Advances in Mental Health and Intellectual Disabilities

Publisher:: Emerald Group Publishing Limited
Publication date:: 2021-02-01

ISBN:: 2044-1282

Issue Number

No. 19-1, December - December - December - December - December - November 2024

Latest documents

Identifying facilitators and barriers associated with caring for individuals with intellectual disability who were at risk of hospital admission
Purpose: This study aims to explore the experiences of professional carers for people with intellectual disabilities who were “at risk” of hospital admission and to identify factors which were helpful or restrictive in the support received from health-care services during this time. Design/methodology/approach: Semi-structured interviews were conducted with eight professional carers from NHS trusts. Data was analysed using thematic analysis. Findings: Three main themes and 11 subthemes were identified. The first theme discusses the processes implemented to facilitate change while the person was at risk of hospital admission. The second theme identifies social and environmental factors increasing risk of hospitalisation. The third theme was the support received by staff. Originality/value: To the best of the authors’ knowledge, this study was the first to gather and analyse data on carer’s experiences in supporting an individual with intellectual disability who is at risk of hospital admission within the locality of Greater Manchester.
Differentiation and co-occurrence of obsessive-compulsive disorder and autism spectrum disorder in people with intellectual developmental disorder: a case series on symptoms specificities
Purpose: In persons with an intellectual developmental disorder, obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) are often difficult to differentiate, particularly when patients present major communication difficulties and low accessibility to subjective symptoms and clinicians are poorly trained in the specific psychopathological phenomenology. OCD and ASD share some important symptoms such as repetitiveness of behaviours, low flexibility to contextual variations or a narrow range of interests. The purpose of this study is to identify and describe symptomatological specificities, including how they manifest at behavioural level. Design/methodology/approach: The present study is a retrospective case series study (n = 3) focusing on in-depth assessment, detection and comprehension of symptomatological specificities as well as on the direct observation of behavioural symptoms. Findings: Some symptoms such as signs of sudden autonomous nervous system activation or behavioural equivalents of obsessive thoughts are crucial in achieving an effective differential or comorbidity diagnosis. These symptoms can be identified through a multidisciplinary and comprehensive evaluation, integrating present clinical and test findings with a thorough developmental and medical history. Symptoms should also be interpreted in the light of antecedent, contextual and personal factors. Originality/value: Differential diagnosis between OCD and ASD in persons with major cognitive and communication issues is a rather neglected research area, although it has significant implications for treatment planning and implementation.
A systematic review of training for mainstream mental health professionals working with people with intellectual disabilities and mental health needs
Purpose: Policy in the UK and many other countries states that mainstream mental health services should be accessible to people with intellectual disabilities (ID). The purpose of this paper is to systematically review training and development needs assessments and delivered training and development for professionals working in mainstream mental health services who may work with people with IQ. Design/methodology/approach: A systematic search of four databases (Web of Science; PsychInfo; PubMed; CINAHL) over the period of 2011–2023 was used. Papers were included if they described training or development delivered to, or specific training or development needs analyses of, mainstream qualified staff to support working with adults who have an ID. Findings: Two papers were found that described training and development initiatives and six that described training and development needs analysis, five of these papers originated from Australia and were part of the development of a comprehensive workforce competency framework. Research limitations/implications: Training and development approaches for mainstream mental health services to facilitate the support of people with IQ should be systematically developed and trialled. Originality/value: To the best of the authors’ knowledge, this is the first study to review training and training needs analysis in this area since 2012. The review finds only a small number of papers in what is an important area for service development.
Mate crime victimization against individuals with intellectual disability
Purpose: Mate crime is a recently coined term in which a perpetrator befriends a vulnerable person to exploit them. The present study aims to investigate this phenomenon by examining mate crime victimization against individuals with intellectual disability in Sarawak, Malaysia. Design/methodology/approach: Data was collected quantitatively from 180 respondents from various governmental and non-government organizations located in Kuching, Kota Samarahan, and Asajaya that provide medical care, residential care, employment opportunities, basic education, rehabilitation, and training for individuals with intellectual disability. Findings: The results showed that majority of the respondents were females (69.4%) between 18 and 28 years old (52.8%). Additionally, most respondents were Malay (48.9%), single (94.4%), diagnosed with mild level of intellectual disability (91.67%), have been victimized by their friends (87.2%) and have known the perpetrators for over five years (68.3%). The result also indicated that a majority of females have experienced mate crime victimization, especially related to emotional abuse [(M = 16.15, SD = 8.16); t(34) = 3.09, p = 0.020] and sexual abuse [(M = 14.01, SD = 7.67); t(38) = 3.29, p = 0.040]. Research limitations/implications: While this study provides valuable insights for place-based evidence on gender differences in the prevalence of self-reported mate crime victimization, it is essential to acknowledge several limitations as well. Firstly, this study is geographically limited to participants from Sarawak (a Malaysian state on the Borneo Island) combined with the use of convenience sampling, which could restrict the generalizability of the findings. However, despite these limitations, the study highlights an important finding – that the victimization