Search results

1 – 10 of 588
Article
Publication date: 2 January 2018

Carlos Peña-Salazar, Francesc Arrufat, Josep Manel Santos, Ramón Novell and Juan Valdés-Stauber

Studies on psychiatric comorbidity in individuals with borderline intellectual functioning (BIF) are scarce, particularly with respect to certain diseases frequently…

Abstract

Purpose

Studies on psychiatric comorbidity in individuals with borderline intellectual functioning (BIF) are scarce, particularly with respect to certain diseases frequently observed in clinical practice. The purpose of this paper is to discuss the relevance of epidemiological research to psychiatric comorbidity in people with BIF.

Design/methodology/approach

Systematic searches of MEDLINE, EMBASE and Cochrane databases. Inclusion criteria: publications about BIF appearing between 1995 and 2017; epidemiological findings about comorbid mental disorders in individuals with BIF; and studies comparing BIF, mild intellectual disability (ID) and normal intellectual functioning. The discussion covers 24 of the 224 studies initially considered.

Findings

The most frequent psychiatric comorbidity reported was personality, post-traumatic as well as psychotic disorders, followed by psychosis, attention deficit and hyperactivity disorder, bipolar and sleep disorders. Individuals with BIF exhibit psychiatric comorbidity more frequently than individuals with normal intellectual functioning. Some psychiatric comorbidities were similarly prevalent in patients with BIF and those with mild or moderate ID; however, the prevalence was always higher in people with severe ID. Environmental factors, especially psychosocial adversity, seem to play an important mediating role. Pharmacotherapy is the most common treatment approach, including behavioural disorders.

Originality/value

This review of literature on mental disorders in people with BIF demonstrates the epidemiological relevance of psychiatric comorbidity, especially personality and post-traumatic disorders. Mental health professionals, general practitioners and other workers in outpatient settings have to be aware about the vulnerability and even fragility of people with BIF.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 12 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 7 September 2015

Angela Hassiotis

The purpose of this paper is to provide a synthesis of the literature on the topic of developmental framework and health comorbidities of children and adults with…

Abstract

Purpose

The purpose of this paper is to provide a synthesis of the literature on the topic of developmental framework and health comorbidities of children and adults with borderline intellectual functioning (BIF) and neurodevelopmental disorders.

Design/methodology/approach

A rapid review of the literature and hand searching of relevant papers from 1999 to 2015 was carried out. Totally, 21 papers were identified covering a range of perspectives from neurodevelopmental trajectories to prevalence, treatment and service use.

Findings

All papers were utilised and complemented a previous review which, however, had not covered the aspect of treatment approaches for this population. As a group they appear to have distinctly different profiles from people with mild intellectual disability and of peers with average intelligence.

Practical implications

The evidence summary indicates an ongoing interest by the international scientific community in the topic of BIF. This group are often lost in the health system and may not receive appropriate care given their unique clinical profile. More should be done to increase clinicians’ awareness of their health needs.

Originality/value

The paper adds substantially to a previous review of the topic. An international collaboration may help to increase the profile of this work and lead to further changes in the care these individuals receive across the diagnostic and treatment spectrum.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 28 November 2020

Laura Neijmeijer, Hubert Korzilius, Hans Kroon, Henk Nijman and Robert Didden

Recent research on flexible assertive community treatment (FACT) for individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF) has…

Abstract

Purpose

Recent research on flexible assertive community treatment (FACT) for individuals with mild intellectual disabilities (MID) or borderline intellectual functioning (BIF) has shown positive results. This paper aims to identify which client variables are associated with treatment outcome of FACT.

Design/methodology/approach

Analyses were performed on assessments made during a six-year longitudinal study in The Netherlands. Data comprised assessments of 281 clients with at least 2 measurements. Treatment outcome was measured by the learning disability version of the Health of the Nation Outcomes Scales. Demographic variables and dynamic risk variables of the short version of the Dynamic Risk Outcome Scales were selected as potential predictor variables of outcome. Data were analysed using linear mixed models.

