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Ali A, McKenzie E, Hassiotis A, Priebe S, Lloyd‐Evans B, Jones R, Panca M, Omar R, Finning S, Moore S, Roe C, King M. A pilot randomised controlled trial of befriending by volunteers in people with intellectual disability and depressive symptoms. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:1010-1019. [PMID: 34570405 PMCID: PMC9291894 DOI: 10.1111/jir.12886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/13/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND People with intellectual disability (ID) are more likely to experience chronic depression compared with the general population, which may be compounded by loneliness and lower levels of social support. Befriending aims to provide social support and promote engagement in community activities. No randomised controlled trials have examined whether befriending improves symptoms of depression and social outcomes in people with ID. The aim of this pilot trial was to assess the feasibility and acceptability of a future larger trial of one-to-one befriending by volunteers in people with ID and depressive symptoms. METHODS Participants were adults with mild or moderate ID with a score of 5 or more on the Glasgow Depression Scale for People with Learning Disabilities (GDS-LD). They were randomised to the intervention arm (matched to a volunteer befriender for 6 months) or the control arm (usual care). Volunteers received training and supervision provided by two community befriending schemes. The main outcomes were feasibility of recruitment (minimum target n = 35), retention rate of participants, adherence (minimum 10 meetings), acceptability of the intervention, changes in depressive symptoms (assessed at baseline and 6 months) and feasibility of collecting data for a health economic analysis. RESULTS Recruitment was challenging, and only 16 participants with ID and 10 volunteers were recruited. Six participants were matched with a volunteer and no participants dropped out (except for two volunteers). Four participants completed 10 meetings (mean 11.8). Befriending was thought to be acceptable, but modifications were suggested. An exploratory analysis suggested that GDS-LD score was lower in the intervention group compared with the control group after adjusting for baseline scores, but not significant (adjusted mean difference: -4.0; 95% confidence interval: -11.2 to 3.2). CONCLUSIONS A large trial would not be feasible based on the recruitment strategies employed in this study. A further feasibility study addressing these challenges or the use of other study designs should be considered.
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Affiliation(s)
- A. Ali
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - E. McKenzie
- Research and Development OfficeGoodmayes Hospital, North East London NHS Foundation TrustLondonUK
| | - A. Hassiotis
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - S. Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services DevelopmentQueen Mary University of LondonLondonUK
| | - B. Lloyd‐Evans
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
| | - R. Jones
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - M. Panca
- Priment Clinical Trials UnitUniversity College LondonLondonUK
| | - R. Omar
- Department of Statistical ScienceUniversity College LondonLondonUK
| | - S. Finning
- Outward HousingOutward, Newlon HouseLondonUK
| | - S. Moore
- The Befriending SchemeSudburySuffolkUK
| | - C. Roe
- The Befriending SchemeSudburySuffolkUK
| | - M. King
- Epidemiology and Applied Clinical Research Department, Division of PsychiatryUniversity College LondonLondonUK
- Priment Clinical Trials UnitUniversity College LondonLondonUK
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Ali A, Mckenzie E, Rasoul Z, Hassiotis A, Priebe S, Lloyd-Evans B, Jones R, Panca M, Omar R, Finning S, Moore S, Roe C, King M. One-to-one volunteer befriending to reduce symptoms of depression in people with intellectual disability: a feasibility RCT. PUBLIC HEALTH RESEARCH 2021. [DOI: 10.3310/phr09100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Little is known about the effectiveness of befriending for people with intellectual disability and whether or not befriending improves depressive symptoms and social outcomes.
Objective
This pilot trial aimed to assess the feasibility and acceptability of conducting a future full-scale randomised controlled trial of one-to-one befriending for people with intellectual disability who had depressive symptoms.
Design
This was a parallel-group, two-armed randomised controlled trial incorporating an exploratory economic analysis and a mixed-methods process evaluation. Outcome assessments were conducted at baseline and at 6 months post randomisation by a research assistant who was blind to allocation. We aimed to approach 50 participants, with a view to recruiting 40.
Setting
Participants with intellectual disability were recruited from one NHS trust and from referrals to two community befriending services. The intervention was delivered by community befriending services.
