Pub Date : 2022-04-22eCollection Date: 2022-01-01DOI: 10.1080/19315864.2022.2061092
Maureen B G Wissing, Andrea S Fokkens, Roos Dijkstra, Johannes S M Hobbelen, Annette A J van der Putten, Peter P De Deyn, Aly Waninge, Alain D Dekker
Introduction: Observable dementia symptoms are hardly studied in people with severe/profound intellectual (and multiple) disabilities (SPI(M)D). Insight in symptomatology is needed for timely signaling/diagnosis. This study aimed to identify practice-based observations of dementia symptoms in this population.
Methods: Care professionals and family members were invited to complete a survey about symptoms. Quantitatively analyzed survey data were further deepened through semi-structured interviews with care professionals having vast experience in signaling/diagnosing dementia in this population. Symptoms were categorized using a symptom matrix.
Results: Survey respondents and interviewees frequently observed a decline in activities of daily living (ADL) functioning and behavioral and psychological changes, like increased irritability, anxiety, apathy and decreased eating/drinking behavior. Cognitive symptoms were particularly recognized in persons with verbal communication and/or walking skills. To lesser extent motor changes and medical comorbidities were reported.
Conclusion: Increased insight in dementia symptoms contributes to developing a dedicated screening instrument for dementia in people with SPI(M)D.
{"title":"Dementia in People with Severe/Profound Intellectual (and Multiple) Disabilities: Practice-Based Observations of Symptoms.","authors":"Maureen B G Wissing, Andrea S Fokkens, Roos Dijkstra, Johannes S M Hobbelen, Annette A J van der Putten, Peter P De Deyn, Aly Waninge, Alain D Dekker","doi":"10.1080/19315864.2022.2061092","DOIUrl":"https://doi.org/10.1080/19315864.2022.2061092","url":null,"abstract":"<p><strong>Introduction: </strong>Observable dementia symptoms are hardly studied in people with severe/profound intellectual (and multiple) disabilities (SPI(M)D). Insight in symptomatology is needed for timely signaling/diagnosis. This study aimed to identify practice-based observations of dementia symptoms in this population.</p><p><strong>Methods: </strong>Care professionals and family members were invited to complete a survey about symptoms. Quantitatively analyzed survey data were further deepened through semi-structured interviews with care professionals having vast experience in signaling/diagnosing dementia in this population. Symptoms were categorized using a symptom matrix.</p><p><strong>Results: </strong>Survey respondents and interviewees frequently observed a decline in activities of daily living (ADL) functioning and behavioral and psychological changes, like increased irritability, anxiety, apathy and decreased eating/drinking behavior. Cognitive symptoms were particularly recognized in persons with verbal communication and/or walking skills. To lesser extent motor changes and medical comorbidities were reported.</p><p><strong>Conclusion: </strong>Increased insight in dementia symptoms contributes to developing a dedicated screening instrument for dementia in people with SPI(M)D.</p>","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"15 4","pages":"364-393"},"PeriodicalIF":2.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33492005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-03DOI: 10.1080/19315864.2022.2029647
Jonathan Ee, B. Stenfert Kroese, J. Rose
ABSTRACT Introduction This research investigated the views of different stakeholders regarding the specialist mental health service for people with intellectual disabilities (ID) in Singapore. Method Interviews were conducted with mental health professionals, family carers and service users with ID. Framework analysis was adopted to identify common dominant themes among the different participant groups. Results Analysis revealed four themes 1) Giving choice and autonomy; 2) Training to become competent; 3) Respect and 4) Part of the community Conclusions People with ID living in Singapore have limited opportunities to express their choices and autonomy especially when it comes to treatment planning. Family carers have a significant influence on the level of community presence of their relatives with ID. Participants identified employment for people with ID as a way to improve public perceptions. There was no mention of people with ID developing social relationships. Recommendations are discussed in the context of current service provision.
