Pub Date : 2020-07-02DOI: 10.1080/19315864.2020.1783039
S. Lennard, R. Sharpe, R. Goodey, Sharon Hudson, R. Shankar
ABSTRACT Introduction People with learning disabilities in the United Kingdom are being incarcerated in hospital settings due to lack of suitable community care and support. Factors influencing discharge from institutional/hospital care to enable successful community living have not been explored systematically. Method A systematic review using the PRISMA guidance identified studies via five electronic database searches of Medline, CINAHL, Embase, psychINFO, and Cochrane Library. A predesigned inclusion/exclusion criterion was applied to selected articles. A thematic analysis approach was used. Results Six qualitative and twelve quantitative articles were identified and divided into three broad themes of support, housing, and health. A further nineteen articles were identified as of peripheral interest. Conclusion Factors affording a successful transition from hospital/institution to community are discussed. Suitable standards of housing, staff support/training, and health-care access influence the success of sustainable repatriation. An evidence-based tool kit is proposed from available factors to enable safe, sustainable, and timely discharge.
{"title":"Creating Capable Communities for People with Intellectual Disabilities: Challenges and Opportunities","authors":"S. Lennard, R. Sharpe, R. Goodey, Sharon Hudson, R. Shankar","doi":"10.1080/19315864.2020.1783039","DOIUrl":"https://doi.org/10.1080/19315864.2020.1783039","url":null,"abstract":"ABSTRACT Introduction People with learning disabilities in the United Kingdom are being incarcerated in hospital settings due to lack of suitable community care and support. Factors influencing discharge from institutional/hospital care to enable successful community living have not been explored systematically. Method A systematic review using the PRISMA guidance identified studies via five electronic database searches of Medline, CINAHL, Embase, psychINFO, and Cochrane Library. A predesigned inclusion/exclusion criterion was applied to selected articles. A thematic analysis approach was used. Results Six qualitative and twelve quantitative articles were identified and divided into three broad themes of support, housing, and health. A further nineteen articles were identified as of peripheral interest. Conclusion Factors affording a successful transition from hospital/institution to community are discussed. Suitable standards of housing, staff support/training, and health-care access influence the success of sustainable repatriation. An evidence-based tool kit is proposed from available factors to enable safe, sustainable, and timely discharge.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"45 1","pages":"174 - 200"},"PeriodicalIF":2.5,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90612206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-02DOI: 10.1080/19315864.2020.1790702
A. Hassiotis
The coronavirus pandemic continues to be a serious global problem with very significant consequences for individual health, wellbeing and economic stability. As we learn more about the disease and its prognosis, several facts have emerged about onset, spread and fatality rates. One of the most striking findings is that of people from Black Asian and Minority Ethnic (BAME) groups bearing more severe forms of the illness and consequently dying at higher rates than their white counterparts. This disparity has been seen in many countries as reports about the characteristics of those infected and hospitalized are being published (Patel et al., 2020). Particular concerns have been raised about what might be driving this increased susceptibility to the virus including the role of widely suspected structural inequalities. A group of people who are exceedingly vulnerable, usually underserved and often stigmatized and discriminated against are those with intellectual and developmental disabilities. Those who are at the intersection of BAME and intellectual and developmental disabilities are likely to fare less well. There has been some research in people with intellectual and developmental disabilities from BAME groups but only a small proportion examines health status. Robertson et al. (2019) found 23 studies reporting on health status and service use in people with intellectual and developmental disabilities living in the UK. BAME status was associated with 4fold increase in abnormal blood glucose levels; a diagnosis of psychosis; lower likelihood to have his/her mental ill-health recognized by a family carer. South Asian families in particular were less likely to access specialist intellectual disability services for a mental health problem and reported increased social care needs. Analysis of US-based databases such as the Adult Consumer Survey of the National Indicators Project (Bershadsky et al., 2014) indicated that ethnicity (White non-Hispanic, Black non-Hispanic, Hispanic) was an important variable in accessing 6 public health preventive programs although the differences dissipated when person characteristics were accounted for. Another study