Findings

Limited awareness of the need for treatment, limited treatment motivation and cooperation, limited social skills, impulsivity and substance abuse were significantly associated with worse treatment outcome. None of the demographic variables influenced treatment outcome significantly, and neither did intelligence quotient or having a judicial or civil measure.

Research limitations/implications

Because of the observational design, no causal inferences can be drawn.

Practical implications

This study produces guidelines regarding nature and scope of the treatment supply and the competences of professionals working in FACT MID/BIF teams.

Originality/value

This paper encourages other countries to make assertive outreach available for people with MID/BIF on a larger scale, taking into account the acquired insights.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 14 no. 6
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 27 September 2018

Jannelien Wieland and Mascha ten Doesschate

In The Netherlands, curative mental health care and supportive care for people with an intellectual disability (ID) are organised in separate domains. Prevalence of mental…

Abstract

Purpose

In The Netherlands, curative mental health care and supportive care for people with an intellectual disability (ID) are organised in separate domains. Prevalence of mental health problems is known to be high among people with borderline intellectual functioning (BIF) or mild intellectual disabilities (MID). By contrast, according to recent findings, prevalence of BIF and MID is high among patients in mental health care (17.5–58 per cent). In The Netherlands, a new quality standard of care (QSOC) on mental health care for people with BIF or MID is developed. It is designed to supplement existing guidelines on mental health care so that they can be used appropriately in people with BIF or MID and meant for use in both mental health care organisations (MHCO) as in organisations for ID care. To a large extent, the QSOC should describe the existing practice. This paper aims to discuss these issues.

Design/methodology/approach

To assess the existing practice in current mental health care for people with BIF or MID in The Netherlands, the authors examined the views and accessibility of MHCO on the mental health care for patients with and IQ<85. In addition, the authors reviewed published criteria for in- and exclusion of all 39 top clinical mental health care departments for criteria on BIF or (mild) ID.

Findings

The authors found there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. Dutch MHCO estimate the prevalence of BIF and MID among their patients to be around 30 per cent. Nonetheless, most MCHO surveyed (76 per cent) indicated they do not routinely estimate or measure IQ among their patients and 53 per cent of MHCO indicated not having knowledge and expertise on the dual diagnoses of mental health problems and BIF or MID. Fitting in with the new QSOC most of the MHCO (59 per cent) agreed on the statement in the survey that professionals should be able to treat patients with BIF or ID and all but one of the MHCO stated to have some form of collaboration with an institute for ID care.

Originality/value

The authors concluded there is a clear awareness of the high prevalence of BIF and MID among large Dutch MHCO. The new QSOC on mental health care for people with BIF or MID can help improve accessibility and quality of mental health care for these patients.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 12 no. 3/4
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 17 November 2011

Elspeth Bradley, Yona Lunsky, Anna Palucka and Soula Homitidis

The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders…

1048

Abstract

Purpose

The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM) diagnostic criteria; the prevalence of reported autism spectrum disorders (ASD); and the extent to which assessment of developmental issues is central to the diagnosis of psychotic disorder, in patients discharged with a diagnosis of psychotic disorder and intellectual disabilities.

Design/methodology/approach

Of all patients discharged with psychotic disorder during a four‐year period (n=3339), chart reviews were completed on those also diagnosed with intellectual disability or borderline IQ.

Findings

The findings if this paper are threefold: only 39 percent of the 41 individuals discharged with a diagnosis of psychotic disorder and intellectual disability met documented DSM criteria for intellectual disability; the prevalence of reported ASD was much lower than expected; and the average number of different discharge diagnoses per individual over time was 4.8. Schizophrenia diagnoses were made early in the diagnostic process and tended to persist even when ASD concerns were documented.