{"title":"Specialist Mental Health Services for People with Intellectual Disabilities in Singapore - What Do Stakeholders Think of Them and How Do They Relate to Service Accomplishments?","authors":"Jonathan Ee, B. Stenfert Kroese, J. Rose","doi":"10.1080/19315864.2022.2029647","DOIUrl":"https://doi.org/10.1080/19315864.2022.2029647","url":null,"abstract":"ABSTRACT Introduction This research investigated the views of different stakeholders regarding the specialist mental health service for people with intellectual disabilities (ID) in Singapore. Method Interviews were conducted with mental health professionals, family carers and service users with ID. Framework analysis was adopted to identify common dominant themes among the different participant groups. Results Analysis revealed four themes 1) Giving choice and autonomy; 2) Training to become competent; 3) Respect and 4) Part of the community Conclusions People with ID living in Singapore have limited opportunities to express their choices and autonomy especially when it comes to treatment planning. Family carers have a significant influence on the level of community presence of their relatives with ID. Participants identified employment for people with ID as a way to improve public perceptions. There was no mention of people with ID developing social relationships. Recommendations are discussed in the context of current service provision.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"66 1","pages":"130 - 150"},"PeriodicalIF":2.5,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80622831","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 : 2022-03-17DOI: 10.1080/19315864.2022.2047845
B. Redquest, Lachina McKenzie, J. Lake, K. Fung, Y. Lunsky
ABSTRACT Introduction Caregivers of autistic children and caregivers of children with fetal alcohol spectrum disorder (FASD) experience considerable stress. However, what is unique or similar across these groups remains understudied. This study explored how female caregivers of children with FASD who registered to participate in a caregiver focused mental health intervention differed from female caregivers of autistic children participating in a similar intervention. Methods Prior to the intervention, caregivers of children with FASD (n = 21), and caregivers of autistic children (n = 22) were asked to complete an online baseline questionnaire. This questionnaire collected information pertaining to caregiver and child demographics, as well as clinical characteristics related to wellbeing, values, and what caregivers identified as rewarding and challenging about raising their child. Results Results identified similarities across caregiver groups in terms of wellbeing, values, and the challenges and rewards they identified with raising their children. Conclusions Given the similarities in these two caregiver groups, and the shortage of research on families of people with FASD relative to families of autistic people, interventions for family caregivers in the autism community may also be applicable for FASD families, for whom fewer resources are available.
{"title":"A Comparison of the Demographic and Clinical Characteristics of Caregivers of Autistic Children and Caregivers of Children with Fetal Alcohol Spectrum Disorder","authors":"B. Redquest, Lachina McKenzie, J. Lake, K. Fung, Y. Lunsky","doi":"10.1080/19315864.2022.2047845","DOIUrl":"https://doi.org/10.1080/19315864.2022.2047845","url":null,"abstract":"ABSTRACT Introduction Caregivers of autistic children and caregivers of children with fetal alcohol spectrum disorder (FASD) experience considerable stress. However, what is unique or similar across these groups remains understudied. This study explored how female caregivers of children with FASD who registered to participate in a caregiver focused mental health intervention differed from female caregivers of autistic children participating in a similar intervention. Methods Prior to the intervention, caregivers of children with FASD (n = 21), and caregivers of autistic children (n = 22) were asked to complete an online baseline questionnaire. This questionnaire collected information pertaining to caregiver and child demographics, as well as clinical characteristics related to wellbeing, values, and what caregivers identified as rewarding and challenging about raising their child. Results Results identified similarities across caregiver groups in terms of wellbeing, values, and the challenges and rewards they identified with raising their children. Conclusions Given the similarities in these two caregiver groups, and the shortage of research on families of people with FASD relative to families of autistic people, interventions for family caregivers in the autism community may also be applicable for FASD families, for whom fewer resources are available.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"194 1","pages":"151 - 167"},"PeriodicalIF":2.5,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76059312","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 : 2022-03-14DOI: 10.1080/19315864.2022.2047844
Nicola Gregson, Catherine Randle-Phillips, C. Delaney