{"title":"The Intersectionality of Ethnicity/race and Intellectual and Developmental Disabilities: Impact on Health Profiles, Service Access and Mortality","authors":"A. Hassiotis","doi":"10.1080/19315864.2020.1790702","DOIUrl":"https://doi.org/10.1080/19315864.2020.1790702","url":null,"abstract":"The coronavirus pandemic continues to be a serious global problem with very significant consequences for individual health, wellbeing and economic stability. As we learn more about the disease and its prognosis, several facts have emerged about onset, spread and fatality rates. One of the most striking findings is that of people from Black Asian and Minority Ethnic (BAME) groups bearing more severe forms of the illness and consequently dying at higher rates than their white counterparts. This disparity has been seen in many countries as reports about the characteristics of those infected and hospitalized are being published (Patel et al., 2020). Particular concerns have been raised about what might be driving this increased susceptibility to the virus including the role of widely suspected structural inequalities. A group of people who are exceedingly vulnerable, usually underserved and often stigmatized and discriminated against are those with intellectual and developmental disabilities. Those who are at the intersection of BAME and intellectual and developmental disabilities are likely to fare less well. There has been some research in people with intellectual and developmental disabilities from BAME groups but only a small proportion examines health status. Robertson et al. (2019) found 23 studies reporting on health status and service use in people with intellectual and developmental disabilities living in the UK. BAME status was associated with 4fold increase in abnormal blood glucose levels; a diagnosis of psychosis; lower likelihood to have his/her mental ill-health recognized by a family carer. South Asian families in particular were less likely to access specialist intellectual disability services for a mental health problem and reported increased social care needs. Analysis of US-based databases such as the Adult Consumer Survey of the National Indicators Project (Bershadsky et al., 2014) indicated that ethnicity (White non-Hispanic, Black non-Hispanic, Hispanic) was an important variable in accessing 6 public health preventive programs although the differences dissipated when person characteristics were accounted for. Another study","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"26 1","pages":"171 - 173"},"PeriodicalIF":2.5,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78931003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-02DOI: 10.1080/19315864.2020.1789250
M. Pieterse, J. VanDerNagel, P. T. ten Klooster, A. Turhan, R. Didden
ABSTRACT Introduction Personality traits may predict the use of substances in individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF). The Dutch version of the Substance Use Risk Profile Scale (SURPS), adapted for this population, was tested on its psychometric properties. Method Individuals with MID or BIF (IQ 50–85; N = 91) were recruited via disability care facilities or addiction treatment centers in the Netherlands. Reliability and validity was assessed with confirmatory factor analyses, internal consistency, and correlational analyses. Results The original four-factor structure of the SURPS was supported. Criterion validity was partially supported by associations between substance use and three subscales, and moderation analyses confirmed that these findings are independent of IQ status (MID vs. BIF). Conclusion The Dutch version of the SURPS adapted for individuals with MID-BIF has adequate psychometric properties, and seems suitable for research both within samples of individuals with MID and individuals with BIF.
人格特征可以预测轻度智力障碍(MID)或边缘性智力功能障碍(BIF)患者的物质使用。荷兰版的物质使用风险量表(SURPS)，针对这一人群进行了心理测量特性测试。方法MID或BIF患者(IQ 50-85;N = 91)通过荷兰的残疾护理机构或成瘾治疗中心招募。信度和效度评估采用验证性因子分析、内部一致性和相关分析。结果支持了SURPS原有的四因子结构。物质使用和三个分量表之间的关联部分支持了标准效度，适度分析证实了这些发现与智商状态无关(MID vs. BIF)。结论荷兰版的SURPS适用于MID-BIF个体具有足够的心理测量特性，似乎适用于MID个体和BIF个体的样本研究。
{"title":"Psychometric Qualities of the Dutch Version of the Substance Use Risk Profile Scale Adapted for Individuals with Mild Intellectual Disabilities and Borderline Intellectual Functioning","authors":"M. Pieterse, J. VanDerNagel, P. T. ten Klooster, A. Turhan, R. Didden","doi":"10.1080/19315864.2020.1789250","DOIUrl":"https://doi.org/10.1080/19315864.2020.1789250","url":null,"abstract":"ABSTRACT Introduction Personality traits may predict the use of substances in individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF). The Dutch version of the Substance Use Risk Profile Scale (SURPS), adapted for this population, was tested on its psychometric properties. Method Individuals with MID or BIF (IQ 50–85; N = 91) were recruited via disability care facilities or addiction treatment centers in the Netherlands. Reliability and validity was assessed with confirmatory factor analyses, internal consistency, and correlational analyses. Results The original four-factor structure of the SURPS was supported. Criterion validity was partially supported by associations between substance use and three subscales, and moderation analyses confirmed that these findings are independent of IQ status (MID vs. BIF). Conclusion The Dutch version of the SURPS adapted for individuals with MID-BIF has adequate psychometric properties, and seems suitable for research both within samples of individuals with MID and individuals with BIF.