Participants
Adults with mild or moderate intellectual disability with a score on the Glasgow Depression Scale for people with a Learning Disability of ≥ 5 were included. Those attending a day service/college for ≥ 3 days a week were excluded. Volunteers were aged ≥ 18 years and had no history of prior convictions.
Intervention
Participants in the intervention group were matched with a volunteer befriender and were expected to meet once per week for 1 hour, over 6 months. Volunteers recorded activities in a logbook. Volunteers received training and regular supervision. Both groups received usual care and a resource booklet of local activities.
Main outcome measures
The feasibility outcomes and progression criteria were recruitment of at least 70% of participants approached; matching of at least 70% of participants in the intervention group to a volunteer; a dropout rate of < 30% of participants and volunteers; adherence to the intervention (10 meetings between pairs); acceptability of the intervention; and feasibility of collecting data on costs and resource use for an economic evaluation. Changes in depressive symptoms (primary clinical outcome: Glasgow Depression Scale) and self-esteem, quality of life, social participation, social support, health-related quality of life and service use were recorded at 6 months. Outcomes in volunteers were also assessed.
Results
We recruited only 16 participants with intellectual disability (40% of target) and 10 volunteers. Six of the eight (75%) participants in the intervention group were matched with a befriender and there was good adherence (mean number of meetings attended 11.8; range 1–21 meetings). Going to a cafe/restaurant and having a conversation were the most frequent activities. All participants were retained at follow-up, but two volunteers dropped out. Trial procedures and the intervention might be acceptable, but modifications were suggested. Data on costs and resource use were obtained, but there were discrepancies in the health-related quality-of-life data.
Limitations
Delays to the study prevented the use of alternative recruitment strategies and the planned 12-month follow-up could not be completed.
Conclusions
Recruitment was not feasible, but other feasibility outcomes were more positive.
Future work
Evaluating befriending for people with intellectual disability could be explored through alternative study designs, such as observational studies.
Trial registration
Current Controlled Trials ISRCTN63779614.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 10. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Afia Ali
- Division of Psychiatry, University College London, London, UK
| | - Emma Mckenzie
- Research and Development Office, Goodmayes Hospital, North East London NHS Foundation Trust, London, UK
| | - Zara Rasoul
- Division of Psychiatry, University College London, London, UK
| | | | - Stefan Priebe
- Unit for Social and Community Psychiatry (World Health Organization Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, UK
| | | | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
| | - Monica Panca
- Priment Clinical Trials Unit, University College London, London, UK
| | - Rumana Omar
- UK Department of Statistical Science, University College London, London, UK
| | | | | | | | - Michael King
- Division of Psychiatry, University College London, London, UK
- Priment Clinical Trials Unit, University College London, London, UK
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Ali A, Mckenzie E, Hassiotis A, Priebe S, Lloyd-Evans B, Omar R, Jones R, Panca M, Fernandez V, Finning S, Moore S, O'Connor D, Roe C, King M. One-to-one befriending for people with intellectual disability and symptoms of depression: protocol for a pilot randomised controlled trial. BMJ Open 2020; 10:e033989. [PMID: 32565450 PMCID: PMC7311030 DOI: 10.1136/bmjopen-2019-033989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION People with intellectual disability (ID) are more likely to experience loneliness and have smaller social networks, which increases vulnerability to depression. Befriending may reduce depressive symptoms in other populations, but randomised controlled trials (RCTs) have not been carried out in this population. This pilot study aims to assess the acceptability and feasibility of carrying out a full RCT of one-to-one befriending by volunteers for people with ID, compared with an active control group. METHODS AND ANALYSIS The trial aims to recruit 40 participants with ID. Participants in the intervention arm will receive weekly visits from a volunteer over 6 months. Community befriending schemes will recruit, train, supervise volunteers and match them to individuals with ID. Both groups will receive a booklet about local activities and have access to usual care. Health and social outcomes will be measured at the end of the intervention and 6 months' follow-up. The following outcomes will be assessed: (1) recruitment and retention of individuals with ID and volunteers in the trial, (2) adverse events related to the intervention, (3) the acceptability of the intervention, (4) whether the intervention is delivered as intended, (5) changes in health and social outcomes and (6) the feasibility of carrying out a cost-effectiveness analysis in a full trial. Qualitative data from participants, volunteers, staff and carers will identify barriers and facilitators of a future full trial. ETHICS AND DISSEMINATION The study has been approved by the London City and East Research Ethics Committee (reference 18/LO/2188). The findings will be presented at conferences and published in a peer-reviewed journal and in the National Institute of Health Research journals library. A public engagement seminar will be held at the end of the study aimed at key stakeholders. TRIAL REGISTRATION NUMBER ISRCTN63779614.
