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Shelley L, Jones C, Pearson E, Richards C, Crawford H, Paricos A, Greenhill C, Woodhead A, Tarver J, Waite J. Measurement tools for behaviours that challenge and behavioural function in people with intellectual disability: A systematic review and meta-analysis of internal consistency, inter-rater reliability, and test-retest reliability. Clin Psychol Rev 2024; 110:102434. [PMID: 38718632 DOI: 10.1016/j.cpr.2024.102434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 03/15/2024] [Accepted: 04/12/2024] [Indexed: 05/25/2024]
Abstract
Behaviours that challenge (BtC) are common in people with intellectual disability (ID) and associated with negative long-term outcomes. Reliable characterisation of BtC and behavioural function is integral to person-centred interventions. This systematic review and meta-analytic study quantitatively synthesised the evidence-base for the internal consistency, inter-rater reliability, and test-retest reliability of measures of BtC and behavioural function in people with ID (PROSPERO: CRD42021239042). Web of Science, Embase, PsycINFO and MEDLINE were searched from inception to March 2024. Retrieved records (n = 3691) were screened independently to identify studies assessing eligible measurement properties in people with ID. Data extracted from 83 studies, across 29 measures, were synthesised in a series of random-effects meta-analyses. Subgroup analyses assessed the influence of methodological quality and study-level characteristics on pooled estimates. COSMIN criteria were used to evaluate the measurement properties of each measure. Pooled estimates ranged across measures: internal consistency (0.41-0.97), inter-rater reliability (0.29-0.93) and test-retest reliability (0.52-0.98). The quantity and quality of evidence varied substantially across measures; evidence was frequently unavailable or limited to a single study. Based on current evidence, candidate measures with the most evidence for internal consistency and reliability are discussed; however, continued assessment of measurement properties in ID populations is a key priority.
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Affiliation(s)
- Lauren Shelley
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Chris Jones
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Effie Pearson
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, UK; Cerebra Network for Neurodevelopmental Disorders, UK.
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, UK; Cerebra Network for Neurodevelopmental Disorders, UK.
| | - Arianna Paricos
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Courtney Greenhill
- School of Psychology, College of Health and Life Sciences, Aston University, UK
| | - Alixandra Woodhead
- School of Psychology, College of Health and Life Sciences, Aston University, UK
| | - Joanne Tarver
- School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Jane Waite
- School of Psychology, College of Health and Life Sciences, Aston University, UK; Cerebra Network for Neurodevelopmental Disorders, UK.
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2
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Lacombe D, Bloch-Zupan A, Bredrup C, Cooper EB, Houge SD, García-Miñaúr S, Kayserili H, Larizza L, Lopez Gonzalez V, Menke LA, Milani D, Saettini F, Stevens CA, Tooke L, Van der Zee JA, Van Genderen MM, Van-Gils J, Waite J, Adrien JL, Bartsch O, Bitoun P, Bouts AHM, Cueto-González AM, Dominguez-Garrido E, Duijkers FA, Fergelot P, Halstead E, Huisman SA, Meossi C, Mullins J, Nikkel SM, Oliver C, Prada E, Rei A, Riddle I, Rodriguez-Fonseca C, Rodríguez Pena R, Russell J, Saba A, Santos-Simarro F, Simpson BN, Smith DF, Stevens MF, Szakszon K, Taupiac E, Totaro N, Valenzuena Palafoll I, Van Der Kaay DCM, Van Wijk MP, Vyshka K, Wiley S, Hennekam RC. Diagnosis and management in Rubinstein-Taybi syndrome: first international consensus statement. J Med Genet 2024; 61:503-519. [PMID: 38471765 DOI: 10.1136/jmg-2023-109438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 02/15/2024] [Indexed: 03/14/2024]
Abstract
Rubinstein-Taybi syndrome (RTS) is an archetypical genetic syndrome that is characterised by intellectual disability, well-defined facial features, distal limb anomalies and atypical growth, among numerous other signs and symptoms. It is caused by variants in either of two genes (CREBBP, EP300) which encode for the proteins CBP and p300, which both have a function in transcription regulation and histone acetylation. As a group of international experts and national support groups dedicated to the syndrome, we realised that marked heterogeneity currently exists in clinical and molecular diagnostic approaches and care practices in various parts of the world. Here, we outline a series of recommendations that document the consensus of a group of international experts on clinical diagnostic criteria for types of RTS (RTS1: CREBBP; RTS2: EP300), molecular investigations, long-term management of various particular physical and behavioural issues and care planning. The recommendations as presented here will need to be evaluated for improvements to allow for continued optimisation of diagnostics and care.
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Affiliation(s)
- Didier Lacombe
- Department of Medical Genetics, University Hospital of Bordeaux, and INSERM U1211, University of Bordeaux, 33076 Bordeaux, France
| | - Agnès Bloch-Zupan
- Faculté de Chirurgie Dentaire, Université de Strasbourg, and Centre de référence des maladies rares orales et dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, and Institut de Génétique et de Biologie Moléculaire et Cellulaire, INSERM U1258, Illkirch, France
| | - Cecilie Bredrup
- Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Edward B Cooper
- Department of Anesthesiology, Cincinnati Children's Hospital, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Sofia Douzgou Houge
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway and Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sixto García-Miñaúr
- Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, Madrid, Spain
| | - Hülya Kayserili
- Department of Medical Genetics, Koc University School of Medicine (KUSOM), 34010 Istanbul, Turkey
| | - Lidia Larizza
- Laboratorio di Ricerca in Citogenetica medica e Genetica Molecolare, Centro di Ricerche e Tecnologie Biomediche IRCCS-Istituto Auxologico Italiano, Milano, Italy
| | - Vanesa Lopez Gonzalez
- Department of Pediatrics, Medical Genetics Section, Virgen de la Arrixaca University Hospital, IMIB, CIBERER, Murcia, Spain
| | - Leonie A Menke
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Donatella Milani
- Fondazione IRCCS, Ca'Granda Ospedale Maggiore, 20122 Milan, Italy
| | - Francesco Saettini
- Fondazione Matilde Tettamanti Menotti De Marchi Onlus, Fondazione Monza e Brianza per il Bambino e la sua Mamma, Monza, Italy
| | - Cathy A Stevens
- Department of Pediatrics, University of Tennessee College of Medicine, Chattanooga, Tennessee, USA
| | - Lloyd Tooke
- Department of Pediatrics, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Jill A Van der Zee
- Department of Pediatric Urology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Maria M Van Genderen
- Bartiméus Diagnostic Center for complex visual disorders, Zeist and Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Julien Van-Gils
- Department of Medical Genetics, University Hospital of Bordeaux, and INSERM U1211, University of Bordeaux, 33076 Bordeaux, France
| | - Jane Waite
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Jean-Louis Adrien
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, Boulogne Billancourt, France
| | - Oliver Bartsch
- MVZ - Humangenetik, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Pierre Bitoun
- Département de Genetique, SIDVA 91, Juvisy-sur-Orge, France
| | - Antonia H M Bouts
- Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anna M Cueto-González
- Department of Clinical and Molecular Genetics, University Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | - Floor A Duijkers
- Department of Human Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Patricia Fergelot
- Department of Medical Genetics, University Hospital of Bordeaux, and INSERM U1211, University of Bordeaux, 33076 Bordeaux, France
| | - Elizabeth Halstead
- Psychology and Human Development Department, University College London, London, UK
| | - Sylvia A Huisman
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Zodiak, Prinsenstichting, Purmerend, Netherlands
| | - Camilla Meossi
- Fondazione IRCCS, Ca'Granda Ospedale Maggiore, 20122 Milan, Italy
| | - Jo Mullins
- Rubinstein-Taybi Syndrome Support Group, Registered Charity, Rickmansworth, UK
| | - Sarah M Nikkel
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Elisabetta Prada
- Fondazione IRCCS, Ca'Granda Ospedale Maggiore, 20122 Milan, Italy
| | - Alessandra Rei
- Associazione Rubinstein-Taybi Syndrome-Una Vita Speciale, Organizzazione di Volontariato (ODV), Gornate Olona, Varese, Italy
| | - Ilka Riddle
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | | | | | - Janet Russell
- Associazione Rubinstein-Taybi Syndrome-Una Vita Speciale, Organizzazione di Volontariato (ODV), Gornate Olona, Varese, Italy
| | | | - Fernando Santos-Simarro
- Unit of Molecular Diagnostics and Clinical Genetics, Hospital Universitari Son Espases, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain
| | - Brittany N Simpson
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, Cincinnati School of Medicine, Cincinnati, Ohio, USA
| | - David F Smith
- Department of Pediatric Otolaryngology, Cincinnati Children's Hospital Medical Center, and Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Markus F Stevens
- Department of Anesthesiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Katalin Szakszon
- Institution of Pediatrics, University of Debrecen Clinical Centre, Debrecen, Hungary
| | - Emmanuelle Taupiac
- Department of Medical Genetics, University Hospital of Bordeaux, and INSERM U1211, University of Bordeaux, 33076 Bordeaux, France
| | - Nadia Totaro
- Associazione Rubinstein-Taybi Syndrome-Una Vita Speciale, Organizzazione di Volontariato (ODV), Gornate Olona, Varese, Italy
| | - Irene Valenzuena Palafoll
- Department of Clinical and Molecular Genetics, University Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Daniëlle C M Van Der Kaay
- Division of Paediatric Endocrinology, Department of Paediatrics, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Michiel P Van Wijk
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University Amsterdam, Amsterdam, Netherlands
| | - Klea Vyshka
- European Reference Network on Rare Congenital Malformations and Rare Intellectual Disability (ERN-ITHACA), Robert Debré University Hospital, Paris, France
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Raoul C Hennekam
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Hughes J, Roberts R, Tarver J, Warters-Louth C, Zhang B, Southward E, Shaw R, Edwards G, Waite J, Pearson E. 'It wasn't the strategies on their own': Exploring caregivers' experiences of accessing services in the development of interventions for autistic people with intellectual disability. Autism 2024; 28:1231-1244. [PMID: 37712611 PMCID: PMC11067391 DOI: 10.1177/13623613231196084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
LAY ABSTRACT Many autistic individuals with intellectual disability experience anxiety, and for those who use few or no words, anxiety may present as behaviour that challenges, such as self-injury and avoiding anxiety-provoking situations. Families report difficulty accessing support from services for autistic individuals experiencing anxiety. Moreover, once receiving support, effective interventions for autistic people with intellectual disability are limited. We completed individual and group discussions with 16 caregivers of autistic people with intellectual disability, to (a) explore their experiences of accessing services for anxiety and/or behaviour that challenges for their child; and (b) understand what matters to caregivers when developing interventions that have been designed for them and the autistic individual with intellectual disability that they support. Caregivers reported that services, in their experience, did not deliver the support that they expected, and that they often needed to 'fight' for support. Caregivers considered services and families working together, the inclusion of peer support, and families being offered interventions that are flexible to individual circumstances to be important. These considerations are valuable for clinicians and researchers developing interventions and aiming to improve outcomes for autistic people with intellectual disability and their families.