Originality/value

The results support the need to systematically assess the developmental issues of patients with intellectual disability as part of the psychiatric diagnostic formulation. Differential diagnoses of psychotic‐like behaviours seen in people with intellectual disability, and alternative frameworks for understanding these behaviours, which in turn should guide more effective interventions and treatment, are discussed.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 5 no. 6
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 29 January 2021

Elien Neimeijer, Judith Kuipers, Nienke Peters-Scheffer, Peer Van der Helm and Robert Didden

The purpose of this study is to provide an in-depth account of how individuelas with a mild intellectual disabilitiy or borderline intellectual functioning (MID-BIF; IQ…

Abstract

Purpose

The purpose of this study is to provide an in-depth account of how individuelas with a mild intellectual disabilitiy or borderline intellectual functioning (MID-BIF; IQ 50–85) perceive their group climate in a secure forensic setting. Giving voice to these service users may provide relevant insights for secure forensic settings.

Design/methodology/approach

The interpretative phenomenological analysis was used to explore what individuals with MID-BIF experience with regard to their group climate.

Findings

In the interviews about the four domains of group climate (i.e. repression, support, growth and atmosphere), five overarching dimensions appeared, namely, autonomy, uniformity, recognition, competence and dignity. Depending on the person and the (treatment) context in which he/she resides, these five dimensions relate to all four factors of the group climate instrument.

Originality/value

From the perspective of individuals with MID-BIF, this study contributes by providing a framework to “fine-tune” group climate on five dimensions. Training socio-therapists to be sensitive to interpret ambiguous signals on these dimensions can contribute to optimizing group climate in secure forensic settings.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 12 no. 1
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 5 January 2015

Krister W. Fjermestad, Torun M. Vatne and Helene Gjone

22q11.2 deletion syndrome (22q11.2DS) is a rare genetic syndrome involving high risk of psychiatric disorders with average intellectual functioning in the lower borderline

Abstract

Purpose

22q11.2 deletion syndrome (22q11.2DS) is a rare genetic syndrome involving high risk of psychiatric disorders with average intellectual functioning in the lower borderline range. Due to the cognitive and social problems many adolescents with 22q11.2DS experience, adaptions may be needed to teach these adolescents cognitive behavioral therapy (CBT) skills. The purpose of this paper is to assess psychosocial functioning in adolescents with 22q11.2DS and to adapt CBT with this group.

Design/methodology/approach

Totally twelve adolescents (M age=14.5 years, SD=1.4, range 12-17 years; 25 percent boys) with 22q11.2DS were recruited from a competence center for rare disorders. Their parents completed the Child Behavior Checklist and the Kiddie SADS screening interview. The adolescents participated in 7×45-minute CBT group sessions, comprising emotional awareness, cognitive restructuring tasks, and problem-solving skills.

Findings

Adolescents had poor parent-reported social and school functioning at onset. The most frequent disorders indicated by screening interviews were attention deficit hyperactivity disorder (92 percent), anxiety (58 percent), depression (50 percent), autism spectrum disorders (50 percent), and potential post traumatic stress disorder (50 percent).

Practical implications

The main adaptions made to CBT groups were shorter sessions, frequent breaks, and repetition of main points, limited use of written materials and items that could distract participants (e.g. balloons, papers), extensive and explicit use of turn taking, and two adult group facilitators per group.

Originality/value

Offers practical advice on teaching CBT skills to adolescents with 22q11.2DS, which may also be applicable to other adolescents with lower borderline intellectual functioning or intellectual disabilities.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 9 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 8 July 2020

Grazia Catalano, Jonathan Mason, Claire Elise Brolan, Siobhan Loughnan and David Harley

The authors reviewed studies of validated tools to screen for cognitive impairment among prisoners. The purpose of this paper is to assist organisations in identifying…

Abstract

Purpose

The authors reviewed studies of validated tools to screen for cognitive impairment among prisoners. The purpose of this paper is to assist organisations in identifying cognitive impairment in correctional facilities.

Design/methodology/approach

A targeted literature review identified peer-reviewed articles on screening of adults in jails, prisons, police watch-houses, custody suites, rehabilitation facilities and forensic settings or community settings for offenders. Validation of screening tools in secure settings, psychometric properties and cultural discrimination is included in this review.