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Affiliation(s)
- Afia Ali
- Division of Psychiatry, University College London, London, UK
| | - Emma Mckenzie
- Research and Development, North East London NHS Foundation Trust Goodmayes Hospital, Ilford, Essex, UK
| | | | - Stefan Priebe
- Unit of Social and Community Psychiatry, Barts and the London School of Medicine and Dentistry, University of London, London, UK
| | | | - Rumana Omar
- Department of Statistical Science, University College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
| | - Monica Panca
- Primary Care and Population Health, University College London, London, UK
| | | | - Sally Finning
- Hackney Volunteer and Befriending Scheme, Outward, London, UK
| | | | | | | | - Michael King
- Division of Psychiatry, University College London, London, UK
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Potvin LA, Barnett BM, Brown HK, Cobigo V. "I Didn't Need People's Negative Thoughts": Women With Intellectual and Developmental Disabilities Reporting Attitudes Toward Their Pregnancy. Can J Nurs Res 2019; 51:154-167. [PMID: 30602298 DOI: 10.1177/0844562118819924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Since the illegalization of involuntary sterilization of persons with intellectual and developmental disabilities, there has been an increase in childbearing in this population. However, women with intellectual and developmental disabilities continue to experience prejudicial attitudes toward their pregnancies. Objective To analyze the experiences of women with intellectual and developmental disabilities regarding their perceptions of support persons’ attitudes toward their pregnancies. Methods Three case studies derived from grounded theory research exploring perinatal social support received by women with intellectual and developmental disabilities. Using inductive content analysis, we further analyzed the perceptions of women with intellectual and developmental disabilities regarding support persons’ attitudes toward their pregnancies. Findings: The nature of interactions with support persons and women’s characteristics, such as help-seeking behaviors, disability, mental illness, and age, influenced support persons’ attitudes toward childbearing. Women preferred support from caregivers perceived as nonjudgmental and tended to restrict contact with persons perceived as prejudicial. However, some attitudes improved following positive interactions with the women. The relationship between support persons’ attitudes and the women’s help-seeking behaviors is thus complex. Conclusions Education of families and medical and social services practitioners and opportunities for positive contact should be further explored. Caseworkers of women with intellectual and developmental disabilities may have invaluable roles in facilitating positive interactions between women with intellectual and developmental disabilities and caregivers.
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Affiliation(s)
| | | | - Hilary K Brown
- 2 Women's College Research Institute, Women's College Hospital, Toronto, Canada.,3 Interdisciplinary Centre for Health and Society, University of Toronto Scarborough, Canada
| | - Virginie Cobigo
- 1 School of Psychology, University of Ottawa, Canada.,4 Centre for Research on Educational and Community Services, University of Ottawa, Canada.,5 Children's Hospital of Eastern Ontario Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Canada
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Giesbers SAH, Tournier T, Hendriks L, Hastings RP, Jahoda A, Embregts PJCM. Measuring emotional support in family networks: Adapting the Family Network Method for individuals with a mild intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:94-105. [PMID: 30004149 PMCID: PMC7379605 DOI: 10.1111/jar.12512] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 11/29/2022]
Abstract
Background Informal supportive networks of individuals with intellectual disability have become increasingly important. The aim of this paper is to describe how the Family Network Method – Intellectual Disability (FNM‐ID) offers a way to gather the perspective of people with mild intellectual disability on their family support. Method The FNM is designed to explore how individuals define their family contexts, and more specifically how they perceive existing supportive relationships in these contexts. Results By carefully piloting ways of questioning people with mild intellectual disability, systematic adaptations were made to the original FNM. Data obtained by the FNM‐ID can be analysed using social network analysis. Thereby, the FNM‐ID provides rich, theoretically significant information on emotional support in the family networks of individuals with mild intellectual disability. Conclusions The FNM‐ID is a useful and successfully adapted tool for other researchers and professionals to systematically explore the family support experiences of individuals with mild intellectual disability.