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Shelley L, Waite J, Tarver J, Oliver C, Crawford H, Richards C, Bissell S. Behaviours that Challenge in SATB2-associated Syndrome: Correlates of Self-injury, Aggression and Property Destruction. J Autism Dev Disord 2023:10.1007/s10803-023-06123-2. [PMID: 37751087 DOI: 10.1007/s10803-023-06123-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/27/2023]
Abstract
SATB2-associated syndrome (SAS) is a genetic syndrome characterised by intellectual disability, severe speech delay, and palatal and dental problems. Behaviours that challenge (BtC) are reported frequently; however, there is limited research on specific forms of BtC and the correlates of these behaviours. The current study explores correlates of well-defined BtC, self-injury, aggression, and property destruction, in SAS. Eighty-one parents/caregivers of individuals with SAS (53.1% male, Mage 10.12 years) completed questionnaire measures of health, behavioural, emotional, and autism characteristics. Individuals with SAS were grouped based on caregiver responses to the presence or absence of self-injury, aggression, and property destruction on the Challenging Behaviour Questionnaire. Rates of self-injury, aggression and property destruction were 42%, 77% and 49%, respectively. Between-group comparisons were conducted to compare characteristics between behaviour groups. Significantly differing characteristics were entered into separate hierarchical logistic regressions for each form of BtC. Behavioural comparisons indicated variation in the characteristics associated with each behaviour. All hierarchical logistic regression models were significant (p < .001): self-injury (χ2(5) = 38.46, R2 = 0.571), aggression (χ2(4) = 25.12, R2 = 0.414), property destruction (χ2(4) = 23.70, R2 = 0.346), explaining between 34.6% and 57.1% of the variance in behaviour presence. This is the first study to identify correlates of self-injury, aggression, and property destruction in SAS. Variability in the characteristics associated with each behaviour highlights the importance of specificity when examining BtC. Understanding correlates of specific forms of BtC has important implications for informing SAS-associated pathways to behavioural outcomes and the implementation of tailored behavioural interventions.
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Affiliation(s)
- Lauren Shelley
- College of Health and Life Sciences, Aston University, Birmingham, UK.
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK.
| | - Jane Waite
- College of Health and Life Sciences, Aston University, Birmingham, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
| | - Joanne Tarver
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
| | - Stacey Bissell
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
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Crawford H, Oliver C, Groves L, Bradley L, Smith K, Hogan A, Renshaw D, Waite J, Roberts J. Behavioural and physiological indicators of anxiety reflect shared and distinct profiles across individuals with neurogenetic syndromes. Psychiatry Res 2023; 326:115278. [PMID: 37285621 DOI: 10.1016/j.psychres.2023.115278] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/11/2023] [Accepted: 05/30/2023] [Indexed: 06/09/2023]
Abstract
Anxiety is heightened in individuals with intellectual disability, particularly in those with specific neurogenetic syndromes. Assessment of anxiety for these individuals is hampered by a lack of appropriate measures that cater for communication impairment, differences in presentation, and overlapping features with co-occurring conditions. Here, we adopt a multi-method approach to identify fine-grained behavioural and physiological (via salivary cortisol) responses to anxiety presses in people with fragile X (FXS; n = 27; Mage = 20.11 years; range 6.32 - 47.04 years) and Cornelia de Lange syndromes (CdLS; n = 27; Mage = 18.42 years; range 4.28 - 41.08 years), two neurogenetic groups at high risk for anxiety, compared to neurotypical children (NT; n = 21; Mage = 5.97 years; range 4.34 - 7.30 years). Results indicate that physical avoidance of feared stimuli and proximity seeking to a familiar adult are prominent behavioural indicators of anxiety/stress in FXS and CdLS. Heightened pervasive physiological arousal was identified in these groups via salivary cortisol. An association between autistic characteristics and anxiety was evident in the FXS group but not in the CdLS group pointing to syndrome-specific nuances in the association between anxiety and autism. This study furthers understanding of the behavioural and physiological presentation of anxiety in individuals with intellectual disability and progresses theoretical developments regarding the development and maintenance of anxiety at the intersection of autism.
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Affiliation(s)
- Hayley Crawford
- Warwick Medical School, University of Warwick, United Kingdom.
| | - Chris Oliver
- School of Psychology, University of Birmingham, United Kingdom
| | - Laura Groves
- School of Psychology, University of Birmingham, United Kingdom
| | - Louise Bradley
- Faculty of Humanities and Social Sciences, University of Portsmouth, United Kingdom
| | - Kayla Smith
- Warwick Medical School, University of Warwick, United Kingdom
| | - Abigail Hogan
- Department of Psychology, University of South Carolina, Columbia, United States
| | - Derek Renshaw
- Research Centre for Sport, Exercise and Life Sciences, Coventry University, United Kingdom
| | - Jane Waite
- School of Psychology, Aston University, United Kingdom
| | - Jane Roberts
- Department of Psychology, University of South Carolina, Columbia, United States
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Bozhilova N, Welham A, Adams D, Bissell S, Bruining H, Crawford H, Eden K, Nelson L, Oliver C, Powis L, Richards C, Waite J, Watson P, Rhys H, Wilde L, Woodcock K, Moss J. Profiles of autism characteristics in thirteen genetic syndromes: a machine learning approach. Mol Autism 2023; 14:3. [PMID: 36639821 PMCID: PMC9837969 DOI: 10.1186/s13229-022-00530-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/07/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Phenotypic studies have identified distinct patterns of autistic characteristics in genetic syndromes associated with intellectual disability (ID), leading to diagnostic uncertainty and compromised access to autism-related support. Previous research has tended to include small samples and diverse measures, which limits the generalisability of findings. In this study, we generated detailed profiles of autistic characteristics in a large sample of > 1500 individuals with rare genetic syndromes. METHODS Profiles of autistic characteristics based on the Social Communication Questionnaire (SCQ) scores were generated for thirteen genetic syndrome groups (Angelman n = 154, Cri du Chat n = 75, Cornelia de Lange n = 199, fragile X n = 297, Prader-Willi n = 278, Lowe n = 89, Smith-Magenis n = 54, Down n = 135, Sotos n = 40, Rubinstein-Taybi n = 102, 1p36 deletion n = 41, tuberous sclerosis complex n = 83 and Phelan-McDermid n = 35 syndromes). It was hypothesised that each syndrome group would evidence a degree of specificity in autistic characteristics. To test this hypothesis, a classification algorithm via support vector machine (SVM) learning was applied to scores from over 1500 individuals diagnosed with one of the thirteen genetic syndromes and autistic individuals who did not have a known genetic syndrome (ASD; n = 254). Self-help skills were included as an additional predictor. RESULTS Genetic syndromes were associated with different but overlapping autism-related profiles, indicated by the substantial accuracy of the entire, multiclass SVM model (55% correctly classified individuals). Syndrome groups such as Angelman, fragile X, Prader-Willi, Rubinstein-Taybi and Cornelia de Lange showed greater phenotypic specificity than groups such as Cri du Chat, Lowe, Smith-Magenis, tuberous sclerosis complex, Sotos and Phelan-McDermid. The inclusion of the ASD reference group and self-help skills did not change the model accuracy. LIMITATIONS The key limitations of our study include a cross-sectional design, reliance on a screening tool which focuses primarily on social communication skills and imbalanced sample size across syndrome groups. CONCLUSIONS These findings replicate and extend previous work, demonstrating syndrome-specific profiles of autistic characteristics in people with genetic syndromes compared to autistic individuals without a genetic syndrome. This work calls for greater precision of assessment of autistic characteristics in individuals with genetic syndromes associated with ID.