ABSTRACT Introduction People with learning disabilities (PWLD) have been disproportionately impacted by the Covid-19 pandemic, with reports of significant impacts on psychological wellbeing. Services that support PWLD in the UK have had to make significant adaptations, however there is limited research into the perceptions and impact of these changes. This exploratory study aims to investigate the experiences of psychologists working in UK learning disability services throughout the pandemic, to explore service delivery, impact on the psychological wellbeing of PWLD, and the implications from this going forward. Methods Twelve psychologists were interviewed, and thematic analysis was used to explore patterns and themes. Results Three superordinate themes were identified. ‘Delivering Psychological Services’ contained five subordinate themes: ‘Context,’ ‘Accessibility and Acceptability,’ ‘Professional Identity,’ ‘Living the Pandemic’ and ‘Team Connection.’ ‘Wellbeing of PWLD’ contained three subordinate themes: ‘Same Storm Different Boat,’ ‘Continued Inequality’ and ‘Resilience and Re-Evaluation.’ ‘Learning and Future Practice’ contained three subordinate themes: ‘Inclusion,’ ‘Choice and Connection’ and ‘Workforce Wellbeing.’ Conclusion Findings conclude that although a time of immense challenge and loss, the pandemic has triggered significant re-thinking and learning within services. With inequality still evident for PWLD, an emphasis on future services carefully considering potential disadvantage by over-digitization of services is key. There is hope that future psychological services can be offered with more choice and flexibility. Staff wellbeing, compassionate leadership and reestablishing team connections is essential in the new landscape of services. Recommendation, practical implications, and future research directions are discussed.
{"title":"Delivering Psychological Services for People with Learning Disabilities during the Covid-19 Pandemic: The Experiences of Psychologists in the UK","authors":"Nicola Gregson, Catherine Randle-Phillips, C. Delaney","doi":"10.1080/19315864.2022.2047844","DOIUrl":"https://doi.org/10.1080/19315864.2022.2047844","url":null,"abstract":"ABSTRACT Introduction People with learning disabilities (PWLD) have been disproportionately impacted by the Covid-19 pandemic, with reports of significant impacts on psychological wellbeing. Services that support PWLD in the UK have had to make significant adaptations, however there is limited research into the perceptions and impact of these changes. This exploratory study aims to investigate the experiences of psychologists working in UK learning disability services throughout the pandemic, to explore service delivery, impact on the psychological wellbeing of PWLD, and the implications from this going forward. Methods Twelve psychologists were interviewed, and thematic analysis was used to explore patterns and themes. Results Three superordinate themes were identified. ‘Delivering Psychological Services’ contained five subordinate themes: ‘Context,’ ‘Accessibility and Acceptability,’ ‘Professional Identity,’ ‘Living the Pandemic’ and ‘Team Connection.’ ‘Wellbeing of PWLD’ contained three subordinate themes: ‘Same Storm Different Boat,’ ‘Continued Inequality’ and ‘Resilience and Re-Evaluation.’ ‘Learning and Future Practice’ contained three subordinate themes: ‘Inclusion,’ ‘Choice and Connection’ and ‘Workforce Wellbeing.’ Conclusion Findings conclude that although a time of immense challenge and loss, the pandemic has triggered significant re-thinking and learning within services. With inequality still evident for PWLD, an emphasis on future services carefully considering potential disadvantage by over-digitization of services is key. There is hope that future psychological services can be offered with more choice and flexibility. Staff wellbeing, compassionate leadership and reestablishing team connections is essential in the new landscape of services. Recommendation, practical implications, and future research directions are discussed.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"79 1","pages":"168 - 196"},"PeriodicalIF":2.5,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80996399","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 : 2022-02-27DOI: 10.1080/19315864.2022.2029644
Noemi Schoop-Kasteler, V. Hofmann, A. Cillessen, C. Müller
ABSTRACT Introduction Individual social status among peers (i.e., acceptance and rejection) has important implications for students’ social and academic development. The present study investigates the role of individual problem behavior and classroom norms in the development of acceptance and rejection among students with intellectual disabilities (ID) in special needs schools. Methods School staff reported on problem behavior and social status of 1125 students with ID (M = 11.26 years, SD = 3.76; 31% female) in special needs schools at the beginning and end of a school year. Results More individual problem behavior at the beginning of the year predicted students’ lower acceptance and greater rejection at the end of the year, controlling for earlier problem behavior and other variables. The effect of problem behavior was independent of the prevailing classroom norms. Conclusion Our findings show that behavioral problems pose a risk for social exclusion of students with ID among their peers in special needs settings.