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Affiliation(s)
- Sanne A H Giesbers
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,Dichterbij Innovation and Science, Gennep, The Netherlands
| | - Tess Tournier
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,ASVZ, Sliedrecht, The Netherlands
| | - Lex Hendriks
- Faculty of Social Sciences, School of Pedagogical and Educational Science, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK.,Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Andrew Jahoda
- Psychological Medicine, University of Glasgow, Glasgow, UK
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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6
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Promoting Wellness in People with Intellectual and Developmental Disabilities Through Relationships. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2018. [DOI: 10.1007/s40474-018-0144-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Scott HM, Havercamp SM. Comparisons of self and proxy report on health-related factors in people with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 31:927-936. [DOI: 10.1111/jar.12452] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2018] [Indexed: 11/28/2022]
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Potvin LA, Brown HK, Cobigo V. Social support received by women with intellectual and developmental disabilities during pregnancy and childbirth: An exploratory qualitative study. Midwifery 2016; 37:57-64. [PMID: 27217238 DOI: 10.1016/j.midw.2016.04.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/25/2016] [Accepted: 04/10/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE this study aims to contribute to the development of a conceptual framework that will inform maternity care improvements for expectant mothers with intellectual and developmental disabilities (IDD) by exploring the structure, functions, and perceived quality of social support received by women with IDD during pregnancy and childbirth. DESIGN/SETTING using a grounded theory approach, we conducted an exploratory study set in Ontario, Canada in 2015. PARTICIPANTS the sample included four adult women with IDD who had given birth in the last five years. MEASUREMENTS data were collected using semi-structured interviews. FINDINGS the structure of social support received by women with IDD consisted of both formal and informal sources, but few or no friendships. Women with IDD reported high levels of informational and instrumental support and low levels of emotional support and social companionship. However, a high level of available support was not always perceived as beneficial. Emergent core categories suggest that social support is perceived as most effective when three conditions are met: (1) support is accessible, (2) support is provided by individuals expressing positive attitudes towards the pregnancy, and (3) autonomy is valued. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE our study confirms and identifies important gaps in the social support received by expectant mothers with IDD. Women with IDD currently lack accessible informational support, emotional support, and social companionship during pregnancy and childbirth. Additional findings regarding the structure and functions of social support are presented, and a preliminary conceptual framework of effective social support during pregnancy and childbirth, as perceived by women with IDD is also proposed. Findings suggest that increasing support accessibility should be a social and clinical priority; however, maternity care providers should be aware of stigmatizing attitudes and respect the autonomy of pregnant women with IDD as they prepare for motherhood.
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Affiliation(s)
- Lynne A Potvin
- University of Ottawa, School of Psychology, 136 Jean Jacques Lussier (5078), Ottawa, Canada ON K1N 6N5.
| | - Hilary K Brown
- Women's College Research Institute, University of Toronto, Department of Psychiatry, 76 Grenville Street, Toronto, Canada ON M5S 1B2.
| | - Virginie Cobigo
- University of Ottawa, School of Psychology, 136 Jean Jacques Lussier (5083), Ottawa, Canada ON K1N 6N5.
