Developmental trauma in a forensic intellectual disability population

Published date27 November 2019
DOIhttps://doi.org/10.1108/JIDOB-06-2019-0011
Date27 November 2019
Pages35-48
AuthorDeborah J. Morris,Shubhinder Shergill,Elizabeth Beber
Subject MatterHealth & social care,Learning & intellectual disabilities,Offending behaviour,Sociology,Sociology of crime & law,Deviant behaviour,Education,Special education/gifted education,Emotional/behavioural disorders
Developmental trauma in a forensic
intellectual disability population
Deborah J. Morris, Shubhinder Shergill and Elizabeth Beber
Abstract
Purpose People with an intellectual disability (ID) are more at risk of experiencing adversechildhood
events. Moreover, prolonged exposure to ACEs results in enduring changes and impairments in
neurological, physiological and psycho-social systemsand functioning. In response, van der Kolk et al.
(2009) have putforward the concept of developmental traumadisorder (DTD) to reflect the ‘‘constellation
of enduring symptoms’’ and complex care needs of this population. The purpose of this paper is to
ascertain the level of exposure to adverse childhood events and the prevalence of DTD in an inpatient
forensicID population.
Design/methodology/approach A retrospective file review and consensus approach to diagnosis
were usedin a sampleof adults with an ID detained in a secure forensic service.
Findings Results revealed that 89 admissions(N¼123) had been exposed to at least one significant
ACE, with 81 being exposed to prolongedACEs. A total of 58 admissions (47 per cent) met criteria for
PTSD and 80 (65 per cent) met the criteria for DTD. Significant gender differences were noted in MHA
status,primary psychiatric diagnoses, exposureto ACEs and DTD.
Research limitations/implications The discussionexplores the implications for workingwith forensic
ID populationswho report high incidents of childhood trauma and the utility,strengths and weaknesses of
the proposedDTD, its relationship to ID diagnoses is explored.
Originality/value The study outlines the prevalenceof DTD and PTSD in ID forensic populations and
suggestsadditional key assessment and treatmentneeds for this population.
Keywords PTSD, Intellectual disability, Forensic, Adult, Adverse childhood events,
Developmental trauma disorder
Paper type Research paper
Introduction
Adolescents and adults within the criminal justice system are significantly more likely to
have experienced adversity and trauma in childhood (Ardino, 2012). The overlap between
early victimisation, offending behaviour and the enduring constellation of negative
outcomes this population experiences has led to significant interest in understanding the
impact of Adverse Childhood Experiences(ACEs).
ACEs are harmful events that include, experiencing or witnessing violence, emotional and
sexual abuse, neglect, being exposed to criminogenic behaviour, alcohol dependency or
substance misuse in primary carers and care giver disruption. Whilst the majority of
research exploring ACEs has been conducted in the non-intellectual disability (ID)
population, evidence suggests that people with an ID are more at risk of experiencing
ACEs.
Children with an ID are significantly more at risk of experiencing physical, verbal and sexual
violence (Jones et al.,2012), emotional abuse (Sullivan and Knutson, 2000) and neglect
(Miller and Brown, 2014) than children without an ID. They experience significantly more
disruptions in attachment and care giver bonding as they are less likely to remain with their
Deborah J. Morris is based
at Academic Centre and
Research Centre, St
Andrews Healthcare,
Northampton, UK.
Shubhinder Shergill is
based at PICU Integrated
Practice Unit, St Andrews
Healthcare, Northampton,
UK. Elizabeth Beber is
based at St Andrews
Healthcare, Northampton,
UK.
Received 4 June 2019
Revised 9 September 2019
22 October 2019
Accepted 25 October 2019
DOI 10.1108/JIDOB-06-2019-0011 VOL. 11 NO. 1 , pp. 35-48, ©Emerald Publishing Limited, ISSN 2050-8824 jJOURNAL OF INTELLECTUAL DISABILITIES AND OFFENDING BEHAVIOUR jPAGE 35

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