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Behavioural, psychiatric and psychosocial factors associated with aggressive behaviour in adults with intellectual disabilities: a systematic review and narrative analysis
- Authors:
- VAN DEN AKKER Natalie, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 34(2), 2021, pp.327-389.
- Publisher:
- Wiley
Background: Aggressive behaviour is prevalent in people with intellectual disabilities. To understand the aetiology, it is important to recognize factors associated with the behaviour. Method: A systematic review was conducted and included studies published between January 2002 and April 2017 on the association of behavioural, psychiatric and psychosocial factors with aggressive behaviour in adults with intellectual disabilities. Results: Thirty‐eight studies were included that presented associations with 11 behavioural, psychiatric and psychosocial factors. Conflicting evidence was found on the association of these factors with aggressive behaviour. Conclusions: The aetiology of aggressive behaviour is specific for a certain person in a certain context and may be multifactorial. Additional research is required to identify contributing factors, to understand causal relationships and to increase knowledge on possible interaction effects of different factors. (Edited publisher abstract)
The Social Information Processing Model as a framework for explaining frequent aggression in adults with mild to moderate intellectual disabilities: a systematic review of the evidence
- Authors:
- LARKIN Peter, JAHODA Andrew, MacMAHON Ken
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 26(5), 2013, pp.447-465.
- Publisher:
- Wiley
There is an established evidence base con-cerning the use of anger management interventions with violent offenders who have intellectual disabilities. However, there has been limited research investigating the role of social cognitive factors underpinning problems of aggression. Psychosocial sources of agg-ression in the non-disabled population are generally discussed using Social Information Processing (SIP) models. A systematic review of the available evidence was carried out to establish whether SIP offers a useful explanatory model for understanding the contribution of social cognitive factors to problems of aggression presented by people with intellectual disabilities. Whilst research relating to the SIP model remains sparse for this population, there was evidence for different patterns of processing between aggressive and non-aggressive individuals. Group diff-erences included interpretation of emotional cues, inter-personal attributions and beliefs about the outcomes of aggressive behaviour. The future direction of SIP research with people who have intellectual disabilities is discussed, along with the possibility of using this framework to help build on current initiatives to develop individually tailored interventions to work at a cognitive level with those who are aggressive and offend. (Edited publisher abstract)
Cognitive behavioural treatment for anger in adults with intellectual disabilities: a systematic review and meta-analysis
- Authors:
- NICOLL Matthew, BEAIL Nigel, SAXON David
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 26(1), 2013, pp.47-62.
- Publisher:
- Wiley
An evidence base for the use of cognitive behavioural treatment (CBT) for adults with intellectual disabilities is emerging. The aim of this paper is to systematically review the current literature on the effectiveness of CBT for anger in adults with intellectual disabilities and provide a meta-analysis of the findings. A literature search found 12 studies published since 1999 eligible for the quality appraisal (10 conducted in the UK and 2 conducted in Australia). Nine of these provided sufficient data to be included in the meta-analysis. The results from the review reveal an emerging evidence base for cognitive behavioural anger interventions in adults with intellectual disabilities. The quality appraisal revealed that studies are now utilising reliable and valid measurements of the anger construct. Furthermore, the quality appraisal revealed a good level of methodological rigour, especially in the studies that were entered into the meta-analysis. The meta-analysis revealed large uncontrolled effect sizes for the treatment of anger in adults with intellectual disabilities, but is viewed with caution due to low sample sizes. Overall, the literature is limited by concatenated data, a lack of comparative control groups and small study samples.
Epilepsy and challenging behaviour in adults with intellectual disability: a systematic review
- Authors:
- BLICKWEDEL Jessica, ALI Afia, HASSIOTIS Angela
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 44(2), 2019, pp.219-231.
- Publisher:
- Taylor and Francis
Background: Epilepsy and challenging behaviour are both highly prevalent in the intellectual disability (ID) population and it is thus crucial to understand any possible associations between the two. Method: PsycINFO, MEDLINE, Embase, CINAHL and Web of Science were searched for quantitative data about epilepsy and any forms of challenging behaviour in adults with ID. Results: A total of 25 articles were included in the review. Overall the evidence suggests that while epilepsy is not a good explanatory variable for the presence of challenging behaviour; the relationship is complex. However, for some people with epilepsy and for certain types of challenging behaviour a link may exist. Conclusions: Given the possible link between epilepsy-related factors such as seizure type and specific subgroups of challenging behaviour, investigating these relationships further and particularly exploring how to best measure challenging behaviour in people with epilepsy could be of great clinical benefit. (Edited publisher abstract)
The topographies and operant functions of challenging behaviours in fragile X syndrome: a systematic review and analysis of existing data
- Authors:
- HARDIMAN Rebecca Lyndsey, McGILL Peter
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 42(2), 2017, pp.190-203.