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Affiliation(s)
- Natali Bozhilova
- grid.5475.30000 0004 0407 4824School of Psychology, University of Surrey, Guilford, UK
| | - Alice Welham
- grid.9918.90000 0004 1936 8411School of Psychology, University of Leicester, Leicester, UK
| | - Dawn Adams
- grid.1022.10000 0004 0437 5432Autism Centre of Excellence, Griffith University, Brisbane, Australia
| | - Stacey Bissell
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Hilgo Bruining
- grid.7177.60000000084992262Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hayley Crawford
- grid.7372.10000 0000 8809 1613Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kate Eden
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Lisa Nelson
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Christopher Oliver
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Laurie Powis
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Caroline Richards
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Jane Waite
- grid.7273.10000 0004 0376 4727School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Peter Watson
- grid.5335.00000000121885934MRC Brain and Cognition Unit, University of Cambridge, Cambridge, UK
| | - Hefin Rhys
- grid.451388.30000 0004 1795 1830Francis Crick Institute, London, UK
| | - Lucy Wilde
- grid.10837.3d0000 0000 9606 9301School of Psychology, Open University, Milton Keynes, UK
| | - Kate Woodcock
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Joanna Moss
- grid.5475.30000 0004 0407 4824School of Psychology, University of Surrey, Guilford, UK
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Waite J, Beck SR, Powis L, Oliver C. The Executive Function Account of Repetitive Behavior: Evidence From Rubinstein-Taybi Syndrome. Am J Intellect Dev Disabil 2023; 128:49-65. [PMID: 36548376 DOI: 10.1352/1944-7558-128.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/29/2022] [Indexed: 06/17/2023]
Abstract
In this study, we focus on Rubinstein-Taybi syndrome (RTS) to explore the associations between executive function deficits and repetitive behaviors. Thirty individuals with RTS completed direct assessments of inhibition, working memory and set-shifting. Informants completed repetitive behavior and executive function questionnaires. Repetitive questions were associated with poorer inhibition and working memory. Stereotypy was associated with poorer inhibition. Adherence to routines was associated with poorer set-shifting, but only on the parental report measure. No other associations were evident. There is evidence of an association between specific repetitive behaviors and executive functioning in RTS, suggesting executive dysfunction may underpin behavioral difference in RTS. The findings point towards specific associations that are of interest for further research across populations in which repetitive behaviors are present.
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Affiliation(s)
- Jane Waite
- Jane Waite, College of Health and Life Sciences, School of Psychology, Aston University, Birmingham, UK
| | - Sarah R Beck
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Laurie Powis
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Chris Oliver
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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Groves L, Moss J, Oliver C, Royston R, Waite J, Crawford H. Divergent presentation of anxiety in high-risk groups within the intellectual disability population. J Neurodev Disord 2022; 14:54. [PMID: 36199025 PMCID: PMC9535841 DOI: 10.1186/s11689-022-09462-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background Anxiety symptomatology is common in individuals with intellectual disability (ID). Symptomatology includes both traditional Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) anxiety disorders and autism spectrum disorder (ASD)-related anxiety traits. Some genetic disorders such as Cornelia de Lange (CdLS) and fragile X syndromes (FXS) are at very high risk of anxiety and afford the opportunity to examine prevalence, profiles and associated person characteristics. However, prevalence and associated characteristics of anxiety in these high-risk groups remain poorly described and understood. The aim of the current study was to examine the prevalence and profile of DSM-5 and ASD-related anxiety symptomatology in individuals with CdLS and FXS and associated behavioural and cognitive characteristics. Methods Questionnaires and interviews assessing DSM-5 and ASD-related anxiety were conducted with caregivers of individuals with CdLS (n = 49) and FXS (n = 36). Results DSM-5 anxiety symptomatology was present in both groups with high co-morbidity across anxiety diagnoses. ASD-related anxiety was also prevalent with specific difficulties related to intolerance of uncertainty identified in both groups. Symptomatology was persistent over the lifespan for both groups. Anxiety type was partially associated with repetitive behaviour but not measures of overall ASD phenomenology in CdLS. Conclusions DSM-5 and ASD-related anxiety are common in these high-risk syndromes associated with ID. Prospective syndrome specific presentations and associations, which may implicate specific underlying mechanisms, are discussed. Clinicians should be aware of the risk and difficulties involved in assessment of anxiety in individuals with ID, including atypical types, to ensure these individuals do not “miss” diagnoses and support in general clinical practice.
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Affiliation(s)
- Laura Groves
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK.
| | - Joanna Moss
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, B15 2TT, UK
| | - Rachel Royston
- Division of Psychiatry, University College London, London, W1T 7NF, UK
| | - Jane Waite
- School of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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9
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Awan N, Pearson E, Shelley L, Greenhill C, Tarver J, Waite J. The behavioral phenotype of Rubinstein-Taybi syndrome: A scoping review of the literature. Am J Med Genet A 2022; 188:2536-2554. [PMID: 35730128 PMCID: PMC9542155 DOI: 10.1002/ajmg.a.62867] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 01/24/2023]
Abstract
Rubinstein-Taybi syndrome (RTS) is a rare genetic syndrome associated with growth delay, phenotypic facial characteristics, microcephaly, developmental delay, broad thumbs, and big toes. Most research on RTS has focused on the genotype and physical phenotype; however, several studies have described behavioral, cognitive, social, and emotional characteristics, elucidating the behavioral phenotype of RTS. The reporting of this review was informed by PRISMA guidelines. A systematic search of CINAHL, Medline, and PsychINFO was carried out in March 2021 to identify group studies describing behavioral, cognitive, emotional, psychiatric, and social characteristics in RTS. The studies were quality appraised. Characteristics reported include repetitive behavior, behaviors that challenge, intellectual disability, mental health difficulties, autism characteristics, and heightened sociability. Findings were largely consistent across studies, indicating that many characteristics are likely to form part of the behavioral phenotype of RTS. However, methodological limitations, such as a lack of appropriate comparison groups and inconsistency in measurement weaken these conclusions. There is a need for multi-disciplinary studies, combining genetic and psychological measurement expertise within single research studies. Recommendations are made for future research studies in RTS.
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Affiliation(s)
- Neelam Awan
- School of Life Sciences and EducationStaffordshire UniversityStoke‐on‐TrentUK,School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK,Present address:
Royal Manchester Children's HospitalManchesterUK
| | - Effie Pearson
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Lauren Shelley
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Courtney Greenhill
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Joanne Tarver
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Jane Waite
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
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10
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Thomas AT, Waite J, Williams CA, Kirk J, Oliver C, Richards C. Phenotypic characteristics and variability in CHARGE syndrome: a PRISMA compliant systematic review and meta-analysis. J Neurodev Disord 2022; 14:49. [PMID: 36045324 PMCID: PMC9429597 DOI: 10.1186/s11689-022-09459-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 08/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background CHARGE syndrome (OMIM #214800) is a phenotypically complex genetic condition characterised by multi-system, multi-sensory impairments. Behavioural, psychological, cognitive and sleep difficulties are not well delineated and are likely associated with biopsychosocial factors. Methods This meta-analysis investigated the prevalence of clinical features, physical characteristics and conditions, behavioural, psychological, cognitive and sleep characteristics in CHARGE syndrome, and statistically evaluated directional associations between these characteristics. Pooled prevalence estimates were calculated using reliable, prespecified quality weighting criteria, and meta-regression was conducted to identify associations between characteristics. Results Of the 42 eligible studies, data could be extracted for 1675 participants. Prevalence estimates were highest for developmental delay (84%), intellectual disability (64%), aggressive behaviour (48%), self-injurious behaviour (44%) and sleep difficulties (45%). Meta-regression indicated significant associations between intellectual disability and choanal atresia, intellectual disability and inner ear anomalies, sleep difficulties and growth deficiency, and sleep difficulties and gross motor difficulties. Conclusions Our comprehensive review of clinical features, behavioural, psychological, cognitive and physical characteristics, conditions and comorbidities in CHARGE syndrome provides an empirically based foundation to further research and practice. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-022-09459-5.
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Affiliation(s)
- Andrea T Thomas
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK. .,Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK.
| | - Jane Waite
- Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK.,Aston University, Birmingham, UK
| | - Caitlin A Williams
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - Jeremy Kirk
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.,Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK
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11
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Edwards G, Jones C, Pearson E, Royston R, Oliver C, Tarver J, Crawford H, Shelley L, Waite J. Prevalence of anxiety symptomatology and diagnosis in syndromic intellectual disability: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 138:104719. [PMID: 35661754 DOI: 10.1016/j.neubiorev.2022.104719] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/24/2022] [Accepted: 05/30/2022] [Indexed: 10/18/2022]
Abstract
Individuals with syndromic intellectual disability are at increased risk of experiencing anxiety. Comparing prevalence estimates of anxiety will allow the identification of at-risk groups and inform causal pathways of anxiety. No known study has explored estimates of anxiety symptomatology and diagnosis, including specific anxiety profiles, across groups whilst accounting for methodological quality of studies. This systematic review and meta-analysis aimed to fill this gap. Prior to review completion, methodology and analysis plans were registered and documented in a protocol (CRD42019123561). Data from 83 papers, involving a pooled sample of 13,708 across eight syndromes were synthesised using a random effects model. Anxiety prevalence ranged from 9 % (95 % CI: 4-14) in Down syndrome to 73% in Rett syndrome (95 % CI: 70-77). Anxiety prevalence across syndromic intellectual disability was higher than for intellectual disability of mixed aetiology and general population estimates. Substantial variability between syndromes identified groups at higher risk than others. The identification of high-risk groups is crucial for early intervention, allowing us to refine models of risk and identify divergent profiles.
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Affiliation(s)
- Georgina Edwards
- The School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Chris Jones
- School of Psychology, University of Birmingham, Edgbaston, UK.
| | - Effie Pearson
- The School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Rachel Royston
- School of Psychology, University of Birmingham, Edgbaston, UK.
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, UK.
| | - Joanne Tarver
- The School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, UK.
| | - Lauren Shelley
- The School of Psychology, College of Health and Life Sciences, Aston University, UK.
| | - Jane Waite
- The School of Psychology, College of Health and Life Sciences, Aston University, UK.
