Anxiety disorders in people with learning disabilities

People with learning disabilities are much more vulnerable to psychiatric illnesses, and will increasingly be accessing generic services. Treatment and management of psychiatric disorders is problematic, primarily because of difficulties in diagnosis, since classificatory systems are standardised on people with average intellectual functioning. This article provides an overview of the clinical implications of anxiety disorders within the context of learning disability.

Assessing Validity of Measurement in Learning Disabilities Using Hierarchical Generalized Linear Modeling: The Roles of Anxiety and Motivation

The purpose of the present studies was to test the hypothesis that the psychometric characteristics of ability scales may be significantly distorted if one accounts for emotional factors during test taking. Specifically, the present studies evaluate the effects of anxiety and motivation on the item difficulties of the Rasch model. In Study 1, the validity of a reading comprehension scale was evaluated using the Rasch model with 60 students with learning disabilities (LD). Item parameters were retested for the presence of anxiety and results indicated that the scale was substantially more difficult in its presence. Study 2 replicated the findings of Study 1 using maladaptive motivation and extended with inclusion of adaptive motivational variables in order to reverse the effect. Results using students with and without LD indicated that the difficulty levels of the scale was lower for students with LD, in the presence of positive motivation, compared with a typical student group. Study 3 extended the dichotomous hierarchical generalized linear model with polytomous data. The measures of an ability test were adjusted for the presence of anxiety and results indicated that differential item functioning was observed at both the global level and the most difficult ability item. It is concluded that the difficulty levels of a scale are heavily influenced by situational factors during testing, such as students' entry levels of motivation and affect.

Mindfulness-based cognitive therapy for adults with intellectual disabilities: an evaluation of the effectiveness of mindfulness in reducing symptoms of depression and anxiety

BACKGROUND

Mindfulness-based interventions have been shown to be effective in the treatment of a range of health and psychological disorders in adults and young people without intellectual disabilities (ID). Clinical studies are emerging reporting on the efficacy of mindfulness-based interventions as a stand-alone treatment for common clinical disorders in adults with ID.

METHOD

This paper aims to evaluate the efficacy of an innovative structured mindfulness-based cognitive therapy (MBCT) group programme adapted for adults with ID with a diagnosis of either recurrent depression, anxiety or both clinical conditions and a history of deliberate self-harm behaviour. Two groups ran consecutively consisting of a total of fifteen participants and seven carers. All participants were recorded as having either a borderline, mild, or moderate ID. The group programme ran over a period of 9 weeks with a follow-up session at 6 weeks post group intervention. Outcome measures included the Hospital Anxiety and Depression Scale and two sub-scales from the Self-Compassion Scale administered at baseline, post therapy and at 6-week follow-up.

RESULTS

The evaluation showed that participants reported an improvement in their experience of depression, anxiety, self-compassion and compassion for others. The most significant impact was in the reduced levels of anxiety reported. Improvements across all outcomes were maintained at 6-week follow-up.

CONCLUSION

The results of the evaluation suggest that people with intellectual disabilities benefit from a structured MBCT group intervention and the results are maintained at 6-week follow-up.