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Crawford C, Burns J, Fernie BA. Psychosocial impact of involvement in the Special Olympics. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 45-46:93-102. [PMID: 26275609 DOI: 10.1016/j.ridd.2015.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 05/13/2015] [Accepted: 07/13/2015] [Indexed: 06/04/2023]
Abstract
Existing evidence suggests that people with intellectual disabilities are vulnerable to low self-esteem leading to additional psychosocial issues such as social exclusion and stress. Previous research into the involvement of Special Olympics (SO) of people with intellectual disabilities has indicted positive psychosocial outcomes. Involvement in sport is known generally to have psychological and social benefits. This study aimed to compare the psychosocial impact of involvement in sport through the SO to no or limited sports involvement, for a sample of people with intellectual disabilities. A cross sectional design was employed comparing three groups, SO, Mencap Sports, and Mencap No Sports on the variables: Self-esteem, quality of life, stress levels and social networks. One hundred and one participants were recruited either through the SO or Mencap. Data were collected through the completion of validated questionnaires by one to one interviews with the participants. Analysis revealed that self-esteem, quality of life, and stress were all significantly associated with SO involvement. Logistic regression analysis was used to explore whether scores on these variables were able to predict group membership. Self-esteem was found to be a significant predictor of group membership, those in the SO having the highest self-esteem. The findings provide further evidence of a positive association between sport involvement and increased psychological wellbeing, especially for those involved in the SO. The implications of these findings for practice and future research into the relationship between sport and psychological wellbeing within the learning disabled population are considered.
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Affiliation(s)
- Clare Crawford
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, Salomons Campus at Tunbridge Wells, Broomhill Road, Southborough, Tunbridge Wells, Kent TN3 0TF, UK
| | - Jan Burns
- Salomons Centre for Applied Psychology, Canterbury Christ Church University, Salomons Campus at Tunbridge Wells, Broomhill Road, Southborough, Tunbridge Wells, Kent TN3 0TF, UK.
| | - Bruce A Fernie
- King's College London, Institute of Psychiatry, Department of Psychology, London, UK; CASCAID, South London & Maudsley NHS Foundation Trust, London, UK
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van Asselt-Goverts AE, Embregts PJCM, Hendriks AHC. Social networks of people with mild intellectual disabilities: characteristics, satisfaction, wishes and quality of life. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:450-461. [PMID: 25040897 DOI: 10.1111/jir.12143] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/04/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND A supportive social network is crucial for facilitating social inclusion, which can, in turn, contribute to the quality of life (QOL) for people with intellectual disabilities (ID). In this study, we investigate how people with mild ID perceive their social networks and which network characteristics relate to satisfaction with the network and perceived QOL. METHOD Data were gathered from 33 young adults with a mild to borderline ID using structured questionnaires: the MSNA to map the social network, the IDQOL-16 to assess QOL, and a questionnaire to determine satisfaction and wishes with regard to the social network. RESULTS The majority of the participants (73.1%) were satisfied with their social networks. Improvement in the area of strengthening existing ties (e.g. more frequent contact, better contact) was desired as opposed to expansion of the network. Affection--especially towards family and professionals--was most strongly related to perceived QOL. It appears to be essential that relatives live in the same town, can frequently meet up and provide both emotional and practical support. CONCLUSIONS The significance of family and the importance of high-quality interpersonal relationships between professional and client in the lives of young adults with ID cannot be overestimated. Although measures of satisfaction and wishes can have limitations, in actual practice it is considered useful to assess the opinions of clients with respect to their social networks. Interventions can then be tailored to the needs and wishes of the persons themselves.
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Affiliation(s)
- A E van Asselt-Goverts
- Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands; Tranzo, Tilburg University, Tilburg, The Netherlands
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The subjective well-being of individuals diagnosed with comorbid intellectual disability and attention deficit hyperactivity disorders. Qual Life Res 2015; 24:1875-86. [PMID: 25676860 DOI: 10.1007/s11136-015-0936-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE The present study's aim was to empirically explore subjective well-being (SWB) and its correlates among adults diagnosed with comorbid intellectual disability (ID) and attention deficit hyperactivity disorder (ADHD). This exploration was guided by the Theory of SWB Homeostasis as a conceptual framework for examining determinants and processes underlying the SWB of this understudied population. METHOD A total of 246 adults receiving residential support completed questionnaires measuring their SWB, ADHD symptomatology, functional limitations, and individual internal (self-determination) and external (financial resources, and social support) resources. RESULTS The participants' SWB was found to be within the normative range. ADHD symptomatology directly predicted reductions in SWB; however, according to the theory, this effect was fully mediated by the individual's internal and external resources. CONCLUSIONS The main findings support the applicability of the SWB Homeostasis theory for understanding the SWB of individuals with comorbid ID and ADHD. The study findings shed light on the psychosocial determinants of SWB and highlight the importance of psychosocial resources as buffers of the effect of health and environmental conditions.