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12
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Bissell S, Oliver C, Moss J, Heald M, Waite J, Crawford H, Kothari V, Rumbellow L, Walters G, Richards C. The behavioural phenotype of SATB2-associated syndrome: a within-group and cross-syndrome analysis. J Neurodev Disord 2022; 14:25. [PMID: 35350986 PMCID: PMC8966214 DOI: 10.1186/s11689-022-09426-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background SATB2-associated syndrome (SAS) is a multisystem neurodevelopmental disorder characterised by intellectual disability, speech delay, and craniofacial anomalies. Although the clinical presentation of SAS is well-delineated, behaviours associated with SAS are less well-defined. Given the varied social profile reported in SAS of a ‘jovial’ predisposition and autistic behaviours, there may be phenotypic overlap with both Angelman syndrome (AS) and non-syndromal autism. This study aimed to describe behaviours in SAS in relation to chronological age and level of ability and contrast aspects of the behavioural phenotype with AS and non-syndromal autism. Methods Informant report questionnaire measures of behaviour, emotion, and autism characteristics were completed for 81 individuals with SAS (aged 1–36 years; 43 male). Within-group associations were analysed, and categorical data were compared between pre-school (1–5 years), school-age (6–15 years), and adolescent and adult SAS sub-groups (16 years and over). Cross-syndrome subscale and item-level analyses were conducted for 63 individuals with SAS (aged 1–27 years; 31 male), who were matched according to age and level of ability to 63 individuals with AS (aged 2–25 years; 32 male) and 63 individuals with non-syndromal autism (aged 3–26 years; 53 male). Results In SAS, higher rates of overactivity were moderately associated with lower self-help ability, and higher general anxiety scores were reported for males compared with females. Cross-syndrome subscale analyses uncovered several significant differences (p < .01), with comparatively low rates of stereotyped behaviour, overactivity, insistence on sameness and positive affect, and comparatively greater interest and pleasure and compulsive behaviour in individuals with SAS. Item-level analyses revealed a distinct profile of repetitive and autistic behaviours. Limitations Developmental analysis was based on a cross-sectional rather than a longitudinal research design, the contribution of pain and sleep to behaviour was not explored, and molecular genetic testing to determine genotype–phenotype behavioural relationships was not possible. Conclusions This study highlights the importance of behavioural comparisons to well-delineated groups and the utility of fine-grained item-level analyses to elucidate aspects of behaviour that might be syndrome related or shared across neurodevelopmental disorders. Future research is needed to further describe the distinctive repetitive and autistic behavioural phenotype in SAS. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-022-09426-0.
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Affiliation(s)
- Stacey Bissell
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Joanna Moss
- School of Psychology, University of Surrey, Guildford, Surrey, UK
| | - Mary Heald
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, Lancashire, UK
| | - Jane Waite
- School of Health and Life Sciences, Aston University, Birmingham, UK
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Vishakha Kothari
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Lauren Rumbellow
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Grace Walters
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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13
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Perry V, Ellis K, Moss J, Beck SR, Singla G, Crawford H, Waite J, Richards C, Oliver C. Executive function, repetitive behaviour and restricted interests in neurodevelopmental disorders. Res Dev Disabil 2022; 122:104166. [PMID: 35016127 DOI: 10.1016/j.ridd.2021.104166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/18/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Individuals with genetic syndromes show unique profiles of repetitive behaviours and restricted interests (RRBs). The executive dysfunction account of RRBs suggests that in autistic (AUT) individuals executive function impairments underpin RRBs, but not communication and social interaction autistic characteristics. AIMS To 1) describe profiles of behavioural manifestations of executive function (EF behaviours) and 2) explore the relationship between EF behaviours and autistic traits across individuals with Cornelia de Lange (CdLS), fragile X (FXS) and Rubinstein-Taybi syndromes (RTS), and AUT individuals. METHOD Carers completed the Behavior Rating Inventory of Executive Function - Preschool Version and the Social Communication Questionnaire. Data reporting on 25 individuals with CdLS (Mage = 18.60, SD = 8.94), 25 with FXS (Mage = 18.48, SD = 8.80), 25 with RTS (Mage = 18.60, SD = 8.65) and 25 AUT individuals (Mage = 18.52, SD = 8.65) matched on chronological age and adaptive ability were included in analyses. RESULTS All groups showed impairments across EF behaviours compared to two-to-three-year-old typically developing normative samples with no differences between groups. Different EF behaviours predicted RRBs in the syndrome groups with no associations found in the AUT group. CONCLUSIONS Syndrome related differences should be considered when developing targeted interventions that focus on EF behaviours and/or RRBs in these groups.
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Affiliation(s)
- Victoria Perry
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; Coventry and Warwickshire Partnership NHS Trust, Wayside House, Wilsons Lane, Coventry, CV6 6NY, United Kingdom
| | - Katherine Ellis
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; School of Psychology, University of Surrey, Guildford, GU2 7XH, United Kingdom.
| | - Jo Moss
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; School of Psychology, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Sarah R Beck
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
| | - Gursharan Singla
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
| | - Hayley Crawford
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; CMHWR and Mental Health and Wellbeing Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Jane Waite
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom; School of Health & Life Sciences, Aston University, Birmingham, B4 7ET, United Kingdom
| | - Caroline Richards
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
| | - Chris Oliver
- School of Psychology, University of Birmingham, B15 2TT, United Kingdom
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14
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Eaton C, Tarver J, Shirazi A, Pearson E, Walker L, Bird M, Oliver C, Waite J. A systematic review of the behaviours associated with depression in people with severe-profound intellectual disability. J Intellect Disabil Res 2021; 65:211-229. [PMID: 33426741 DOI: 10.1111/jir.12807] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 11/09/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
The assessment of depression in people with severe to profound intellectual disability (severe-profound ID) is challenging, primarily due to inability to report internal states such as mood, feelings of worthlessness and suicidal ideation. This group also commonly presents with challenging behaviours (e.g. aggression and self-injury) with debate about whether these behaviours should be considered 'depressive equivalents' or are sensitive for, but not specific to, depression in severe-profound ID. We conducted a systematic review exploring behaviours associated with depression and low mood in individuals with severe-profound ID. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2009) guidelines. Three electronic databases were searched (Embase, PsycINFO and Ovid MEDLINE), and 13 studies were included and rated for quality. Few studies were rated as having high methodological quality. Behaviours captured by standard diagnostic schemes for depression (e.g. Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases) showed a relationship with depression in severe-profound ID, including the two core symptoms (depressed affect and anhedonia), as well as irritability, sleep disturbance, psychomotor agitation, reduced appetite and fatigue. Challenging behaviours such as aggression, self-injury, temper tantrums, screaming and disruptive behaviour were associated with depression. Challenging behaviours show a robust relationship with depression. Whilst these behaviours may suggest an underlying depression, study limitations warrant caution in labelling them as 'depressive equivalents'. These limitations include not controlling for potential confounds (autism, other affective disorders and pain) and bias associated with comparing depressed/non-depressed groups on the same behavioural criteria used to initially diagnose and separate these groups. Future studies that use depressive measures designed for ID populations, which control for confounds and which explore low mood irrespective of psychiatric diagnosis, are warranted to better delineate the behaviours associated with depression in this population (PROSPERO 2018: CRD42018103244).
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Affiliation(s)
- C Eaton
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
- Department of Child Life and Health, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Tarver
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - A Shirazi
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - E Pearson
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - L Walker
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - M Bird
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - C Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - J Waite
- School of Life and Health Sciences, Aston University, Birmingham, UK
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15
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Royston R, Oliver C, Howlin P, Waite J. Anxiety characteristics in individuals with Williams syndrome. J Appl Res Intellect Disabil 2021; 34:1098-1107. [PMID: 33561900 DOI: 10.1111/jar.12864] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Williams syndrome anxiety research predominantly focuses on disorder prevalence and symptomatology, categorised using standardised mental health classifications. However, the use of these assessments may not fully capture the phenotypic features of anxiety in Williams syndrome. In this study, we examined characteristics of anxiety using a formulation framework. METHOD A semi-structured interview was conducted with thirteen parents of individuals with Williams syndrome (median age: 19, age range: 12-45, 8 females). RESULTS Various anxiety triggers were reported, including anxiety triggered by phobias, uncertainty and negative emotions in others. The range of described behaviours was diverse with both avoidant and active coping strategies for anxiety management reported. CONCLUSIONS Many of the characteristics described were consistent with findings in the intellectual disability and typically developing literature, although novel information was identified. The study demonstrates the utility of a formulation framework to explore anxiety characteristics in atypical populations and has outlined new avenues for research.
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Affiliation(s)
| | | | | | - Jane Waite
- University of Birmingham, Birmingham, UK
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16
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Oliver C, Adams D, Allen D, Crawford H, Heald M, Moss J, Richards C, Waite J, Welham A, Wilde L, Woodcock K. The behaviour and wellbeing of children and adults with severe intellectual disability and complex needs: the Be-Well checklist for carers and professionals. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.paed.2020.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Autistic children experience higher levels of anxiety than their peers. Making appropriate diagnoses of anxiety disorders and providing effective treatment for these children is particularly difficult. Inconsistent evidence suggests that levels of anxiety in autistic children are related to intellectual functioning. We provide the first meta-analysis of this evidence. A systematic search identified 49 papers for review. These papers included measures of anxiety and intelligence quotient in 18,430 autistic children. Studies employing correlations showed evidence of a significant relationship between intelligence quotient and anxiety in autistic children: children with higher intelligence quotient scored higher on measures of anxiety. Studies directly comparing groups of autistic children with and without intellectual disability also supported this conclusion. Most studies employing other designs also supported this finding. Employing a quality assessment framework identified common threats to validity. Many studies used measures of anxiety that were not validated across the samples they measure. This was most notable for those autistic children with an intellectual disability. It is vital that future research determines whether the identified relationship between intelligence quotient and anxiety reflects something important in the mechanism for anxiety in autistic children, or quantifies the lack of sensitivity of our measures of anxiety across different groups.