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"180 1","pages":"250 - 266"},"PeriodicalIF":2.5,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76926991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-20DOI: 10.1080/19315864.2020.1760973
R. Ng, K. Heinrich, E. Hodges
ABSTRACT Introduction The primary aim of this retrospective study was to assess differential associations between sleep disturbances with externalizing/internalizing problems, ADHD profiles (inattention, hyperactivity/impulsivity), and social impairment among children with ADHD, autism spectrum disorder (ASD), and comorbid diagnoses (ASD+ADHD). Methods Caregivers of patients with ADHD (N = 28), ASD (N = 29), and ASD+ADHD (N = 57) completed the Child Behavior Checklist, Conners 3rd Edition, and Pediatric Sleep Questionnaire to assess externalizing/internalizing problems, social functioning, ADHD presentations, and sleep disturbances. Results Findings indicated that among the ASD+ADHD group, select sleep factors contributed to 17% of the variance in externalizing problems, 16% in hyperactivity/impulsivity, and 15% in inattention problems, despite controlling for intellectual functioning and stimulant use; whereas no associations were observed among ASD or ADHD groups. Conclusions In brief, sleep may impact behavioral and attention dysregulation more intimately among those with ASD+ADHD, underscoring the need to incorporate sleep screening measures in diagnostic evaluations and in treatment considerations for behavioral dysregulation.
{"title":"Do You Really Lose When You Snooze? Sleep Correlates of Externalizing and Attention Problems Among Pediatric Patients with ADHD, ASD, and Comorbid Diagnosis","authors":"R. Ng, K. Heinrich, E. Hodges","doi":"10.1080/19315864.2020.1760973","DOIUrl":"https://doi.org/10.1080/19315864.2020.1760973","url":null,"abstract":"ABSTRACT Introduction The primary aim of this retrospective study was to assess differential associations between sleep disturbances with externalizing/internalizing problems, ADHD profiles (inattention, hyperactivity/impulsivity), and social impairment among children with ADHD, autism spectrum disorder (ASD), and comorbid diagnoses (ASD+ADHD). Methods Caregivers of patients with ADHD (N = 28), ASD (N = 29), and ASD+ADHD (N = 57) completed the Child Behavior Checklist, Conners 3rd Edition, and Pediatric Sleep Questionnaire to assess externalizing/internalizing problems, social functioning, ADHD presentations, and sleep disturbances. Results Findings indicated that among the ASD+ADHD group, select sleep factors contributed to 17% of the variance in externalizing problems, 16% in hyperactivity/impulsivity, and 15% in inattention problems, despite controlling for intellectual functioning and stimulant use; whereas no associations were observed among ASD or ADHD groups. Conclusions In brief, sleep may impact behavioral and attention dysregulation more intimately among those with ASD+ADHD, underscoring the need to incorporate sleep screening measures in diagnostic evaluations and in treatment considerations for behavioral dysregulation.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"19 1","pages":"231 - 249"},"PeriodicalIF":2.5,"publicationDate":"2020-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86406810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-14DOI: 10.1080/19315864.2020.1760972
A. Kildahl, S. B. Helverschou, T. L. Bakken, H. Oddli
ABSTRACT Introduction Individuals with autism spectrum disorder (ASD) and intellectual disability (ID) seem to be at increased risk for post-traumatic stress disorder (PTSD), but knowledge is sparse regarding its identification in this population. Previous research indicates that certain symptoms of PTSD may be more easily recognized, and that identifying reexperiencing and avoidance is particularly challenging. Methods Interpretative phenomenological analysis was used to explore 18 experienced clinicians’ perceptions of PTSD symptom expression in ASD and ID through individual, qualitative interviews. Results Informants provided examples from all symptom groups, but these differed in how frequently they were described. Recognition of reexperiencing may rely on knowledge about individuals’ trauma experience. Avoidance may present in a wider range of ways. Conclusion Development of reexperiencing and avoidance may follow different trajectories in this population, contributing to challenges in recognition. Reexperiencing may be more severe in ASD/ID. Implications are discussed in light of current diagnostic criteria.