{"title":"Social Status of Students with Intellectual Disabilities in Special Needs Schools: The Role of Students’ Problem Behavior and Descriptive Classroom Norms","authors":"Noemi Schoop-Kasteler, V. Hofmann, A. Cillessen, C. Müller","doi":"10.1080/19315864.2022.2029644","DOIUrl":"https://doi.org/10.1080/19315864.2022.2029644","url":null,"abstract":"ABSTRACT Introduction Individual social status among peers (i.e., acceptance and rejection) has important implications for students’ social and academic development. The present study investigates the role of individual problem behavior and classroom norms in the development of acceptance and rejection among students with intellectual disabilities (ID) in special needs schools. Methods School staff reported on problem behavior and social status of 1125 students with ID (M = 11.26 years, SD = 3.76; 31% female) in special needs schools at the beginning and end of a school year. Results More individual problem behavior at the beginning of the year predicted students’ lower acceptance and greater rejection at the end of the year, controlling for earlier problem behavior and other variables. The effect of problem behavior was independent of the prevailing classroom norms. Conclusion Our findings show that behavioral problems pose a risk for social exclusion of students with ID among their peers in special needs settings.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"22 1","pages":"67 - 91"},"PeriodicalIF":2.5,"publicationDate":"2022-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81279934","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 : 2022-02-07DOI: 10.1080/19315864.2022.2029641
C. Peña-Salazar, F. Arrufat, Josep-Manel Santos López, Abel Fontanet, P. Roura-Poch, M. Gil-Girbau, Cristina Carbonell-Ducastella, A. Serrano-Blanco
ABSTRACT Background The purpose of this study was to assess the prevalence of unknown comorbid mental disorders in individuals with mild/moderate intellectual disability (ID) with/without autism spectrum disorders (ASD) and to compare the severity of challenging behavior with respect to the comorbidity of ASD and comorbid psychiatric disorders. Methods This is a cross-sectional study of 91 adults with mild or moderate ID with no previous psychiatric diagnosis (except ASD). The assessment tools were the PAS-ADD checklist, Mini-PAS-ADD, PAS-ADD clinical interview and the Inventory for Client and Agency Planning (ICAP). Results A previously undiagnosed mental disorder was found in 23.81% of the individuals with ID and ASD and in 10.20% of the individuals without. The most prevalent mental disorder was major depressive disorder. An association between psychiatric comorbidity and challenging behavior was found in people with ID and ASD. Conclusions The prevalence of underdiagnosed mental disorders in individuals with ASD and ID is high and is associated with challenging behavior.
