PTSD in adults with intellectual disabilities: stabilisation during inpatient stay
| Pages | 237-247 |
| Date | 02 July 2014 |
| DOI | https://doi.org/10.1108/AMHID-10-2013-0061 |
| Published date | 02 July 2014 |
| Author | Trine Lise Bakken,Vibeke Gjersoe,Espen Matre,Tone Kristiansen,Arvid Ro,Anne Louise Tveter,Siv Helene Hoeidal,Arvid Nikolai Kildahl |
| Subject Matter | Health & social care,Learning & intellectual disabilities,Accounting education |
PTSD in adults with intellectual disabilities:
stabilisation during inpatient stay
Trine Lise Bakken, Vibeke Gjersoe, Espen Matre, Tone Kristiansen, Arvid Ro,
Anne Louise Tveter, Siv Helene Hoeidal and Arvid Nikolai Kildahl
Vibeke Gjersoe, Espen Matre,
Tone Kristiansen,
Arvid Ro and Siv Helene
Hoeidal all are based at
Psychiatric Department for
Persons with Intellectual
Disabilities, Oslo University
Hospital, Oslo, Norway, where
Trine Lise Bakken is a
Researcher, Anne Louise Tveter
is a Researcher/Consultant and
Arvid NikolaiKildahl is a
Psychologist.
Abstract
Purpose – The purpose of this paper is to describe and discuss interventions of stabilisation of emotions
and behaviour in adults with post-traumatic stress disorder (PTSD). This topic is understudied in persons
with intellectual disability.
Design/methodology/approach – The aim of this study was to investigate interventions of stabilisation in
persons with more severe intellectual disability; i.e. persons with moderate or severe intellectual disabilities.
Five patients in a specialised psychiatric inpatient unit for patients with intellectual disabilities were included.
Information about treatment of the patients was collected through case files, observations, and interviews.
The authors of this paper followed a training programme for trauma therapists in addition to the inpatient
treatment of the five patients.
Findings – Six main areas of stabilisation of emotions and behaviour were identified: validation, anxiety
relief, treatment of depressed mood, increased mastering of daily activities, protection against anxiety
triggers, and facilitated staff communication. Protection from anxiety triggers seems to be a core element
of milieu therapy interventions. Interventions for neurotypical PTSD patients, such as exposure therapy may
be contraindicated for patients with more severe intellectual disabilities.
Originality/value – Research on interventions of stabilisation towards adults with more severe intellectual
disabilities is still in its infancy. The case reports may help milieu therapists to facilitate interventions towards
patients with moderate or severe intellectual disabilities.
Keywords Intellectual disabilities, Adults, PTSD, Milieu therapy, Stabilization
Paper type Case study
Introduction
Post-traumatic stress disorder (PTSD) is currently defined as exposure to a traumatic event
in which both of the following have been present: the person experienced, witnessed, or was
confronted with an event or events that involved actual or threatened death or serious injury, or a
threat to the physical integrity of self or others; and the person’s response involved intense fear,
helplessness, or horror. PTSD in persons with intellectual disabilities has gained increased
interest within the last decade, though publications on this topic are still few (Mevissen and de
Jongh, 2010). It is suggested that people with intellectual disabilities are more likely to develop
PTSD than persons in the general population due to problems with information processing
(Mitchell et al., 2005). Few publications explore what kind of events may cause PTSD, especially
in persons with more severe intellectual disabilities. It has been reported that adverse life events
such as residential replacement (moving from the parents or being moved from one residence
to the next), and consented adult sexual experiences have lead to traumatic reactions in
adults with intellectual disabilities (Tomasulo and Razza, 2007). However, the relationship
between adverse life events and traumatic reactions remains unclear as long as existing study
methodologies still are at descriptive levels (Wigham et al., 2011). It is suggested that individual
characteristics are more important than characteristics of the traumatic event (Tomasulo and
The present study is a result of
a training programme for health
professionals working in the
psychiatric services in Norway,
known as Safer Trauma Therapists
(in Norwegian: Tryggere
Traumeterapeuter ( TT )). The
authors, who all work in the same
specialised psychiatric unit for
adults with intellectual disabilities,
participated in this programme
lasting ten months (rvts.no). The
insights from this programme urged
the authors to facilitate assessment
and interventions towards people
with intellectual disabilities who
experience post-traumatic stress
disorder, PTSD. The authors are
grateful to the five patients and their
families for their co-operation with
this study. The authors also wish to
thank psychologist Trine Anstorp
for her clinical counselling and her
encouragement while preparing
the manuscript.
DOI 10.1108/AMHID-10-2013-0061 VOL. 8 NO. 4 2014, pp. 237-247, CEmeraldGroup Publishing Limited, ISSN 2044-1282
j
ADVANCES IN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
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