{"title":"“Driven and Tense, Stressed Out and Anxious”: Clinicians’ Perceptions of Post-Traumatic Stress Disorder Symptom Expressions in Adults with Autism and Intellectual Disability","authors":"A. Kildahl, S. B. Helverschou, T. L. Bakken, H. Oddli","doi":"10.1080/19315864.2020.1760972","DOIUrl":"https://doi.org/10.1080/19315864.2020.1760972","url":null,"abstract":"ABSTRACT Introduction Individuals with autism spectrum disorder (ASD) and intellectual disability (ID) seem to be at increased risk for post-traumatic stress disorder (PTSD), but knowledge is sparse regarding its identification in this population. Previous research indicates that certain symptoms of PTSD may be more easily recognized, and that identifying reexperiencing and avoidance is particularly challenging. Methods Interpretative phenomenological analysis was used to explore 18 experienced clinicians’ perceptions of PTSD symptom expression in ASD and ID through individual, qualitative interviews. Results Informants provided examples from all symptom groups, but these differed in how frequently they were described. Recognition of reexperiencing may rely on knowledge about individuals’ trauma experience. Avoidance may present in a wider range of ways. Conclusion Development of reexperiencing and avoidance may follow different trajectories in this population, contributing to challenges in recognition. Reexperiencing may be more severe in ASD/ID. Implications are discussed in light of current diagnostic criteria.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"11 1","pages":"201 - 230"},"PeriodicalIF":2.5,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90044504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-02DOI: 10.1080/19315864.2020.1753267
L. Mevissen, R. Didden, A. de Jongh, H. Korzilius
ABSTRACT Introduction: Persons with mild intellectual disability or borderline intellectual functioning (MID-BIF, IQ 50–85) are at high risk for the development of posttraumatic stress disorder (PTSD). A diagnostic instrument to establish a valid and reliable DSM-5 PTSD diagnosis in adults with MID-BIF was lacking. Aim of the current study was to determine the reliability and validity of the Adapted ADIS-C PTSD-adults for the assessment of PTSD according to DSM-IV-TR and DSM-5 in adults with MID-BIF Method: 106 adults (18– 72 years old) with MID-BIF were interviewed using the Adapted ADIS-C PTSD-adults Results: Agreement between raters appeared to be good (mean Cohen’s kappa for traumatic event scores 0.84, fulfillment of PTSD A-criterion 0.50, and PTSD symptom scores 0.90). Content validity was supported by a significant positive association with scores on the IES-IDs, a DSM-IV PTSD screening instrument (DSM-IV: r = .58; DSM-5: r = .43; ps <.001). Convergent validity appeared to be good considering positive correlations between rates of PTSD symptoms and scores on the ADESS, measuring symptoms of anxiety and stress, depression, and social avoidance (DSM-IV: r = .47; DSM-5: r = .49; ps <.001) Conclusion: The Adapted ADIS-C PTSD-adults is suitable for assessing DSM-5 PTSD in adults with MID-BIF, an important step to gain access to trauma-focused interventions that have shown to be applicable and potentially effective for this high-risk target group.