- Publisher:
- Taylor and Francis
Background: Challenging behaviour, such as self-injury and physical aggression, is an issue of concern regarding a high proportion of individuals with fragile X syndrome. The aim of this review was to provide a comprehensive overview of the topographies and operant functions of challenging behaviours within the syndrome. Method: Five electronic databases were searched, identifying 18 manuscripts. Overall proportions of individuals with particular topographies of behaviour, or behaviour serving different functions, were calculated. Results: Across all participants, biting was the most common form of self-injury for males but not females. A pattern of behavioural function was observed, characterised by high levels of social-negative reinforcement, such as escape from demands. Conclusion: The existence of within-syndrome biases in the manifestation of behavioural challenges is supported by our review. (Publisher abstract)
Psychomotor therapy targeting anger and aggressive behaviour in individuals with mild or borderline intellectual disabilities: a systematic review
- Authors:
- BELLEMANS Tina, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 44(1), 2019, pp.121-130.
- Publisher:
- Taylor and Francis
Background: Poor anger regulation is considered a risk factor of aggression in individuals with mild or borderline intellectual disabilities. Psychomotor therapy (PMT) targets anger regulation through body- and movement-oriented interventions. This study aims to inform practitioners on efficacy and research-base of PMT in this population. Method: This systematic review evaluated nine studies which met inclusion criteria in terms of participants, intervention procedures, outcomes and certainty of evidence. Results: Seven studies revealed a substantial reduction of aggressive behaviour or anger. Certainty of evidence was rated inconclusive in most cases due to absence of experimental control. Conclusions: We can conclude that body-oriented PMT, involving progressive relaxation and meditation procedure “Soles of the Feet”, is a promising approach. However, the paucity of studies and methodological limitations preclude classifying it as an evidence-based practice. This suggests stronger methodological research and research aimed at PMT’s mechanisms of action (e.g., improved interoceptive awareness) is warranted. (Edited publisher abstract)
Psychological interventions for anger and aggression in people with intellectual disabilities in forensic services
- Author:
- BROWNE Claire
- Journal article citation:
- Aggression and Violent Behavior, 39, 2018, pp.1-14.
- Publisher:
- Elsevier
This systemic review investigates the current evidence for the effectiveness of anger and/or aggression interventions for people with intellectual disabilities (ID) in receipt of forensic mental health services. Due to the prevalence within this population of difficulties with anger and aggression, and the associated substantial individual and societal consequences, the provision of psychological interventions has become increasingly common. However, no critical synthesis of the empirical evidence relating to their effectiveness has previously been conducted. Sixteen peer-reviewed controlled trials or case series designs published between 2001 and 2016 met the inclusion criteria. The results highlight an emerging evidence base for the use of CBT in improving anger regulation, and for a range of psychological therapies in reducing aggressive behaviour. However, consistent methodological shortcomings limit the generalisability of findings and currently preclude firm conclusions on effectiveness. Recommendations are made for future research to address these shortcomings, including clearly-defined adaptations, adequately powered sample sizes, carefully designed baselines and follow-up periods. Despite the current status of evidence, the review provides an accessible and objective foundation to inform decision-making by service commissioners and clinicians providing anger and aggression interventions to people with ID. (Publisher abstract)
Anger management interventions for adults with learning disabilities living in the community: a review of recent (2000–2010) evidence
- Author:
- BORSAY Clare
- Journal article citation:
- British Journal of Learning Disabilities, 41(1), 2013, pp.38-44.
- Publisher:
- Wiley
Estimates suggest that around a quarter of adults with learning disabilities living in the community have difficulties controlling their anger. Angry or aggressive behaviour can have serious repercussions, including loss of residential or day placements, admission to hospital and reduced quality of life. In addition, the psychological well being of both paid and family carers can be adversely affected. The current study provides an update to an earlier review conducted by Whitaker in 2001, into the effectiveness of cogntive-behavioural (CBT) approaches as anger management interventions for people with learning disabilities. This review considers papers published in the last 10 years and expands its scope to include a variety of therapeutic interventions. A systematic search of peer-reviewed journals identified 14 relevant documents, the majority of which were group-based and CBT in their approach. Overall, methodological weaknesses made it difficult to draw any firm conclusions about the effectiveness of the different approaches. Implications for clinical and research practice are discussed. (Edited publisher abstract)