Findings

Eight screening tools are considered suitable for use in correctional settings. Two screening tools are recommended for cognitive impairment, one is recommended for adaptive functioning assessment and one is recommended for screening of brain injury. Two screening tools are noted to be subject to piloting and further development for use with First Nations people, and two screening tools for cognitive impairment are noted for positive consideration.

Research limitations/implications

Recommendations for screening tools are based on review only and evaluation was infeasible.

Practical implications

Short, reliable measures of cognitive ability for use in correctional facilities are needed. Such tools must be appropriate with respect to their purpose, feasible within the clinical capability of staff and sufficiently cheap to administer to allow widespread use.

Originality/value

Screening of prisoners for cognitive impairment allows early detection to facilitate rehabilitation and therapy. This research is at the systems level. Therefore, the authors do not purport to provide guidance for individual clinicians.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 11 no. 4
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 4 January 2016

Hans P. Giltaij, Paula S. Sterkenburg and Carlo Schuengel

The purpose of this paper is to describe the mental and intellectual developmental status of children with combined intellectual disabilities, reactive attachment disorder…

Abstract

Purpose

The purpose of this paper is to describe the mental and intellectual developmental status of children with combined intellectual disabilities, reactive attachment disorder (RAD), and/or disinhibited social engagement disorder (DSED), and to describe the presence of comorbid diagnoses.

Design/methodology/approach

The study included 55 children that were referred for psychiatric consultation due to low intellectual functioning (borderline or mild; IQ 50-84). Attachment diagnoses were based on the Clinical Observation of Attachment (COA) procedure. Development was measured with the Dutch version of the Vineland Adaptive Behaviour Scales. Psychopathology was measured with the DISC-IV and AUTI-R. Emotional and behavioural problems were measured with the Dutch version of the Developmental Behaviour Checklist.

Findings

Children with and without attachment diagnoses had similar IQs. However, children with disturbed attachment, RAD, and/or DSED had lower levels of adaptive behaviour than those without attachment diagnoses. No comorbidity was associated with autism or ADHD. However, 80 per cent of children with RAD and/or DSED were also diagnosed with ADHD. Parents of children with DSED often reported disruptive anti-social behaviour.

Practical implications

Children with RAD and/or DSED may have unused developmental potential. Disturbed attachment should be considered in some cases of ADHD.

Originality/value

Findings suggested that diagnostic expertise provided added value for distinguishing disordered attachment in young clients with intellectual disability.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 7 September 2012

Julia Kelly, Angie Collier and Julie Stringer

The purpose of this paper is to report on a three‐year contract to provide learning disability in‐reach to young offenders serving a sentence of Imprisonment for Public…

209

Abstract

Purpose

The purpose of this paper is to report on a three‐year contract to provide learning disability in‐reach to young offenders serving a sentence of Imprisonment for Public Protection (IPP) at HMYOI Aylesbury.

Design/methodology/approach

A whole population sample (n=75) was obtained between December 2009 and July 2011, where all had received an assessment of intellectual functioning using either the in‐reach screening protocol, consisting of the Kaufman Brief Intelligence Test – Version 2 (KBIT‐2) and four background questions, the Wechsler Abbreviated Scale of Intelligence (WASI) or the Wechsler Adult Intelligence Scale (WAIS).

Findings

It was found that 5.5 per cent of the population had a standard score of less than 70 (significant impairment) and a further 18.6 per cent fell between 70 and 79 (borderline range). The mean standard score of the KBIT‐2 (85.8) was consistent with previous studies of prison populations. The background had a significant but weak association with the KBIT‐2 scores, but lacked sufficient specificity.

Research limitations/implications

Further research is required if these findings are to be generalised to the wider prison population.

Practical implications

Systematic screening for learning disability can be of clinical benefit in identifying the needs of young offenders, which is the first step to addressing these needs.

Originality/value

A number of publications by the Department of Health, the Home Office and third sector organisations have identified the need for services for offenders with a learning disability. In‐reach provision to prisons is still in its infancy and, currently, no gold standard exists for screening tools.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 3 no. 3
Type: Research Article
ISSN: 2042-0927

Keywords

1 – 10 of 588