of individuals with intellectual disability is not unique to Western contexts or heavily researched regions alone. The results demonstrate that similar vulnerabilities and patterns of abuse exist in underrepresented cultural and societal settings, contributing to a growing recognition that intellectual disability, gender-based vulnerability and the risk of victimization are issues that transcend geographic boundaries. This underscores the need for more research focusing on mate crime victimization in non-Western countries, where such studies are notably scarce. Secondly, the current research is a cross-sectional study that focuses on the emotional and sexual abuse domains alone. Hence, to capture the variations of mate crime experiences among individuals with intellectual disability other domains such as financial abuse and physical abuse should be incorporated in future research. Another significant limitation of this study is its focus on individuals who are already engaged with disability support services. In reality, those who are not connected to such services may be at greater risk of mate crime victimization but remain invisible in the data due to lack of connection/engagement with support systems. This omission limits a comprehensive understanding of the full scope of mate crime victimization against individuals with intellectual disability. It is likely that individuals without access to services are more isolated, face heightened vulnerability and have reduced access to protection and support. Thus, future research should therefore explore strategies to include these underserved individuals, as they represent a crucial yet overlooked population in the study of mate crime victimization. Originality/value: To the best of the author’s knowledge, this is the first research study conducted in Sarawak, Malaysia, that examined mate crime victimization against individuals with intellectual disability. It contributes to the knowledge pool by providing place-based evidence that takes into account mate crime victimization against individuals with intellectual disability in Sarawak, Malaysia, from an Asian perspective to promote the attainment of Sustainable Development Goal 10 (reduced inequalities).
The use of the UKU side effect rating scale for adults with intellectual disabilities in a clinical sample
Purpose: The UKU Side Effect Rating Scale for Adults with Intellectual Disabilities (UKU-SERS-ID) was developed to detect side effects in patients with intellectual disabilities who receive psychotropic medication. The aim of the present study was to examine the frequency and distribution of the side effects of psychotropic medication in persons with intellectual disabilities. Design/methodology/approach: In all, 100 patients receiving in- and outpatient treatment participated in this study. The UKU-SERS-ID, encompassing 34 items, was scored for all participants at two time points. T1 was the baseline rating, and T2 was scored around two to four weeks after starting on new medication. Findings: Mean scores on the psychological side effects scale were found to be substantially higher than on any other scale, especially the items tension/inner unrest and depressed mood. The patients most frequently received antipsychotic medication, as well as a combination of antipsychotic and antidepressants or antianxiety medication. The study sample was highly heterogeneous, and missing baseline information prevented assumptions being made about causality. The analyses revealed no increase or decrease from T1 to T2 for the side effects measured in the study group. Research limitations/implications: Further research is necessary on the association between the side effects and specific groups of psychotropic medication. Practical implications: The UKU-SERS-ID may be a feasible tool in clinical practice on an individual level. Social implications: Monitoring of side effects for patients using psychotropic medication. Originality/value: Studies of side effects from the use of psychotropic medication in people with ID is still sparse. This study may hopefully contribute to an increased interest in this topic.
Exploring the views and experiences of professionals using PBS and emotional development assessment for individuals with an intellectual disability: a case study
Purpose: The purpose of this paper was to investigate the utility of including emotional development (ED) assessment into a Positive Behaviour Support (PBS) approach in clinical practice with a patient with an intellectual disability (ID) and challenging behaviour. Design/methodology/approach: Interviews were conducted with four staff involved in the care of the patient. The interviews were transcribed and analysed using thematic analysis and three reflective sessions were completed with the lead psychologist of the service. Findings: Using thematic analysis, four themes were identified: getting everyone around the table: a collaborative approach, complementary approaches: a feedback loop, helping to make sense of the individual and ensuring a voice for service users. Research limitations/implications: This was a case study selected from routine clinical practice and as such generalisability may be limited. This case study was designed as an exploration of the potential benefits of incorporating ED alongside PBS for ID and provides a basis for future research. Practical implications: This study highlights the value of integration of ED assessment for people with ID and challenging behaviour within a healthcare team. Originality/value: There is a lack of literature relating to ED and challenging behaviour within an ID population, particularly exploring ED within a PBS framework. This study provides a starting point for exploring how practice can be improved through incorporating ED assessment for individuals with ID and challenging behaviour.
Emotional regulation, self-compassion and adaptive functioning in parents: a comparative study in families of neurodevelopmental disorder and typically developing children