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12
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van Asselt-Goverts AE, Embregts PJCM, Hendriks AHC. Structural and functional characteristics of the social networks of people with mild intellectual disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1280-1288. [PMID: 23417133 DOI: 10.1016/j.ridd.2013.01.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 01/18/2013] [Accepted: 01/18/2013] [Indexed: 06/01/2023]
Abstract
In the research on people with intellectual disabilities and their social networks, the functional characteristics of their networks have been examined less often than the structural characteristics. Research on the structural characteristics of their networks is also usually restricted to the size and composition of the networks, moreover, with little attention to such characteristics as the variety, accessibility, length and origin of the relationships or the frequency and initiation of the contacts. A comprehensive examination of both the structural and functional characteristics of the social networks of 33 people with intellectual disabilities was therefore undertaken. The social networks of the individuals who all lived in the community varied from 4 to 28 members (mean 14.21); 42.65% of the network members were family members, 32.84% acquaintances and 24.51% professionals. Remarkable is the high frequency of contact with network members; the finding that the participants considered themselves to be the main initiator of contact more often than the other members of their networks as the main initiators; the high scores assigned to neighbours and professionals for functional characteristics; and the relatively low scores assigned to network members for the connection characteristic of the social networks. The important role of professionals in the social networks of people with mild intellectual disabilities and practical implications to facilitate their social inclusion are discussed.
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Affiliation(s)
- A E van Asselt-Goverts
- HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, The Netherlands.
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13
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Peterson JJ, Andrew Peterson N, Lowe JB, Nothwehr FK. Promoting Leisure Physical Activity Participation among Adults with Intellectual Disabilities: Validation of Self-Efficacy and Social Support Scales. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2009. [DOI: 10.1111/j.1468-3148.2009.00500.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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14
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Lippold T, Burns J. Social support and intellectual disabilities: a comparison between social networks of adults with intellectual disability and those with physical disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2009; 53:463-473. [PMID: 19302469 DOI: 10.1111/j.1365-2788.2009.01170.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Social support has been identified as a major protective factor in preventing mental health problems and also as a major contributor to quality of life. People with intellectual disabilities (ID) have been identified as having limited social support structures. Interventions have been focused on promoting their social presence and integration. However, previous studies have shown that this does not always lead to the formation of social relationships. To date few studies have looked at how having an ID leads to impoverished social networks. This study aimed to do this by contrasting the social relationships of people with physical disabilities (PD) and people with ID. METHODS Two groups of participants were recruited; 30 people with mild ID and 17 people with PD. Social and functional support networks were assessed, in addition to life experiences. Between and within group differences were then explored statistically. RESULTS Adults with ID had more restricted social networks than PD, despite being involved in more activities. Social support for adults with ID was mainly provided by family and carers and few relationships with non-disabled people were identified. In contrast adults with PD had larger social networks than had been reported in the mainstream literature and had a balance of relationships with disabled and non-disabled people. CONCLUSIONS The results suggest that there are additional processes attached to having an ID, which lead to continued impoverished lifestyles. The findings also endorse other work that suggests being physically integrated and engaged in a wide range of activities does not guarantee good social and emotional support.
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Affiliation(s)
- T Lippold
- Surrey and Borders Partnership NHS Foundation Trust, Greenlaws, Guildford, Surrey, UK
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Peterson JJ, Lowe JB, Peterson NA, Nothwehr FK, Janz KF, Lobas JG. Paths to leisure physical activity among adults with intellectual disabilities: self-efficacy and social support. Am J Health Promot 2008; 23:35-42. [PMID: 18785373 DOI: 10.4278/ajhp.07061153] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study tested a path model that included perceptions of social support and self-efficacy for leisure physical activity and leisure physical activity participation among adults with intellectual disabilities. DESIGN A cross-sectional design was used. Data was collected via oral interview. SETTING Community-based group, supported-living settings in one Midwestern state. SAMPLE A total of 152 adults with mild to moderate intellectual disabilities, which provided a 39% response rate. MEASURES Self-efficacy and social support (from family, residential staff and peers with disabilities) for leisure physical activity were assessed using self-reported scales. Leisure physical activity participation was measured with a self-reported checklist of the frequency of leisure physical activity participation. ANALYSIS Path analysis was conducted for the entire sample and was repeated for younger and older age groups. RESULTS The hypothesized model fit the data from each group. Social support and self-efficacy predicted physical activity participation, and self-efficacy served as a mediator between social support and physical activity. Significant sources of social support differed between groups; among younger participants, social support from family predicted physical activity, whereas, for the older group, social support from staff and peers predicted physical activity. CONCLUSION Self-efficacy and social support for leisure physical activity are related to leisure physical activity participation among adults with intellectual disabilities who are receiving supported-living services. The results provide information to guide health promotion programs for this group.