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Affiliation(s)
| | | | | | | | - Andrew DR Surtees
- University of Birmingham, UK
- Birmingham Children’s Hospital, UK
- Andrew DR Surtees, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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18
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Ellis K, Lewington P, Powis L, Oliver C, Waite J, Heald M, Apperly I, Sandhu P, Crawford H. Scaling of Early Social Cognitive Skills in Typically Developing Infants and Children with Autism Spectrum Disorder. J Autism Dev Disord 2020; 50:3988-4000. [PMID: 32189228 PMCID: PMC7557487 DOI: 10.1007/s10803-020-04449-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We delineate the sequence that typically developing infants pass tasks that assess different early social cognitive skills considered precursors to theory-of-mind abilities. We compared this normative sequence to performance on these tasks in a group of autistic (AUT) children. 86 infants were administered seven tasks assessing intention reading and shared intentionality (Study 1). Infants responses followed a consistent developmental sequence, forming a four-stage scale. These tasks were administered to 21 AUT children (Study 2), who passed tasks in the same sequence. However, performance on tasks that required following others' eye gaze and cooperating with others was delayed. Findings indicate that earlier-developing skills provide a foundation for later-developing skills, and difficulties in acquiring some early social cognitive skills in AUT children.
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Affiliation(s)
- Katherine Ellis
- School of Psychology, University of Surrey, Guildford, Surrey, GU2 7XH, UK
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Philippa Lewington
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Laurie Powis
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- The West Community Assessment and Treatment Service, Marlowes Health and Wellbeing Centre, 39-41 The Marlowes, Hemel Hempstead, HP1 1LD, UK
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Jane Waite
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- School of Life & Health Sciences, Aston University, Birmingham, B4 7ET, UK
| | - Mary Heald
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Ian Apperly
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Priya Sandhu
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
- School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK
| | - Hayley Crawford
- CMHWR and Mental Health and Wellbeing Unit, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
- Faculty of Health & Life Sciences, Coventry University, Coventry, UK
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19
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Tarver J, Pearson E, Edwards G, Shirazi A, Potter L, Malhi P, Waite J. Anxiety in autistic individuals who speak few or no words: A qualitative study of parental experience and anxiety management. Autism 2020; 25:429-439. [PMID: 32998530 PMCID: PMC7874371 DOI: 10.1177/1362361320962366] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Anxiety is a common co-occurring condition in autism and impacts quality of life of autistic individuals and their families; autistic individuals who speak few or no words represent an under-researched group. This qualitative study aimed to understand more about parental recognition and management of anxiety in autistic individuals who speak few or no words. Semi-structured interviews were conducted with parents/carers of 17 autistic individuals (mage = 14.29) recruited from an existing participant database and social media adverts. Using thematic analysis, 15 themes were placed under three a-priori grand themes: parental recognition of anxiety; parental management of anxiety; and anxiety impact on the autistic individual and their family. Due to reduced verbal language use and overlap with other behaviours, parents described difficulties recognising anxiety in their child. However, they also described use of a number of management strategies, including some which overlap with components of evidence-based interventions for emotional and behavioural problems in autistic individuals (e.g. exposure/sensory calming). Despite this, parents reported that anxiety continues to have significant impact on quality of life. The findings of this study can help to inform the development of targeted intervention and assessment measures for anxiety in autistic individuals who speak few or no words.
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20
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Royston R, Oliver C, Howlin P, Dosse A, Armitage P, Moss J, Waite J. The Profiles and Correlates of Psychopathology in Adolescents and Adults with Williams, Fragile X and Prader-Willi Syndromes. J Autism Dev Disord 2020; 50:893-903. [PMID: 31802317 PMCID: PMC7010621 DOI: 10.1007/s10803-019-04317-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Psychopathology is prevalent in Williams (WS), fragile X (FXS) and Prader–Willi (PWS) syndromes. However, little is known about the potential correlates of psychopathology in these groups. A questionnaire study was completed by 111 caregivers of individuals with WS (n = 35); FXS (n = 50) and PWS (n = 26). Mean age was 26 years (range 12–57 years); 74 (67%) were male. Multiple regression analyses indicated that higher rates of health problems and sensory impairments predicted higher psychopathology in WS (p < .0001). In PWS, poorer adaptive ability predicted higher overall psychiatric disturbance (p = .001), generalised anxiety (p = .006) and hyperactivity (p = .003). There were no significant predictors in FXS. This study highlights dissociations in the potential risk markers of psychopathology between genetic syndromes. Implications for intervention are discussed.
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Affiliation(s)
- R Royston
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,Division of Psychiatry, University College London, London, W1T 7NF, UK.
| | - C Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - P Howlin
- Department of Psychology, King's College London, Strand, London, WC2R 2LS, UK
| | - A Dosse
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - P Armitage
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - J Moss
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,Institute of Cognitive Neuroscience, University College London, Alexandra House, 17 Queen Square, London, WC1N 3AZ, UK
| | - J Waite
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,School of Life & Health Sciences, Aston University, Birmingham, B4 7ET, UK
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21
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Woodcock KA, Waite J. Back to basics in behavioural phenotypes: insights from developing a detailed understanding of behaviour. J Intellect Disabil Res 2019; 63:1071-1074. [PMID: 31407863 DOI: 10.1111/jir.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- K A Woodcock
- Centre for Applied Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - J Waite
- School of Health and Life Sciences, Aston University, Birmingham, UK
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22
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Cressey H, Oliver C, Crawford H, Waite J. Temper outbursts in Lowe syndrome: Characteristics, sequence, environmental context and comparison to Prader-Willi syndrome. J Appl Res Intellect Disabil 2019; 32:1216-1227. [PMID: 31144417 PMCID: PMC6851695 DOI: 10.1111/jar.12613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 04/13/2019] [Accepted: 04/15/2019] [Indexed: 11/01/2022]
Abstract
BACKGROUND There is limited research into the nature and aetiology of temper outbursts in people with intellectual disabilities. In this study, we describe the phenomenology and environmental context of temper outbursts in Lowe syndrome, a rare genetic syndrome in which outbursts are purportedly frequent. METHOD A temper outburst interview (TOI) was conducted with caregivers of seventeen individuals with Lowe syndrome to generate an account of the behavioural sequence, common antecedents and consequences of temper outbursts, and to enable comparisons with similar work on Prader-Willi syndrome. RESULTS Outbursts in Lowe syndrome were frequently triggered by thwarted goal-directed behaviour and were associated with high levels of physical aggression and property destruction. CONCLUSIONS Form and sequence of outbursts showed similarities to Prader-Willi syndrome and to behaviours reported in literature on typically developing children. The results highlight the importance of considering shared aetiology as well as syndrome-specific pathways in the development of outbursts.
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Affiliation(s)
- Helen Cressey
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Chris Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - Hayley Crawford
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK.,Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Jane Waite
- School of Life and Health Sciences, Aston University, Birmingham, UK
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23
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Royston R, Oliver C, Moss J, Adams D, Berg K, Burbidge C, Howlin P, Nelson L, Stinton C, Waite J. Brief Report: Repetitive Behaviour Profiles in Williams syndrome: Cross Syndrome Comparisons with Prader-Willi and Down syndromes. J Autism Dev Disord 2019; 48:326-331. [PMID: 28980100 DOI: 10.1007/s10803-017-3319-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study describes the profile of repetitive behaviour in individuals with Williams syndrome, utilising cross-syndrome comparisons with people with Prader-Willi and Down syndromes. The Repetitive Behaviour Questionnaire was administered to caregivers of adults with Williams (n = 96), Prader-Willi (n = 103) and Down (n = 78) syndromes. There were few group differences, although participants with Williams syndrome were more likely to show body stereotypies. Individuals with Williams syndrome also showed more hoarding and less tidying behaviours than those with Down syndrome. IQ and adaptive ability were negatively associated with repetitive questioning in people with Williams syndrome. The profile of repetitive behaviour amongst individuals with Williams syndrome was similar to the comparison syndromes. The cognitive mechanisms underlying these behaviours in genetic syndromes warrant further investigation.
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Affiliation(s)
- R Royston
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - C Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - J Moss
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - D Adams
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,Griffith University, PO Box 3370, South Brisbane Qld 4101, Sidon Street, South Bank, QLD, Australia
| | - K Berg
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,School of Psychology, University of East London, AE 1.10, Stratford Campus, London, E15 4LZ, UK
| | - C Burbidge
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,Coventry and Warwickshire Partnership NHS Trust, Wayside House, Wilsons Lane, Coventry, CV6 6NY, UK
| | - P Howlin
- Department of Psychology, King's College London, Strand, London, WC2R 2L, UK.,University of Sydney, Sydney, Australia
| | - L Nelson
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - C Stinton
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.,University of Warwick, Coventry, CV4 7AL, UK
| | - J Waite
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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24
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Vereenooghe L, Flynn S, Hastings RP, Adams D, Chauhan U, Cooper SA, Gore N, Hatton C, Hood K, Jahoda A, Langdon PE, McNamara R, Oliver C, Roy A, Totsika V, Waite J. Interventions for mental health problems in children and adults with severe intellectual disabilities: a systematic review. BMJ Open 2018; 8:e021911. [PMID: 29921688 PMCID: PMC6020952 DOI: 10.1136/bmjopen-2018-021911] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment options have received little attention. The aim of this study was to identify and evaluate the effectiveness of pharmacological and psychological interventions in the treatment of mental health problems in children and adults with severe and profound intellectual disabilities, given their difficulties in accessing standard mental health interventions, particularly talking therapies, and difficulties reporting drug side effects. DESIGN A systematic review using electronic searches of PsycINFO, PsycTESTS, EMBASE, MEDLINE, CINAHL, ERIC, ASSIA, Science Citation Index, Social Science Citation Index and CENTRAL was conducted to identify eligible intervention studies. Study selection, data extraction and quality appraisal were performed by two independent reviewers. PARTICIPANTS Study samples included at least 70% children and/or adults with severe or profound intellectual disabilities or reported the outcomes of this subpopulation separate from participants with other levels of intellectual disabilities. INTERVENTIONS Eligible intervention studies evaluated a psychological or pharmacological intervention using a control condition or pre-post design. OUTCOMES Symptom severity, frequency or other quantitative dimension (e.g., impact), as assessed with standardised measures of mental health problems. RESULTS We retrieved 41 232 records, reviewed 573 full-text articles and identified five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two studies evaluating psychological interventions. Study designs ranged from double-blind placebo controlled crossover trials to single-case experimental reversal designs. Quality appraisals of this very limited literature base revealed good experimental control, poor reporting standards and a lack of follow-up data. CONCLUSIONS Mental ill health requires vigorous treatment, yet the current evidence base is too limited to identify with precision effective treatments specifically for children or adults with severe and profound intellectual disabilities. Clinicians therefore must work on the basis of general population evidence, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities. PROSPERO REGISTRATION NUMBER CRD 42015024469.