{"title":"Intellectual Disability, Autism Spectrum Disorders, Psychiatric Comorbidities and Their Relationship with Challenging Behavior","authors":"C. Peña-Salazar, F. Arrufat, Josep-Manel Santos López, Abel Fontanet, P. Roura-Poch, M. Gil-Girbau, Cristina Carbonell-Ducastella, A. Serrano-Blanco","doi":"10.1080/19315864.2022.2029641","DOIUrl":"https://doi.org/10.1080/19315864.2022.2029641","url":null,"abstract":"ABSTRACT Background The purpose of this study was to assess the prevalence of unknown comorbid mental disorders in individuals with mild/moderate intellectual disability (ID) with/without autism spectrum disorders (ASD) and to compare the severity of challenging behavior with respect to the comorbidity of ASD and comorbid psychiatric disorders. Methods This is a cross-sectional study of 91 adults with mild or moderate ID with no previous psychiatric diagnosis (except ASD). The assessment tools were the PAS-ADD checklist, Mini-PAS-ADD, PAS-ADD clinical interview and the Inventory for Client and Agency Planning (ICAP). Results A previously undiagnosed mental disorder was found in 23.81% of the individuals with ID and ASD and in 10.20% of the individuals without. The most prevalent mental disorder was major depressive disorder. An association between psychiatric comorbidity and challenging behavior was found in people with ID and ASD. Conclusions The prevalence of underdiagnosed mental disorders in individuals with ASD and ID is high and is associated with challenging behavior.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"49 1","pages":"77 - 94"},"PeriodicalIF":2.5,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82832565","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 : 2022-02-03DOI: 10.1080/19315864.2022.2029642
J. Scheirs, A. Muller, N. Manders, C. D. van der Zanden
ABSTRACT Introduction Estimates of the prevalence of depression in people with intellectual disability range from almost nonexistent to 39%. We analyzed the outcomes of three screening instruments to find out more about the prevalence in people with mild or borderline disability. Methods 102 Dutch individuals residing in institutions or living independently took part. The Beck Depression Inventory, the Glasgow Depression Scale and the Signaallijst Depressie voor Zwakzinnigen were used. Results Using the standard cutoff values, the numbers of people identified as depressed by the tests were 31%, 44%, and 22%, respectively. These were high numbers, and they did not refer to the same cases. When scoring above cutoff on all three tests simultaneously was the criterion, 13.7% of the participants were identified as depressed. Conclusion The combined use of several measuring instruments taught us that depression in people with intellectual disabilities might occur more frequently than often assumed: 13.7% might be the lower limit of its actual prevalence. People in this group still run the risk of being underdiagnosed.
{"title":"The Prevalence and Diagnosis of Depression in People with Mild or Borderline Intellectual Disability: Multiple Instrument Testing Tells Us More","authors":"J. Scheirs, A. Muller, N. Manders, C. D. van der Zanden","doi":"10.1080/19315864.2022.2029642","DOIUrl":"https://doi.org/10.1080/19315864.2022.2029642","url":null,"abstract":"ABSTRACT Introduction Estimates of the prevalence of depression in people with intellectual disability range from almost nonexistent to 39%. We analyzed the outcomes of three screening instruments to find out more about the prevalence in people with mild or borderline disability. Methods 102 Dutch individuals residing in institutions or living independently took part. The Beck Depression Inventory, the Glasgow Depression Scale and the Signaallijst Depressie voor Zwakzinnigen were used. Results Using the standard cutoff values, the numbers of people identified as depressed by the tests were 31%, 44%, and 22%, respectively. These were high numbers, and they did not refer to the same cases. When scoring above cutoff on all three tests simultaneously was the criterion, 13.7% of the participants were identified as depressed. Conclusion The combined use of several measuring instruments taught us that depression in people with intellectual disabilities might occur more frequently than often assumed: 13.7% might be the lower limit of its actual prevalence. People in this group still run the risk of being underdiagnosed.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"59 1","pages":"54 - 66"},"PeriodicalIF":2.5,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88689797","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 : 2022-01-26DOI: 10.1080/19315864.2022.2029643
S. Mayes, R. Baweja, D. Waschbusch, S. Calhoun
ABSTRACT Introduction Findings regarding the relationship between IQ and comorbidity in autism and ADHD are inconsistent. Methods Mothers rated 1,436 children with autism and 1,056 with ADHD without autism (IQs 9–149, ages 2–17) on the Pediatric Behavior Scale. Results Children with IQs < 70 (vs. ≥ 70) had less oppositional behavior, irritability, tantrums, conduct problems, generalized anxiety, and depression and more separation anxiety. Children with ADHD-Inattentive had less comorbidity than children with autism and children with ADHD-Combined. For autism, 80% had ADHD-Combined symptoms and 9% had ADHD-Inattentive symptoms. Most children with autism and with ADHD-Combined with IQs ≥ 70 had oppositional defiant disorder, as did almost half with IQs < 70. For autism, 45% with IQs ≥ 70 had generalized anxiety and 47% with IQs < 70 had separation anxiety. Conclusions Given high rates of comorbid symptoms in autism and ADHD, clinicians should be alert to and assess for psychiatric comorbidity.
