articles involve treatment of PTSD in people with ID. Interventions reported involve those aimed to establish environmental change, the use of medication and psychological treatments (i.e., cognitive behavioral therapy, EMDR and psychodynamic based treatments). Case reports suggest positive treatment effects for various treatment methods. Development of diagnostic instruments for assessment of PTSD symptomatology in this population is required, as it could facilitate further research on its prevalence and treatment.
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Affiliation(s)
- L Mevissen
- Accare, Centre for Child and Adolescent Psychiatry, Drenthe, The Netherlands.
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31
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Taggart L, McMillan R, Lawson A. Listening to women with intellectual disabilities and mental health problems: a focus on risk and resilient factors. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2009; 13:321-340. [PMID: 20048351 DOI: 10.1177/1744629509353239] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Women without intellectual disabilities are more likely to develop mental health problems as a result of physiological functioning and psychosocial risk factors. However, little is known about the mental health of women with intellectual disabilities. The aim of this study was to explore a small group of women's perceptions of the risk and protective factors pertaining to their mental health conditions. Twelve semi-structured interviews were conducted in 2007 in Northern Ireland. Thematic content analysis identified three risk factors and four protective/resilient factors. None of the women identified physiological functioning as a risk factor. Results suggest that women with intellectual disabilities experience psychosocial risk factors similar to those reported by women without intellectual disability. Additional risk factors place them at higher risk of developing mental health problems. However, more research is required.
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Affiliation(s)
- L Taggart
- University of Ulster, Coleraine, Antrim BT52 1SA, Northern Ireland.
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32
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Biswas AB, Furniss FG. Life events and mental illness in people with learning disabilities. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.mppsy.2009.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Martorell A, Tsakanikos E, Pereda A, Gutiérrez-Recacha P, Bouras N, Ayuso-Mateos JL. Mental health in adults with mild and moderate intellectual disabilities: the role of recent life events and traumatic experiences across the life span. J Nerv Ment Dis 2009; 197:182-6. [PMID: 19282685 DOI: 10.1097/nmd.0b013e3181923c8c] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of the present study is to investigate the association between recent life events and traumatic experiences across the life span and psychiatric disorders in people with ID. One hundred seventy-seven individuals with mild and moderate intellectual disability and their principal carers were assessed. Psychiatric disorders were evaluated with a semistructured psychiatric interview, the Psychiatric Assessment for Adults with Developmental Disabilities. This interview also includes a checklist of life events experienced over the previous 12 months, which was assessed through key informants. Presence of traumas was assessed through Allen's trauma history screen, also administered to key informants. After a descriptive analysis, binary logistic regression was used to see whether traumatic events and life events predicted the presence of ICD-10 disorders. A 75% of the participants had experienced at least 1 traumatic event during their life span, and 50% of the participants had experienced at least 1 life event in the 12 months previous to the study. Binary logistic regression showed that exposure to 1 or more traumatic experiences significantly increased the odds of a mental disorder (OR = 1.8), as did exposure to life events (OR = 1.4). However, when both life events and traumatic experiences were entered together in the model, calculation of odds ratios revealed that traumatic experiences significantly increased the odds of ICD-10 disorders (OR = 1.7) although life events were no longer significant. Though they have been less studied by the literature regarding predictors of mental illness in people with intellectual disability, traumatic experiences seem to play a more important role in psychopathology than life events.
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Affiliation(s)
- Almudena Martorell
- Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, CIBER-SAM, Madrid, Spain.
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Allen D. The relationship between challenging behaviour and mental ill-health in people with intellectual disabilities: a review of current theories and evidence. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2008; 12:267-294. [PMID: 19074934 DOI: 10.1177/1744629508100494] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Challenging behaviours and problems of mental ill-health are common amongst people with intellectual disabilities. The article examines conceptual similarities and differences between these conditions, examines the data on comorbidity, and explores possible hypothetical relationships between behavioural and psychiatric disorder in this population. While there is little evidence at present to suggest that many of the challenging behaviours seen in people with intellectual disabilities are underpinned by problems of mental ill-health, only qualified conclusions are possible because of limitations in the quality and scope of existing research. A conceptual model for looking at the risk variables that may contribute to both conditions is suggested, and requirements for future research and current multi-disciplinary practice are outlined.
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Affiliation(s)
- David Allen
- Abertawe Bro Morgannwg University NHS Trust & Cardiff University, Wales, UK.