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Affiliation(s)
- Leen Vereenooghe
- Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Samantha Flynn
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - 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, Clayton, Victoria, Australia
| | - Dawn Adams
- Autism Centre of Excellence, Griffith University, Brisbane, Queensland, Australia
| | - Umesh Chauhan
- Mackenzie Chair in Primary Care Medicine, School of Medicine, University of Central Lancashire, Preston, UK
| | - Sally-Ann Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nick Gore
- Tizard Centre, University of Kent, Canterbury, UK
| | - Chris Hatton
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Kerry Hood
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Andrew Jahoda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | | | - Chris Oliver
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Ashok Roy
- Brooklands Hospital, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Vasiliki Totsika
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Centre for Education Studies, University of Warwick, Coventry, UK
| | - Jane Waite
- School of Life & Health Sciences, Aston University, Birmingham, UK
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25
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Pearson EV, Waite J, Oliver C. Differences in the Information Needs of Parents With a Child With a Genetic Syndrome: A Cross-Syndrome Comparison. Journal of Policy and Practice in Intellectual Disabilities 2018. [DOI: 10.1111/jppi.12231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
| | - Jane Waite
- University of Birmingham, Birmingham; UK
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26
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Abstract
Abstract
Computing, a broad discipline including computer science, information technology and digital literacy, was introduced as a mandatory national curriculum subject in England in 2014. This meant the introduction of both computer programing and more academic computer science into the curriculum. Such a significant curriculum change involves a period of transition, lasting several years. Here we consider what we have learned about the implementation of the new curriculum, the external influences that have come to bear on teachers’ and pupils’ experiences, and the challenges that are faced.
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Affiliation(s)
- Sue Sentance
- King’s College London , Waterloo Bridge Wing 3/18, 150 Stamford Street , London SE1 9NH , UK
| | - Jane Waite
- King’s College London , Waterloo Bridge Wing 3/18, 150 Stamford Street , London SE1 9NH , UK
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27
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Connerney JEP, Adriani A, Allegrini F, Bagenal F, Bolton SJ, Bonfond B, Cowley SWH, Gerard JC, Gladstone GR, Grodent D, Hospodarsky G, Jorgensen JL, Kurth WS, Levin SM, Mauk B, McComas DJ, Mura A, Paranicas C, Smith EJ, Thorne RM, Valek P, Waite J. Jupiter's magnetosphere and aurorae observed by the Juno spacecraft during its first polar orbits. Science 2018; 356:826-832. [PMID: 28546207 DOI: 10.1126/science.aam5928] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/20/2017] [Indexed: 11/02/2022]
Abstract
The Juno spacecraft acquired direct observations of the jovian magnetosphere and auroral emissions from a vantage point above the poles. Juno's capture orbit spanned the jovian magnetosphere from bow shock to the planet, providing magnetic field, charged particle, and wave phenomena context for Juno's passage over the poles and traverse of Jupiter's hazardous inner radiation belts. Juno's energetic particle and plasma detectors measured electrons precipitating in the polar regions, exciting intense aurorae, observed simultaneously by the ultraviolet and infrared imaging spectrographs. Juno transited beneath the most intense parts of the radiation belts, passed about 4000 kilometers above the cloud tops at closest approach, well inside the jovian rings, and recorded the electrical signatures of high-velocity impacts with small particles as it traversed the equator.
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Affiliation(s)
- J E P Connerney
- Space Research Corporation, Annapolis, MD 21403, USA. .,NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - A Adriani
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, Rome, 00133, Italy
| | - F Allegrini
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - F Bagenal
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
| | - S J Bolton
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - B Bonfond
- Institut d'Astrophysique et de Geophysique, Universite de Liege, Liege, B-4000 Belgium
| | | | - J-C Gerard
- Institut d'Astrophysique et de Geophysique, Universite de Liege, Liege, B-4000 Belgium
| | - G R Gladstone
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - D Grodent
- Institut d'Astrophysique et de Geophysique, Universite de Liege, Liege, B-4000 Belgium
| | | | - J L Jorgensen
- National Space Institute, Technical University of Denmark, Kongens Lyngby, 2800, Denmark
| | - W S Kurth
- University of Iowa, Iowa City, IA 52242, USA
| | - S M Levin
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA 91109, USA
| | - B Mauk
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD 20723, USA
| | - D J McComas
- Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544, USA
| | - A Mura
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, Rome, 00133, Italy
| | - C Paranicas
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD 20723, USA
| | - E J Smith
- Jet Propulsion Laboratory/California Institute of Technology, Pasadena, CA 91109, USA
| | - R M Thorne
- Department of Atmospheric and Oceanic Sciences, University of California-Los Angeles, Los Angeles, CA 90095, USA
| | - P Valek
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - J Waite
- Southwest Research Institute, San Antonio, TX 78238, USA
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28
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Bolton SJ, Adriani A, Adumitroaie V, Allison M, Anderson J, Atreya S, Bloxham J, Brown S, Connerney JEP, DeJong E, Folkner W, Gautier D, Grassi D, Gulkis S, Guillot T, Hansen C, Hubbard WB, Iess L, Ingersoll A, Janssen M, Jorgensen J, Kaspi Y, Levin SM, Li C, Lunine J, Miguel Y, Mura A, Orton G, Owen T, Ravine M, Smith E, Steffes P, Stone E, Stevenson D, Thorne R, Waite J, Durante D, Ebert RW, Greathouse TK, Hue V, Parisi M, Szalay JR, Wilson R. Jupiter's interior and deep atmosphere: The initial pole-to-pole passes with the Juno spacecraft. Science 2018; 356:821-825. [PMID: 28546206 DOI: 10.1126/science.aal2108] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/01/2017] [Indexed: 11/02/2022]
Abstract
On 27 August 2016, the Juno spacecraft acquired science observations of Jupiter, passing less than 5000 kilometers above the equatorial cloud tops. Images of Jupiter's poles show a chaotic scene, unlike Saturn's poles. Microwave sounding reveals weather features at pressures deeper than 100 bars, dominated by an ammonia-rich, narrow low-latitude plume resembling a deeper, wider version of Earth's Hadley cell. Near-infrared mapping reveals the relative humidity within prominent downwelling regions. Juno's measured gravity field differs substantially from the last available estimate and is one order of magnitude more precise. This has implications for the distribution of heavy elements in the interior, including the existence and mass of Jupiter's core. The observed magnetic field exhibits smaller spatial variations than expected, indicative of a rich harmonic content.
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Affiliation(s)
- S J Bolton
- Southwest Research Institute, San Antonio, TX 78238, USA.
| | - A Adriani
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, 00133 Rome, Italy
| | - V Adumitroaie
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - M Allison
- Goddard Institute for Space Studies, New York, NY 10025, USA
| | - J Anderson
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - S Atreya
- University of Michigan, Ann Arbor, MI 48109, USA
| | - J Bloxham
- Harvard University, Cambridge, MA 02138, USA
| | - S Brown
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - J E P Connerney
- Space Research Corporation, Annapolis, MD 21403, USA.,NASA Goddard Space Flight Center, Greenbelt, MD 20771, USA
| | - E DeJong
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - W Folkner
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - D Gautier
- Laboratoire d'Études Spatiales et d'Instrumentation en Astrophysique, Observatoire de Paris, 92195 Meudon, France
| | - D Grassi
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, 00133 Rome, Italy
| | - S Gulkis
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - T Guillot
- Université Côte d'Azur, Observatoire de la Côte d'Azur, Laboratoire Lagrange CNRS, 06304 Nice, France
| | - C Hansen
- Planetary Science Institute, Tucson, AZ 85719, USA
| | - W B Hubbard
- Lunar and Planetary Laboratory, University of Arizona, Tucson, AZ 85721, USA
| | - L Iess
- Sapienza University of Rome, 00185 Rome, Italy
| | - A Ingersoll
- California Institute of Technology, Pasadena, CA 91125, USA
| | - M Janssen
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - J Jorgensen
- National Space Institute, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Y Kaspi
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - S M Levin
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - C Li
- California Institute of Technology, Pasadena, CA 91125, USA
| | - J Lunine
- Cornell University, Ithaca, NY 14853, USA
| | - Y Miguel
- Université Côte d'Azur, Observatoire de la Côte d'Azur, Laboratoire Lagrange CNRS, 06304 Nice, France
| | - A Mura
- Institute for Space Astrophysics and Planetology, National Institute for Astrophysics, 00133 Rome, Italy
| | - G Orton
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - T Owen
- Institute for Astronomy, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - M Ravine
- Malin Space Science Systems, San Diego, CA 92121, USA
| | - E Smith
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - P Steffes
- Center for Space Technology and Research, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - E Stone
- California Institute of Technology, Pasadena, CA 91125, USA
| | - D Stevenson
- California Institute of Technology, Pasadena, CA 91125, USA
| | - R Thorne
- Department of Atmospheric and Oceanic Sciences, University of California, Los Angeles, CA 90095, USA
| | - J Waite
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - D Durante
- Sapienza University of Rome, 00185 Rome, Italy
| | - R W Ebert
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - T K Greathouse
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - V Hue
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - M Parisi
- Jet Propulsion Laboratory/Caltech, Pasadena, CA 91109, USA
| | - J R Szalay
- Southwest Research Institute, San Antonio, TX 78238, USA
| | - R Wilson
- Laboratory for Atmospheric and Space Physics, University of Colorado, Boulder, CO 80303, USA
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29
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Royston R, Howlin P, Waite J, Oliver C. Anxiety Disorders in Williams Syndrome Contrasted with Intellectual Disability and the General Population: A Systematic Review and Meta-Analysis. J Autism Dev Disord 2017; 47:3765-3777. [PMID: 27696186 PMCID: PMC5676825 DOI: 10.1007/s10803-016-2909-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Individuals with specific genetic syndromes associated with intellectual disability (ID), such as Williams syndrome (WS), are at increased risk for developing anxiety disorders. A systematic literature review identified sixteen WS papers that could generate pooled prevalence estimates of anxiety disorders for WS. A meta-analysis compared these estimates with prevalence estimates for the heterogeneous ID population and the general population. Estimated rates of anxiety disorders in WS were high. WS individuals were four times more likely to experience anxiety than individuals with ID, and the risk was also heightened compared to the general population. The results provide further evidence of an unusual profile of high anxiety in WS.