摘要简介:轻度智力残疾或边缘性智力功能障碍(MID-BIF, IQ 50-85)的患者是创伤后应激障碍(PTSD)的高危人群。缺乏一种诊断工具来建立有效和可靠的DSM-5对成人MID-BIF的PTSD诊断。本研究的目的是根据DSM-IV-TR和DSM-5确定适应性ADIS-C PTSD-成人对中度bif成人PTSD评估的信度和效度。采用适应性ADIS-C PTSD-成人对106例(18 - 72岁)中度bif成人进行了访谈。结果:评分者之间的一致性很好(创伤事件的平均Cohen kappa得分0.84,PTSD a标准的满足程度0.50,PTSD症状得分0.90)。内容效度与DSM-IV PTSD筛查工具ies - id得分呈显著正相关(DSM-IV: r = 0.58;DSM-5: r = 0.43;ps <措施)。考虑到PTSD症状率与ADESS评分、焦虑和压力、抑郁和社交回避症状的测量之间的正相关，收敛效度似乎很好(DSM-IV: r = 0.47;DSM-5: r = 0.49;结论:改编版ADIS-C成人PTSD适用于评估中bif成人的DSM-5 PTSD，这是获得以创伤为重点的干预措施的重要一步，该干预措施已被证明适用于这一高危目标群体并可能有效。
{"title":"Assessing Posttraumatic Stress Disorder in Adults with Mild Intellectual Disabilities or Borderline Intellectual Functioning","authors":"L. Mevissen, R. Didden, A. de Jongh, H. Korzilius","doi":"10.1080/19315864.2020.1753267","DOIUrl":"https://doi.org/10.1080/19315864.2020.1753267","url":null,"abstract":"ABSTRACT Introduction: Persons with mild intellectual disability or borderline intellectual functioning (MID-BIF, IQ 50–85) are at high risk for the development of posttraumatic stress disorder (PTSD). A diagnostic instrument to establish a valid and reliable DSM-5 PTSD diagnosis in adults with MID-BIF was lacking. Aim of the current study was to determine the reliability and validity of the Adapted ADIS-C PTSD-adults for the assessment of PTSD according to DSM-IV-TR and DSM-5 in adults with MID-BIF Method: 106 adults (18– 72 years old) with MID-BIF were interviewed using the Adapted ADIS-C PTSD-adults Results: Agreement between raters appeared to be good (mean Cohen’s kappa for traumatic event scores 0.84, fulfillment of PTSD A-criterion 0.50, and PTSD symptom scores 0.90). Content validity was supported by a significant positive association with scores on the IES-IDs, a DSM-IV PTSD screening instrument (DSM-IV: r = .58; DSM-5: r = .43; ps <.001). Convergent validity appeared to be good considering positive correlations between rates of PTSD symptoms and scores on the ADESS, measuring symptoms of anxiety and stress, depression, and social avoidance (DSM-IV: r = .47; DSM-5: r = .49; ps <.001) Conclusion: The Adapted ADIS-C PTSD-adults is suitable for assessing DSM-5 PTSD in adults with MID-BIF, an important step to gain access to trauma-focused interventions that have shown to be applicable and potentially effective for this high-risk target group.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"35 3 1","pages":"110 - 126"},"PeriodicalIF":2.5,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85767870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-02DOI: 10.1080/19315864.2020.1756080
A. Hassiotis, Afia Ali, A. Courtemanche, Y. Lunsky, L. L. McIntyre, Deborah Napolitamo, J. van der Nagel, S. Werner
Since late January 2020, the world has been trying to deal with the coronavirus pandemic and its impact on populations and societies. Whilst no one is exempt from contracting COVID-19 as a result o...
{"title":"In the Time of the Pandemic: Safeguarding People with Developmental Disabilities against the Impact of Coronavirus","authors":"A. Hassiotis, Afia Ali, A. Courtemanche, Y. Lunsky, L. L. McIntyre, Deborah Napolitamo, J. van der Nagel, S. Werner","doi":"10.1080/19315864.2020.1756080","DOIUrl":"https://doi.org/10.1080/19315864.2020.1756080","url":null,"abstract":"Since late January 2020, the world has been trying to deal with the coronavirus pandemic and its impact on populations and societies. Whilst no one is exempt from contracting COVID-19 as a result o...","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"290 1","pages":"63 - 65"},"PeriodicalIF":2.5,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77502768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-02DOI: 10.1080/19315864.2020.1750742
Elizabeth M. O'Donoghue, D. Pogge, Philip D. Harvey
ABSTRACT Introduction: Features of intellectual disability (ID) and/or autism spectrum disorder (ASD) may hinder responsiveness to interventions typically used during psychiatric hospitalization to manage severely disruptive behavior, and could increase the likelihood of experiencing restraint and/or seclusion (R/S). This study investigated the occurrence of R/S in psychiatrically hospitalized children rated by their treatment team as having ID and/or ASD and those who were rated as having neither. Methods: Pre-adolescents (N = 777; M = 9.71; SD = 2.71; Range 5–12) consecutively admitted to an acute psychiatric hospital during a one-year period were assigned a consensus DSM-5 diagnosis of ID (n = 295), ASD (n = 48), Both (n = 77), or Neither (n = 361). R/S occurrences were recorded in terms of their frequency and duration. Results:52% of patients experienced at least one R/S while hospitalized. The modal number of R/S events for this sample was 0, and for children who experienced any R/S, the mode was 2. Comparisons (ID, ASD, Both, Neither) showed statistically significant differences (p <.001) in R/S events. Children rated as meeting diagnostic criteria for ID (68%; M = 13.9), or Both ID and ASD (78%; M = 18.2), had elevated rates of R/S events compared to cases with Neither diagnosis (35%; M = 7.3). ASD alone (50%; M = 10.0) was not associated with an increase in R/S compared to cases with Neither diagnosis. Data on the duration of these events completely paralleled the frequency results. Conclusion: Children who met DSM-5 criteria for ID had a greater risk of experiencing R/S during psychiatric hospitalization. To reduce the occurrence of R/S, interventions must be refined and staff specially trained to address the complexities of treating children with ID.