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Affiliation(s)
- Jana J Peterson
- Oregon Health and Science University, Child Development and Rehabilitation Center, 3181 Sam Jackson Park Road, Portland, OR 97239, USA.
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Diagnosis and treatment of mood disorders in adults with developmental disabilities. Psychiatr Q 2008; 79:171-92. [PMID: 18726158 DOI: 10.1007/s11126-008-9079-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2008] [Accepted: 08/04/2008] [Indexed: 10/21/2022]
Abstract
While the idea that individuals with developmental disabilities (DD) can suffer from mental illness has been largely accepted since the late 1980's, this is still an underserved and poorly studied population. In particular, mood disorders have traditionally been misdiagnosed, under-recognized and poorly treated. Through the years, reported rates of mood disorders in adults with DD have varied widely. Recent epidemiological studies have focused on community samples and find rates of mood disorders from 3 to 8.1%. Mood disorders are found to be more prevalent than psychotic disorders or anxiety disorders. The empirical literature on assessment of mood symptoms in adults with DD is limited, particularly in individuals with severe and profound DD. Several tools have been developed to assist in identification and diagnosis. However, the work on their psychometric properties and validity studies is still quite limited. The treatment literature is sparse and focused primarily on pharmacotherapy. This review considers the epidemiology and diagnosis of mood disorders in individuals with DD. Recent developments in assessment are reviewed. The literature regarding pharmacological treatment with antidepressants, mood stabilizers, electroconvulsive therapy and antipsychotics is summarized and the current state of psychological treatments for mood disorders in persons with DD is presented. Implications for clinical care and future research are considered.
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Hartley SL, MacLean WE. A review of the reliability and validity of Likert-type scales for people with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2006; 50:813-27. [PMID: 16999781 DOI: 10.1111/j.1365-2788.2006.00844.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Likert-type scales are increasingly being used among people with intellectual disability (ID). These scales offer an efficient method for capturing a wide range of variance in self-reported attitudes and behaviours. This review is an attempt to evaluate the reliability and validity of Likert-type scales in people with ID. METHODS Fifty-one studies reporting response rates, response bias, reliability and validity of Likert-type scales among adolescents and adults with ID were reviewed. RESULTS Low response rates were found among adolescents and adults with moderate to profound ID, when pictorial representations of response alternatives were not employed, and for Likert-type scales with self-descriptive statements. Response bias was evident, particularly among adolescents and adults with moderate to profound ID. Likert-type scales have better reliability and validity among adolescents and adults with borderline IQ or mild ID. Pretests and clarifying questions increase reliability and validity. CONCLUSIONS Likert-type scales should include pictorial representations of response alternatives, a single set of one or two word response descriptors, clarifying questions, and pretests, and are best used with adolescents and adults with borderline IQ to mild ID.
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Affiliation(s)
- S L Hartley
- Department of Psychology, University of Wyoming, Laramie, Wyoming 82071, USA.