{"title":"Relationship between IQ and Internalizing and Externalizing Symptoms in Children with Autism and Children with ADHD","authors":"S. Mayes, R. Baweja, D. Waschbusch, S. Calhoun","doi":"10.1080/19315864.2022.2029643","DOIUrl":"https://doi.org/10.1080/19315864.2022.2029643","url":null,"abstract":"ABSTRACT Introduction Findings regarding the relationship between IQ and comorbidity in autism and ADHD are inconsistent. Methods Mothers rated 1,436 children with autism and 1,056 with ADHD without autism (IQs 9–149, ages 2–17) on the Pediatric Behavior Scale. Results Children with IQs < 70 (vs. ≥ 70) had less oppositional behavior, irritability, tantrums, conduct problems, generalized anxiety, and depression and more separation anxiety. Children with ADHD-Inattentive had less comorbidity than children with autism and children with ADHD-Combined. For autism, 80% had ADHD-Combined symptoms and 9% had ADHD-Inattentive symptoms. Most children with autism and with ADHD-Combined with IQs ≥ 70 had oppositional defiant disorder, as did almost half with IQs < 70. For autism, 45% with IQs ≥ 70 had generalized anxiety and 47% with IQs < 70 had separation anxiety. Conclusions Given high rates of comorbid symptoms in autism and ADHD, clinicians should be alert to and assess for psychiatric comorbidity.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"101 1","pages":"95 - 110"},"PeriodicalIF":2.5,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72519397","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 : 2022-01-26DOI: 10.1080/19315864.2022.2029645
Katrin Müller, A. Helmes, Annika Kleischmann, J. Bengel
ABSTRACT Introduction Adults with intellectual disabilities (ID) face a high risk of developing psychiatric disorders, yet there is a lack of valid instruments measuring psychopathology in this population. Two existing instruments are the PAS-ADD Checklist questionnaire and the Mini PAS-ADD interview, two third-party assessments that can be used for the purpose of screening. Methods German versions of the PAS-ADD Checklist and the Mini PAS-ADD were performed on 78 and 55 adults with ID, respectively. Internal consistency, sensitivity, and specificity were calculated for both instruments and the convergent validity of the two tools was tested. Results Cronbach’s alphas of the Checklist’s scales and the total score were questionable (alpha over 0.6), except for a very low alpha for Organic Condition (0.34). For the scales of the Mini PAS-ADD, Cronbach’s alpha varied between 0.34 (Unspecified Disorder) and 0.72 (Psychosis). Using current clinical diagnoses as a reference, sensitivity was rather poor in both instruments, with a case identification of 52% each. Specificity was 70% for the Checklist and 100% for the Mini PAS-ADD. The correlation between the tools was low to moderate (Spearman’s ρ = 0.32, Kendall’s τ = 0.22). Applying the available thresholds, the instruments resulted in the same conclusion about the possible occurrence of psychopathology in only 52.7% of the cases. Discussion The PAS-ADD Checklist and the Mini PAS-ADD are feasible third-party instruments for the assessment of psychiatric disorders in people with ID. Professionals must be aware of the low sensitivity of both tools, meaning that a referral to further assessment should not be based on the thresholds alone. More research is needed as to the adjustment of the thresholds, the suitability of the unusual scoring system and the additional development of self-report instruments.