{"title":"The Impact of Intellectual Disability and Autism Spectrum Disorder on Restraint and Seclusion in Pre-Adolescent Psychiatric Inpatients","authors":"Elizabeth M. O'Donoghue, D. Pogge, Philip D. Harvey","doi":"10.1080/19315864.2020.1750742","DOIUrl":"https://doi.org/10.1080/19315864.2020.1750742","url":null,"abstract":"ABSTRACT Introduction: Features of intellectual disability (ID) and/or autism spectrum disorder (ASD) may hinder responsiveness to interventions typically used during psychiatric hospitalization to manage severely disruptive behavior, and could increase the likelihood of experiencing restraint and/or seclusion (R/S). This study investigated the occurrence of R/S in psychiatrically hospitalized children rated by their treatment team as having ID and/or ASD and those who were rated as having neither. Methods: Pre-adolescents (N = 777; M = 9.71; SD = 2.71; Range 5–12) consecutively admitted to an acute psychiatric hospital during a one-year period were assigned a consensus DSM-5 diagnosis of ID (n = 295), ASD (n = 48), Both (n = 77), or Neither (n = 361). R/S occurrences were recorded in terms of their frequency and duration. Results:52% of patients experienced at least one R/S while hospitalized. The modal number of R/S events for this sample was 0, and for children who experienced any R/S, the mode was 2. Comparisons (ID, ASD, Both, Neither) showed statistically significant differences (p <.001) in R/S events. Children rated as meeting diagnostic criteria for ID (68%; M = 13.9), or Both ID and ASD (78%; M = 18.2), had elevated rates of R/S events compared to cases with Neither diagnosis (35%; M = 7.3). ASD alone (50%; M = 10.0) was not associated with an increase in R/S compared to cases with Neither diagnosis. Data on the duration of these events completely paralleled the frequency results. Conclusion: Children who met DSM-5 criteria for ID had a greater risk of experiencing R/S during psychiatric hospitalization. To reduce the occurrence of R/S, interventions must be refined and staff specially trained to address the complexities of treating children with ID.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"1 1","pages":"86 - 109"},"PeriodicalIF":2.5,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83168812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-02DOI: 10.1080/19315864.2020.1753268
J. Weise, R. Cvejic, Claire Eagleson, J. Trollor
ABSTRACT Introduction: People with intellectual disability (ID) experience barriers in accessing mental health care. Recommendations have been made to implement specialist intellectual disability mental health (IDMH) services in Australia. However, there is limited evidence to inform service development. Method: Family members and support persons of people with ID (n = 42) completed an on-line survey about support for, and operation of, a tertiary IDMH service in New South Wales, Australia. Results: Participants agreed that a tertiary IDMH service would assist in meeting the needs of people with ID. Key service features included that it be delivered within the public health system, by psychiatrists and psychologists, provide face-to-face clinical contact and advice. Key service areas included behaviors of concern, self-harm, assessments, and interventions. Conclusion: These findings suggest support for a tertiary IDMH service and how it could be delivered. Further research is required from the perspective of people with ID, mental health staff, and clinical experts.