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18
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Individual Differences in Interpersonal Relationships for Persons with Mental Retardation. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0074-7750(05)31004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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19
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Lunsky Y. Suicidality in a clinical and community sample of adults with mental retardation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2004; 25:231-243. [PMID: 15134790 DOI: 10.1016/j.ridd.2003.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2002] [Revised: 03/08/2003] [Accepted: 06/07/2003] [Indexed: 05/24/2023]
Abstract
This paper will argue that suicidal ideation and suicidal gestures are evident in adults with mental retardation, including individuals not receiving mental health services currently, and that psychosocial correlates of suicidality are similar to those noted in the general population. Findings are based on structured interviews with 98 adults with mental retardation, with corroborative information from caregivers and clinical charts. One in three individuals reported that they think "life is not worth living" sometimes or a lot. Eleven percent of individuals reported previous suicide attempt(s). Twenty-three percent of informants were unaware of the current suicidal ideation that their family member/client was reporting. Individuals reporting suicidal ideation endorsed more loneliness, stress, anxiety and depression, along with less social support than other individuals, consistent with reports of suicidal individuals in the general population. Adults with mental retardation who report thinking that life is not worth living should be a target group for future suicide prevention efforts. More research is needed to better understand the risk factors and protective factors for suicidality in this population.
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Affiliation(s)
- Y Lunsky
- Centre for Addiction and Mental Health, University of Toronto, 1001 Queen Street West, Toronto, Ont., Canada M6J 1H4.
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20
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Lunsky Y. Depressive symptoms in intellectual disability: does gender play a role? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2003; 47:417-427. [PMID: 12919192 DOI: 10.1046/j.1365-2788.2003.00516.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Gender issues remain largely unaddressed in the dual diagnosis arena, even in the area of depression where there is a 2:1 female to male ratio in the general population. This paper argues that women with intellectual disability (ID) report higher levels of depressive symptoms than men with ID and that risk factors for depression identified for women in the general population are relevant to this group. METHOD Findings are based on structured interviews with 99 men and women with ID, with corroborative information provided from caregivers and casebook reviews. RESULTS Overall, women reported higher levels of depression than men. Individuals with higher depression scores were more lonely and had higher stress levels than individuals with lower scores. Women with higher depression scores were more likely to report coming from abusive situations, to have poor social support from family and to be unemployed when compared to women with lower scores, but similar differences were not found when comparing men with higher and lower depression scores. CONCLUSION Men and women who report experiencing these psychosocial correlates of depression should be a target group for future prevention efforts, taking gender specific concerns into consideration.
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Affiliation(s)
- Y Lunsky
- Department of Psychiatry, University of Toronto, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
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21
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Finlay WM, Lyons E. Methodological issues in interviewing and using self-report questionnaires with people with mental retardation. Psychol Assess 2001; 13:319-35. [PMID: 11556269 DOI: 10.1037/1040-3590.13.3.319] [Citation(s) in RCA: 222] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this article the authors review methodological issues that arise when interviews and self-report questionnaires are used with people with mental retardation and offer suggestions for overcoming some of the difficulties described. Examples are drawn from studies that use qualitative methodology, quantitative studies assessing different question types, and studies reporting on the development of instruments measuring psychiatric symptoms, self-concept, and quality of life. Specific problems that arise with respect to item content (e.g., quantitative judgments, generalizations), question phrasing (e.g., modifiers), response format (e.g., acquiescence, multiple-choice questions), and psychometric properties (factor structure and validity) are discussed. It is argued that because many self-report questionnaires include questions that have been found to be problematic in this population, more attention needs to be paid to establishing the validity of such measures and to clearly defining the population for which the instrument is designed.
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Affiliation(s)
- W M Finlay
- School of Human Sciences, Department of Psychology, University of Surrey, Guildford, GU2 5XH, England, United Kingdom
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22
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Lunsky Y, Benson BA. Association between perceived social support and strain, and positive and negative outcome for adults with mild intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2001; 45:106-14. [PMID: 11298249 DOI: 10.1046/j.1365-2788.2001.00334.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Social strain has been identified as a trigger for both depression and physical health problems, but has not been well researched in people with intellectual disability (ID). The present study contrasted the effects of social support with social strain on depressive symptoms, somatic complaints and quality of life over time in adults with mild ID. The level of social support explained a significant proportion of variance in quality of life 6 months later, but not depressive symptoms or somatic complaints. In contrast, the level of social strain accounted for a significant proportion of variance in depressive symptoms and somatic complaints 6 months later, but not quality of life. The results suggest that interpersonal relationships can be both positively and negatively associated with physical and mental health for people with ID.
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Affiliation(s)
- Y Lunsky
- Surrey Place Centre, University of Toronto, Toronto, Ontario, Canada.
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