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Affiliation(s)
- R Royston
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - P Howlin
- Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - J Waite
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - C Oliver
- The Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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30
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Abstract
Anxiety disorders are heightened in specific genetic syndromes in comparison to intellectual disability of heterogeneous aetiology. In this study, we described and contrasted anxiety symptomatology in fragile X (FXS), Cornelia de Lange (CdLS) and Rubinstein-Taybi syndromes (RTS), and compared the symptomatology to normative data for typically-developing children and children diagnosed with an anxiety disorder. Scores did not differ between children diagnosed with an anxiety disorder and (a) participants with FXS on social phobia, panic/agoraphobia, physical injury fears, and obsessive-compulsive subscales (b) participants with CdLS on separation anxiety, generalized anxiety, panic/agoraphobia, physical injury fears and obsessive-compulsive subscales, and (c) participants with RTS on panic/agoraphobia and obsessive-compulsive subscales. The results highlight divergent profiles of anxiety symptomatology between these groups.
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Affiliation(s)
- Hayley Crawford
- Centre for Research in Psychology, Behaviour and Achievement, Coventry University, James Starley Building (JSG12), Priory Street, Coventry, CV1 5FB, UK.
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Jane Waite
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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31
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Flynn S, Vereenooghe L, Hastings RP, Adams D, Cooper SA, Gore N, Hatton C, Hood K, Jahoda A, Langdon PE, McNamara R, Oliver C, Roy A, Totsika V, Waite J. Measurement tools for mental health problems and mental well-being in people with severe or profound intellectual disabilities: A systematic review. Clin Psychol Rev 2017; 57:32-44. [DOI: 10.1016/j.cpr.2017.08.006] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 06/27/2017] [Accepted: 08/09/2017] [Indexed: 11/29/2022]
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32
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Waite J, Rose J, Wilde L, Eden K, Stinton C, Moss J, Oliver C. Associations between behaviours that challenge in adults with intellectual disability, parental perceptions and parental mental health. Br J Clin Psychol 2017; 56:408-430. [PMID: 28801992 DOI: 10.1111/bjc.12146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 05/27/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study examined parental perceptions of behaviours that challenge (CB) in their adult children with intellectual disability (ID), and explored whether perceptions mediated associations between CB and parental psychological distress. DESIGN A within-group correlational design was employed. METHODS Sixty-five parents reported on individuals with genetic syndromes and ID who had chronic CB. Parents completed the Illness Perception Questionnaire-Revised (IPQ-R) adapted to measure perceptions of self-injury, aggression or property destruction, alongside assessments of parental locus of control, attributions about behaviour, parental psychological distress, and CB. RESULTS A high proportion of parents evidenced anxiety and depression at clinically significant levels (56.9% and 30.8%, respectively). Contrary to predictions, psychological distress was not significantly associated with CB. The perception that the adult with ID exerted control over the parent's life mediated the association between CB and parental psychological distress. Few parents endorsed operant reinforcement as a cause of CB (< 10%). CONCLUSIONS The high levels of psychological distress in parents is notable and of concern. Further research should consider the reasons why parents have causal attributions that might be inconsistent with contemporary interventions. PRACTITIONER POINTS Parents experience high levels of psychological distress while supporting adults with ID who engage in chronic behaviours that challenge. A stronger belief that the adult with ID exerts control over the parent's life may mediate an association between CB exhibited by the individual with ID and parental psychological distress. Few parents endorsed operant reinforcement as a cause of behaviours that challenge.
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Affiliation(s)
- Jane Waite
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, UK
| | - John Rose
- School of Psychology, University of Birmingham, UK
| | - Lucy Wilde
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, UK
| | - Kate Eden
- Department of Psychology, University of Bath, UK
| | - Chris Stinton
- Health Sciences Research Institute, University of Warwick, Coventry, UK
| | - Jo Moss
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, UK.,Institute of Cognitive Neuroscience, University College London, UK
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, UK
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Atrey A, Hussain N, Gosling O, Giannoudis P, Shepherd A, Young S, Waite J. A 3 year minimum follow up of Endoprosthetic replacement for distal femoral fractures - An alternative treatment option. J Orthop 2017; 14:216-222. [PMID: 28115800 DOI: 10.1016/j.jor.2016.12.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/25/2016] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Although the use of an endoprosthesis for distal femoral fractures remains a valid treatment option the widespread use is in its infancy. METHODOLOGY In this retrospective case series, we review cases of distal femoral fracture treated with endoprosthetic replacement (EPR). The outcomes we assessed were the time to start mobilising, the time to discharge, morbidity and mortality as well as an Oxford knee score to assess pain and function and also the early survivorship. 6 of the 11 from the cohort had existing Total Knee Replacements (TKRs) in situ. RESULTS There were 11 knees in our cohort with a mean age of 81.5 years (range 52-102 years). The median time to follow up was 3.5 years (range 1.6 to 5.5 years). The median times to theatre was 3 days and to discharge was 16 days. Oxford functional and pain scores were 32/48. DISCUSSION In the appropriate patient and fracture pattern, Endoprosthetic knee replacement is an excellent option in the treatment of distal femoral fractures whether associated with an existing TKR or not. The implant is more costly than traditional open reduction and internal fixation, but the earlier return to full mobility post-operatively may save on hospital/care home stay and free up hospital space and minimise complications.
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Affiliation(s)
- A Atrey
- St Michael's Hospital, Toronto, Canada
| | | | | | | | - A Shepherd
- Warwick Hospital Orthopaedic Research Unit, UK
| | - S Young
- Warwick Hospital Orthopaedic Research Unit, UK
| | - J Waite
- Warwick Hospital Orthopaedic Research Unit, UK
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Oliver C, Waite J. JIDR: 60 years of diversity. J Intellect Disabil Res 2016; 60:1137-1139. [PMID: 27859939 DOI: 10.1111/jir.12348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Moss J, Nelson L, Powis L, Waite J, Richards C, Oliver C. A Comparative Study of Sociability in Angelman, Cornelia de Lange, Fragile X, Down and Rubinstein Taybi Syndromes and Autism Spectrum Disorder. Am J Intellect Dev Disabil 2016; 121:465-486. [PMID: 27802104 DOI: 10.1352/1944-7558-121.6.465] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Few comparative studies have evaluated the heterogeneity of sociability across a range of neurodevelopmental disorders. The Sociability Questionnaire for People with Intellectual Disability (SQID) was completed by caregivers of individuals with Cornelia de Lange (n = 98), Angelman (n = 66), Fragile X (n = 142), Down (n = 117) and Rubinstein Taybi (n = 88) syndromes and autism spectrum disorder (ASD; n = 107). Between groups and age-band (<12yrs; 12-18yrs; >18yrs) comparisons of SQID scores were conducted. Rates of behaviors indicative of selective mutism were also examined. Fragile X syndrome achieved the lowest SQID scores. Cornelia de Lange, ASD, and Fragile X groups scored significantly lower than Angelman, Down and Rubinstein Taybi groups. Selective mutism characteristics were highest in Cornelia de Lange (40%) followed by Fragile X (17.8%) and ASD (18.2%). Age-band differences were identified in Cornelia de Lange and Down syndrome.
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Affiliation(s)
- Joanna Moss
- Joanna Moss, Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham, and Institute of Cognitive Neuroscience, University College London; Lisa Nelson, Laurie Powis, Jane Waite, Caroline Richards, and Chris Oliver, Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham
| | | | | | | | | | - Chris Oliver
- Joanna Moss, Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham, and Institute of Cognitive Neuroscience, University College London; Lisa Nelson, Laurie Powis, Jane Waite, Caroline Richards, and Chris Oliver, Cerebra Centre for Neurodevelopmental Disorders, University of Birmingham
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Waite J, Moss J, Beck SR, Richards C, Nelson L, Arron K, Burbidge C, Berg K, Oliver C. Repetitive Behavior in Rubinstein–Taybi Syndrome: Parallels with Autism Spectrum Phenomenology. J Autism Dev Disord 2014; 45:1238-53. [DOI: 10.1007/s10803-014-2283-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Atrey A, Morison Z, Waite J, Young SK. A method for the placement of the ceramic liner in an uncemented cup. Ann R Coll Surg Engl 2014; 96:250. [PMID: 24780810 DOI: 10.1308/rcsann.2014.96.3.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- A Atrey
- 1South Warwickshire NHS Foundation Trust, UK.