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35
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Hulbert-Williams L, Hastings RP. Life events as a risk factor for psychological problems in individuals with intellectual disabilities: a critical review. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:883-895. [PMID: 18671807 DOI: 10.1111/j.1365-2788.2008.01110.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Stressful life events such as bereavement, moving house and changing jobs have repeatedly been implicated as risk factors for mental and physical ill health. Since the 1940s, researchers have demonstrated the negative effects of stressful life events, refined methods of recording such events and investigated the relative impact of different types of event. These investigations have generally not extended to include people with intellectual disabilities. METHODS We conducted a narrative review of research on life events as they occur to people with intellectual disabilities and critically assessed the evidence that life events function as a risk factor for psychological problems. Evidence was reviewed for an association between life events and a range of outcome variables, including affective disorders, challenging behaviour, psychosis and psychological problems more generally. We also critiqued the methodology behind the current evidence base and discussed a number of methodological advances that would help to strengthen it. CONCLUSIONS There is reasonable evidence that life events are associated with psychological problems, and that there is some tentative evidence that life events play a causal role, although to date, no relationship with psychosis in people with intellectual disabilities has been demonstrated. Life events are likely to be pertinent in clinical work with people with intellectual disabilities.
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Affiliation(s)
- L Hulbert-Williams
- School of Applied Sciences, University of Wolverhampton, Wolverhampton, UK.
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36
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Prevalence of, and factors associated with, problem behaviors in adults with intellectual disabilities. J Nerv Ment Dis 2008; 196:678-86. [PMID: 18791429 DOI: 10.1097/nmd.0b013e318183f85c] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study aimed to determine the prevalence of problem behaviors in adults with intellectual disabilities and to investigate which factors are independently associated with problem behaviors. A population-based cohort (n = 1023) had comprehensive individual assessments. Data were examined using multivariate logistic regression. The prevalence of problem behaviors was 22.5% (psychiatrists' opinion) or 18.7% (DC-LD criteria). Factors independently associated with problem behaviors were lower ability level, female gender, living in a congregate care setting or with paid carer support (rather than living with a family carer), having urinary incontinence; visual impairment, not having Down syndrome, and not having severe physical disabilities. Further studies focusing on the etiology, course, and treatment of problem behaviors are required.
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Abstract
PURPOSE OF REVIEW The aim of this article is to present and critically evaluate recent research on life events and traumatic experiences as predictors of psychopathology in people with intellectual disability. RECENT FINDINGS The area has not developed significantly in the last years. Although life events have been associated with a range of mental health problems, only few studies have tried to clarify their role in psychopathology. It is often the case that differences between life events and traumatic experiences have been overlooked, mainly because establishing a clear cut-off point between the two types of events is not always possible. In addition, traumatic experiences per se, and as potential predictors of psychopathology, have been scarcely investigated in people with intellectual disability. SUMMARY The role of recent life events and traumatic experiences across the life-span of people with intellectual disability deserves more research. An outstanding question is whether these events are risk factors or triggering factors, as well as how to differentiate between traumatic and life events. Identifying possible protective factors for mental health seems to be a very promising line for future research with important clinical implications.
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Abstract
PURPOSE OF REVIEW To critically review recent publications on the relationship between challenging behaviour and psychiatric disorder in people with intellectual disabilities. RECENT FINDINGS Although a number of recent studies have highlighted possible similarities in the aetiology of challenging behaviour and psychiatric disorder, these findings need to be viewed with caution as they do not constitute evidence that the two phenomena are equivalent. While research into their possible interrelationship has produced equivocal findings, there are a number of theoretical perspectives that have been tested to some degree by empirical studies. Intervention studies that attempt to explore these perspectives are rare, however, and there is some evidence that people with complex mental health and behavioural needs are receiving far from optimal treatment. SUMMARY The relationship between challenging behaviour and psychiatric disorder has yet to be adequately explored in the research literature. While both undoubtedly coexist in some people with intellectual disability, available research suggests that it is unlikely that disturbances in psychiatric functioning will underpin the majority of challenging behaviours. Evidence to link specific patterns of behaviour with particular disorders also remains elusive. Recommendations for future research are discussed.
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Affiliation(s)
- David Allen
- Bro Morgannwg NHS Trust & University of Glamorgan Special Projects Team, Cardiff, UK.
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Abstract
PURPOSE OF REVIEW To summarize recent research on psychosocial interventions for people with intellectual disabilities and mental ill-health. RECENT FINDINGS Psychosocial interventions for people with intellectual disabilities and mental ill-health are poorly developed. Recent research has focused upon individual therapeutic interventions and the evaluation of structures for the delivery of services to people with intellectual disabilities and mental ill-health. There is little research that has examined psychosocial interventions with carers or families, and the impact of housing, leisure and employment for this group of people. SUMMARY As people with intellectual disabilities are increasingly recognized as having severe and enduring mental ill-health, the development of an evidence base for psychosocial intervention is of considerable importance.
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Affiliation(s)
- Dave Dagnan
- Cumbria Partnership NHS Trust, Distington, UK.
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