Purpose: This study aims to investigate the associations between emotional regulation strategies, self-compassion and adaptive functioning in families of children with neurodevelopmental disorders (NDD) in comparison to families with typically developing (TD) children. Design/methodology/approach: This cross-sectional study used a comprehensive set of validated measures to assess emotional regulation strategies, self-compassion and adaptive functioning. The study cohort consisted of 116 parents; 58 parents of children with NDD and 58 parents of TD children. The mean age of the children was 6.40 years (SD = 1.82). Findings: The findings indicate that higher self-compassion is associated with improved adaptive functioning, evidenced by reduced levels of internalizing (depression, anxiety, withdrawal, somatic complaints) and externalizing (aggressive behaviors) problems. Parents of children with NDD reported greater levels of depression, anxiety and withdrawal compared to parents of TD children. Parents of TD children used cognitive reappraisal more frequently and exhibited higher levels of self-compassion, whereas the use of expressive suppression was more prevalent among parents of children with NDD. Practical implications: These findings highlight the need for family-centered and tailored interventions that promote self-compassion and adaptive emotional regulation strategies to reduce internalizing and externalizing problems among parents of children with NDD. By providing comprehensive psychological support and accessible community resources, parental ability to cope with stress may be improved, fostering adaptive functioning that benefits both parents and children with NDD. Originality/value: This study introduces a novel perspective on the importance of self-compassion and emotional regulation strategies in protecting and improving the mental well-being of parents with neurodevelopmental disorder children. It provides valuable insights for targeted interventions in NDD families, focusing on reducing the risk of mental health deterioration while promoting emotional resilience.
Stigma toward individuals with intellectual disabilities and severe mental disorders: analysis of postgraduate university students’ perceptions
Purpose: The purpose of this study is to delve into societal stigma surrounding severe mental disorders and intellectual disabilities, emphasizing gender differences and students’ proximity influence. Design/methodology/approach: Involving 572 Spanish master’s students, this nonexperimental study categorizes participants based on contact frequency, using Goratu and CAEE questionnaires to measure stigma. Findings: Gender-based stigma differences are absent; however, increased contact correlates with lower stigma levels. Notably, greater closeness is associated with more positive attitudes toward intellectual disability, resulting in diminished stigma toward severe mental disorders. Practical implications: This research sheds light on the pervasive stigma faced by individuals with intellectual disabilities and severe mental disorders among postgraduate university students. Notably, the recognition of widespread stigma among individuals with higher education highlights a more significant societal problem. The findings underscore the urgent need for targeted interventions, especially in higher education contexts, to enhance understanding and reduce societal bias. Social implications: By identifying factors influencing stigma and emphasizing the importance of contact in fostering empathy, the study lays the groundwork for informed socioeducational strategies. These strategies have the potential to promote inclusivity, challenge stereotypes and contribute to the well-being and social integration of those affected by intellectual disabilities and severe mental disorders. Originality/value: The findings highlight the efficacy of direct contact in reducing stigma and underscore the necessity for nuanced understanding. The study suggests fostering positive attitudes through increased contact can combat prejudice and promote social inclusion. Nevertheless, further research is crucial to explore factors influencing stigma reduction and design comprehensive socioeducational interventions addressing diverse cultural proficiencies. This study contributes valuable insights for mitigating stigma, fostering inclusivity and informing future interventions.
Risk factors related to the mental health issues of selected South African adolescent learners living with mild to moderate intellectual difficulties
Purpose: The risk factors related to the mental health issues of adolescents diagnosed with mild to moderate intellectual difficulties (MMID) are not consistently recognised in South Africa. This paper aims to address the scarcity of literature by examining the risk factors linked to the mental health issues of adolescents with MMID. Design/methodology/approach: Four hundred and fourteen participants were sampled from adolescent learners attending three special educational needs schools in Gauteng, South Africa. The selected sample included 275 male and 139 female participants with a median age of 16.5 years. The three schools represented Grade 8 with 177 learners and Grade 9 with 237 learners. Data were collected through a biographical questionnaire and an Adverse Child Experiences Questionnaire. A quantitative approach was used to identify the risk factors impacting the mental health of adolescents with MMID. The findings were used to propose intervention programmes for the support of adolescents diagnosed with MMID. Findings: The findings suggest that risk factors for mental health difficulties issues among adolescents with MMID include family dysfunction, along with experiences of physical, sexual and verbal abuse as well as emotional and physical neglect. The recommendations stemming from the findings advocate empowering teachers, parents and caregivers to provide support for the mental health of learners with MMID. Originality/value: The study makes a valuable contribution to reducing the existing gap in the literature regarding risk factors impacting the mental health of adolescents with MMID in South Africa. The study served as a platform for adolescents diagnosed with MMID to articulate their challenges. This cohort is occasionally marginalised and this research acts as an active contribution to research that focuses on their experiences. Their insights are crucial for enhancing intervention programmes and promoting their overall well-being.
The effectiveness of family-based treatment and pharmacotherapy in an adolescent with anorexia nervosa and intellectual disability: a case report
Purpose: This study aims to report the effectiveness of family based treatment and pharmacotherapy on an adolescent boy with anorexia nervosa and intellectual disability. Design/methodology/approach: The authors reported the case of a 16-year-old boy with AN and ID and referred him to a family therapist and psychiatrist in Tehran. Findings: The patient experienced fatigue, weakness, dissatisfaction, suicidal thoughts and self-harm signs over the past one year. He also had behaviors such as abstinence from eating and voluntary vomiting. He was diagnosed with AN and MDD. Originality/value: The results suggest that these interventions can be effective but should be used with special consideration. Combining family therapy and pharmacotherapy might offer a chance to alleviate anorexia symptoms in people with ID.