{"title":"Assessing Psychiatric Symptomatology in Adults with Intellectual Disabilities: Psychometric Properties of German Versions of the PAS-ADD Checklist and the Mini PAS-ADD","authors":"Katrin Müller, A. Helmes, Annika Kleischmann, J. Bengel","doi":"10.1080/19315864.2022.2029645","DOIUrl":"https://doi.org/10.1080/19315864.2022.2029645","url":null,"abstract":"ABSTRACT Introduction Adults with intellectual disabilities (ID) face a high risk of developing psychiatric disorders, yet there is a lack of valid instruments measuring psychopathology in this population. Two existing instruments are the PAS-ADD Checklist questionnaire and the Mini PAS-ADD interview, two third-party assessments that can be used for the purpose of screening. Methods German versions of the PAS-ADD Checklist and the Mini PAS-ADD were performed on 78 and 55 adults with ID, respectively. Internal consistency, sensitivity, and specificity were calculated for both instruments and the convergent validity of the two tools was tested. Results Cronbach’s alphas of the Checklist’s scales and the total score were questionable (alpha over 0.6), except for a very low alpha for Organic Condition (0.34). For the scales of the Mini PAS-ADD, Cronbach’s alpha varied between 0.34 (Unspecified Disorder) and 0.72 (Psychosis). Using current clinical diagnoses as a reference, sensitivity was rather poor in both instruments, with a case identification of 52% each. Specificity was 70% for the Checklist and 100% for the Mini PAS-ADD. The correlation between the tools was low to moderate (Spearman’s ρ = 0.32, Kendall’s τ = 0.22). Applying the available thresholds, the instruments resulted in the same conclusion about the possible occurrence of psychopathology in only 52.7% of the cases. Discussion The PAS-ADD Checklist and the Mini PAS-ADD are feasible third-party instruments for the assessment of psychiatric disorders in people with ID. Professionals must be aware of the low sensitivity of both tools, meaning that a referral to further assessment should not be based on the thresholds alone. More research is needed as to the adjustment of the thresholds, the suitability of the unusual scoring system and the additional development of self-report instruments.","PeriodicalId":45864,"journal":{"name":"Journal of Mental Health Research in Intellectual Disabilities","volume":"1 1","pages":"111 - 129"},"PeriodicalIF":2.5,"publicationDate":"2022-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89801829","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 : 2021-12-10DOI: 10.1080/19315864.2021.1992549
Catherine Walton, D. Medhurst, G. Madhavan, R. Shankar
ABSTRACT Background 1 1. please could you change corrresponding author email from rohit.shankar@nhs.net to rohit.shankar@plymouth.ac.uk People with mild intellectual disability (ID) experience a higher prevalence of mental health (MH) problems in comparison to the general population, yet there is little consensus on the most appropriate type and nature of services for support and treatment for this specific group of individuals. Objective The objective of this scoping review is to explore the current evidence for the organization, structure, and delivery of mental health services for people with mild ID. Methods The PRISMA-SCr (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist was followed. Online databases were used to identify systematic reviews, meta-analyses, scoping reviews, or guidelines published between 2003 and 2020. Articles were reviewed using Roever & Zoccai criteria for critical appraisal of systematic reviews and meta-analyses. Results 130 records were identified, of which 91 were longlisted. Of these, 28 articles were shortlisted after review of abstracts prior to review of full-text papers. The review included 11 studies: one meta-analysis, eight systematic reviews, and two scoping reviews. These studies approached the provision of mental health services for individuals with mild ID from various angles – including service organization and access, therapies, and patient feedback. Conclusions According to the Roever & Zoccai criteria, there was a lack of high-quality evidence, which limited the findings and conclusions. The available evidence suggested that despite higher levels of psychopathology there is not a corresponding consideration in care for individuals with mild ID in general psychiatric services. There was no conclusive evidence on better level of services or outcomes being provided either by the general psychiatric services or specialist ID psychiatric services. Some evidence was found for intensive case management and assertive outreach for individuals with mild ID, but this was not replicated in further studies. In terms of treatment, there was no high-quality evidence found for pharmacological interventions, with some limited evidence around psychological therapy for the treatment of depression in this vulnerable population. Overall, it was found that an increase in staff training would be beneficial in terms of timely access to services and appropriate treatment. There is a need for inclusive, evidence-based guidance as regards service development for people with mild ID and MH problems. Abbreviations: ID: intellectual disability; MH: mental health; CBT: Cognitive Behavioral Therapy; RCT: randomized controlled trial; ACT: assertive community treatment; ECT: electroconvulsive therapy
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