{"title":"A Scoping Study of a Tertiary Intellectual Disability Mental Health Service: A Family Member and Support Person Perspective","authors":"J. Weise, R. Cvejic, Claire Eagleson, J. Trollor","doi":"10.1080/19315864.2020.1753268","DOIUrl":"https://doi.org/10.1080/19315864.2020.1753268","url":null,"abstract":"ABSTRACT Introduction: People with intellectual disability (ID) experience barriers in accessing mental health care. Recommendations have been made to implement specialist intellectual disability mental health (IDMH) services in Australia. However, there is limited evidence to inform service development. Method: Family members and support persons of people with ID (n = 42) completed an on-line survey about support for, and operation of, a tertiary IDMH service in New South Wales, Australia. Results: Participants agreed that a tertiary IDMH service would assist in meeting the needs of people with ID. Key service features included that it be delivered within the public health system, by psychiatrists and psychologists, provide face-to-face clinical contact and advice. Key service areas included behaviors of concern, self-harm, assessments, and interventions. Conclusion: These findings suggest support for a tertiary IDMH service and how it could be delivered. Further research is required from the perspective of people with ID, mental health staff, and clinical experts.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"24 1","pages":"141 - 156"},"PeriodicalIF":2.5,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79783133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-02DOI: 10.1080/19315864.2020.1755918
J. McCarthy, Frances Bahi, Reed J. Welson, Taylor A. Liberta, Lauren M. Lipner, Henry Eff, Jared Band, Baptiste Barbot
ABSTRACT Background: There is no study to date that has examined the association between history of abuse and adaptive functioning deficits in youth with co-occurring and psychotic disorders or mood disorders. Method: This study used a retrospective chart review of 98 youth under the age of 18 (Mean age = 16.06 years) with co-occurring intellectual impairment (Mean IQ = 63.9) and psychotic disorders, mood disorders, or other psychiatric disorders. Using multi-mediation models in the path analytic framework, this study examined the relationships between psychiatric diagnosis (based on DSM-IV criteria), cognitive functioning (Full Scale IQ Scores), adaptive functioning (Socialization, Communication, Motor Skills, Daily Living Skills), and the presence of the history of physical, sexual, and/or emotional abuse/neglect. Results: A very high incidence of all three forms of abuse was present in the study sample, with more than three-quarters of the youth having experienced at least one form of abuse and more than half having experienced two or the three forms of abuse. A history of sexual abuse was significantly and directly associated with an increased incidence of mood disorders. Mood disorders were the strongest predictors of adaptive functioning deficits. Youth with schizophrenia spectrum disorder scored significantly lower in communication skills than those with bipolar disorder. Conclusion: Results are discussed in terms of the need for treatment studies and further investigations of the relationship between childhood maltreatment and adaptive functioning in youth with intellectual impairment and psychiatric disorders.
{"title":"Impact of Mood Disorders, Psychotic Disorders, and Histories of Abuse on Adaptive Functioning Deficits in Adolescents with Intellectual Impairment","authors":"J. McCarthy, Frances Bahi, Reed J. Welson, Taylor A. Liberta, Lauren M. Lipner, Henry Eff, Jared Band, Baptiste Barbot","doi":"10.1080/19315864.2020.1755918","DOIUrl":"https://doi.org/10.1080/19315864.2020.1755918","url":null,"abstract":"ABSTRACT Background: There is no study to date that has examined the association between history of abuse and adaptive functioning deficits in youth with co-occurring and psychotic disorders or mood disorders. Method: This study used a retrospective chart review of 98 youth under the age of 18 (Mean age = 16.06 years) with co-occurring intellectual impairment (Mean IQ = 63.9) and psychotic disorders, mood disorders, or other psychiatric disorders. Using multi-mediation models in the path analytic framework, this study examined the relationships between psychiatric diagnosis (based on DSM-IV criteria), cognitive functioning (Full Scale IQ Scores), adaptive functioning (Socialization, Communication, Motor Skills, Daily Living Skills), and the presence of the history of physical, sexual, and/or emotional abuse/neglect. Results: A very high incidence of all three forms of abuse was present in the study sample, with more than three-quarters of the youth having experienced at least one form of abuse and more than half having experienced two or the three forms of abuse. A history of sexual abuse was significantly and directly associated with an increased incidence of mood disorders. Mood disorders were the strongest predictors of adaptive functioning deficits. Youth with schizophrenia spectrum disorder scored significantly lower in communication skills than those with bipolar disorder. Conclusion: Results are discussed in terms of the need for treatment studies and further investigations of the relationship between childhood maltreatment and adaptive functioning in youth with intellectual impairment and psychiatric disorders.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"31 1","pages":"157 - 170"},"PeriodicalIF":2.5,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83141121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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