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Herbert R, Ashraf AN, Yates TA, Spriggs K, Malinnag M, Durward-Brown E, Phillips D, Mewse E, Daniel A, Armstrong M, Kidd IM, Waite J, Wilks P, Burns F, Bailey R, Brown M. Nurse-delivered universal point-of-care testing for HIV in an open-access returning traveller clinic. HIV Med 2012; 13:499-504. [PMID: 22413841 DOI: 10.1111/j.1468-1293.2012.01001.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Early diagnosis of HIV infection reduces morbidity and mortality associated with late presentation. Despite UK guidelines, the HIV testing rate has not increased. We have introduced universal HIV screening in an open-access returning traveller clinic. METHODS Data were prospectively recorded for all patients attending the open-access returning traveller clinic between August 2008 and December 2010. HIV testing was offered to all patients from May 2009; initially testing with laboratory samples (phase 1) and subsequently a point-of-care test (POCT) (phase 2). RESULTS A total of 4965 patients attended the clinic; 1342 in phase 0, 792 in phase 1 and 2831 in phase 2. Testing rates for HIV increased significantly from 2% (38 of 1342) in phase 0 to 23.1% (183 of 792) in phase 1 and further increased to 44.5% (1261 of 2831) during phase 2 (P < 0.0001). Two new diagnoses of HIV-1 were identified in phase 1 (1.1% of tested); seven patients had a reactive POCT test in phase 2, of whom five (0.4% of those tested) were confirmed in a 4th generation assay. The patients with false reactive tests had a concurrent Plasmodium falciparum infection. Patients travelling to the Middle East and Europe were less likely to accept an HIV test with POCT. CONCLUSIONS A nurse-delivered universal point-of-care HIV testing service has been successfully introduced and sustained in an acute medical clinic in a low-prevalence country. Caution is required in communicating reactive results in low-prevalence settings where there may be alternative diagnoses or a low population prevalence of HIV infection.
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Affiliation(s)
- R Herbert
- Hospital for Tropical Diseases, UCLH NHS Foundation Trust, London, UK.
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Giordano R, Weber E, Waite J, Bencivenga N, Krogh PH, Soto-Adames F. Effect of a high dose of three antibiotics on the reproduction of a parthenogenetic strain of Folsomia candida (Isotomidae: Collembola). Environ Entomol 2010; 39:1170-7. [PMID: 22127168 DOI: 10.1603/en10027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Folsomia candida Willem (Isotomidae: Collembola) is an edaphic parthenogenetic species commonly used in ecotoxicity studies. We exposed F. candida to a high dose of three antibiotics, tylosin, ampicillin, and oxytetracycline, that target different bacterial groups. Possible toxic effects were assessed through egg production, hatching, and body size. All three antibiotics caused toxic effects. Treatment with oxytetracycline proved the most toxic. This group showed the smallest body size and lowest number of eggs laid, likely the result of a combination of antibiotic toxicity and avoidance of the antibiotic spiked food. Active toxin avoidance by F. candida in toxicological assays may play a role in minimizing their exposure to toxic compounds. Despite the administration of high doses of oxytetracycline, F. candida individuals remained infected with the intracellular bacteria Wolbachia indicating that this strain is resistant to this antibiotic or that the host or its gut flora had detoxified the compound. An increase in percent egg hatch with time was seen in the ampicillin and oxytetracycline treatments, indicating a possible accommodation of the host and/or gut-flora to these antibiotics.
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Affiliation(s)
- R Giordano
- Illinois Natural History Survey, Institute of Natural Resource Sustainability, University of Illinois, 1816 S. Oak St., Champaign, IL 61820, USA.
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Nguyen K, Stefansic J, Waite J, Lennon B, Gamblin T, Tsung A, Geller D. PL6. The Use of a 3D Image-Guided Liver Surgery (IGLS) System For Pre-OP Planning and Intra-OP Real-Time Guidance for Hepatic Resection. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
BACKGROUND Aggression, agitation or psychosis occur in the majority of people with dementia at some point in the illness. There have been a number of trials of atypical antipsychotics to treat these symptoms over the last five years, and a systematic review is needed to evaluate the evidence in a balanced way. OBJECTIVES To determine whether evidence supports the use of atypical antipsychotics for the treatment of aggression, agitation and psychosis in people with Alzheimer's disease. SEARCH STRATEGY The trials were identified from a last updated search of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group on 7 December 2004 using the terms olanzapine, quetiapine, risperidone, clozapine, amisulpride, sertindole, zotepine, aripiprazole, ziprasidone. This Register contains articles from all major healthcare databases and many ongoing trials databases and is updated regularly. SELECTION CRITERIA Randomised, placebo-controlled trials, with concealed allocation, where dementia and psychosis and/or aggression were assessed. DATA COLLECTION AND ANALYSIS 1. Two reviewers extracted data from included trials2. Data were pooled where possible, and analysed using appropriate statistical methods3. Analysis included patients treated with an atypical antipsychotic, compared with placebo MAIN RESULTS Sixteen placebo controlled trials have been completed with atypical antipsychotics although only nine had sufficient data to contribute to a meta-analysis and only five have been published in full in peer reviewed journals. No trials of amisulpiride, sertindole or zotepine were identified which met the criteria for inclusion. The included trials led to the following results:1. There was a significant improvement in aggression with risperidone and olanzapine treatment compared to placebo.2. There was a significant improvement in psychosis amongst risperidone treated patients.3. Risperidone and olanzpaine treated patients had a significantly higher incidence of serious adverse cerebrovascular events (including stroke), extra-pyramidal side effects and other important adverse outcomes.4. There was a significant increase in drop-outs in risperidone (2 mg) and olanzapine (5-10 mg) treated patients.5. The data were insufficient to examine impact upon cognitive function. AUTHORS' CONCLUSIONS Evidence suggests that risperidone and olanzapine are useful in reducing aggression and risperidone reduces psychosis, but both are associated with serious adverse cerebrovascular events and extra-pyramidal symptoms. Despite the modest efficacy, the significant increase in adverse events confirms that neither risperidone nor olanzapine should be used routinely to treat dementia patients with aggression or psychosis unless there is marked risk or severe distress. Although insufficient data were available from the considered trials, a meta-analysis of seventeen placebo controlled trials of atypical neuroleptics for the treatment of behavioural symptoms in people with dementia conducted by the Food and Drug Administration (using data not in the public domain) suggested a significant increase in mortality (OR 1.7).
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Affiliation(s)
- C Ballard
- Kings College London, Wolfson Centre for Age-Related Diseases, Wolfson Wing, Hodgkin Building, Guy's Campus, London, UK, SE1 1UL.
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Papadopoulos MG, Waite J, Winter CS, Oliver SN. Interpretation of the second hyperpolarizability of bis(ethylene-1,2-dithiolato)nickel and some of its derivatives. A comparative study. Inorg Chem 2002. [DOI: 10.1021/ic00055a008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Waite J, Papadopoulos MG. Calculation of induced moments in large molecules. 6. Scale of polarization for some functional groups. A comparative study. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100338a014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Waite J, Papadopoulos MG. The effect of charge transfer on the polarizability and hyperpolarizabilities of some selected, substituted polythiophenes: a comparative study. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100379a018] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Waite J, Papadopoulos MG. Electric second hyperpolarizability as a novel probe to the stability of dianions. Case study: four conformers of C6H82-. J Org Chem 2002. [DOI: 10.1021/jo00194a035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Waite J, Papadopoulos MG. Dependence of the polarizability, .alpha., and hyperpolarizabilities, .beta. and .gamma., of a series of nitrogen heterocyclics on their molecular structure: a comparative study. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100368a010] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Waite J, Papadopoulos MG. Polarizability and second hyperpolarizability of some molecular cations. The effect of charge variation on these properties. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100257a028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rothera IC, Jones R, Harwood R, Avery AJ, Waite J. Survival in a cohort of social services placements in nursing and residential homes: factors associated with life expectancy and mortality. Public Health 2002; 116:160-5. [PMID: 12082598 DOI: 10.1038/sj.ph.1900832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2002] [Indexed: 11/08/2022]
Abstract
The aim of this study was to examine the life expectancy of elderly people in nursing and residential care over a 20-month period and its relationship to specific risk factors. Using a retrospective cohort design, data obtained on 1888 residents placed between 1 July 1997 and 30 April 1999 in residential, nursing and dual registered homes within Nottingham Health Authority boundaries were examined. Additional data on physical and mental disability at placement were available for 514 residents. Main outcome measures comprised survival rate overall, and in relation to gender, age, home type (nursing, residential or dual), source of placement (hospital or community) and various disability factors.One-year survival rates were: overall, 66%; nursing homes, 59%; dual homes, 58%; and residential homes 76%. Median survival in nursing homes was 541 days, but was not reached in residential homes. Male gender, admission to nursing or dual registered homes, placement from hospital, decreased mobility and increased age were associated with decreased life expectancy. Although no association was found between length of survival and level of cognitive function, lack of cognitive impairment was associated with lower survival. In conclusion, mortality is high in nursing, dual and residential homes where life expectancy has been shown to be associated with gender, home type, origin of placement and mobility. Rates of survival are related to higher comorbidity and disability. Important data for planning and assessing care needs can be yielded through the analysis of mortality data.
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Affiliation(s)
- I C Rothera
- Section Of Old Age Psychiatry, Division of Psychiatry, Queen's Medical Centre, Nottingham, UK.
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Abstract
This descriptive study investigated an outbreak of hepatitis A virus (HAV) infection among injecting drug users (IDUs) and their contacts. Twenty-seven cases of acute HAV infection were identified in a 5-month period. Connections with the local injecting drug using (IDU) population were established for 25 of the cases of whom 14 admitted to injecting drug use. HAV RNA genotyping revealed two HAV variants, closely related to variants found in Scandinavian IDUs and in South East Asia. The study demonstrates that once HAV enters the IDU population extensive outbreaks are possible. We recommend that all IDUs should be tested for HAV and hepatitis B virus (HBV) infections and offered combined hepatitis A and B vaccines if non-immune.
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Affiliation(s)
- D O'Donovan
- Department of Public Health Medicine, East Sussex, Brighton Hove Health Authority, Lewes
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