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A study of complicated grief symptoms in people with intellectual disabilities
- Authors:
- DODD P., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 52(5), May 2008, pp.414-425.
- Publisher:
- Wiley
Previous studies have shown a significant association between familial bereavement and the onset of challenging behaviours and psychopathology in people with intellectual disabilities (ID). However, little work has been done to accurately describe the specific symptoms of grief, in particular symptoms of complicated grief in this population. Consensus criteria for the diagnosis of complicated grief have been drawn up and tested for validity in the general population. This study aimed to examine the occurrence of symptoms of complicated grief, and to explore the relationships between complicated grief and bereavement experience. A bereavement history questionnaire and a newly developed measure examining for symptoms of complicated grief were administered to a group of carers of people with mild or moderate ID, who had experienced a parental bereavement within the previous 2 years. The sample was recruited from two large voluntary agencies providing residential and day services to people with ID in Dublin. The questionnaires were also administered to a matched comparison group, who had not been bereaved. This carer-based comparison study has revealed that bereaved individuals with ID experience complicated grief symptoms following the death of a parent, with one-third of the bereaved group experiencing 10 or more clinically apparent symptoms. In addition, complicated grief symptoms were more likely to occur with higher rates of bereavement ritual involvement. These findings have both clinical and research implications.
The Leicestershire Intellectual Disability Tool: a simple measure to identify moderate to profound intellectual disability
- Authors:
- TYRER Freya, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(3), May 2008, pp.268-276.
- Publisher:
- Wiley
It is often useful to ascertain whether adults have moderate to profound intellectual disability when deciding whether to refer to specialist or mainstream services. The aim of the present study was to develop a simple measure to estimate moderate to profound intellectual disability in adults with a potential need for specialist care. Three hundred and twenty-two individuals with information on home interviews from the Leicestershire Learning Disability Register were also assessed using the Vineland Adaptive Behaviour Scales. A variety of variables concerning intelligence, adaptive functioning and dependency were used to predict developmental age (as estimated from the Vineland) using backward stepwise regression. The derived equation formed the Leicestershire Intellectual Disability (LID) tool. A cut-off point was chosen using a receiver operator characteristic (ROC) curve to achieve 95% sensitivity in identifying moderate to profound intellectual disability. Seven variables from the home interviews were found to predict estimated developmental age at the 10% level. When the tool was used to detect adults with moderate to profound intellectual disability, the area under the ROC curve was 0.93. The chosen cut-off point was 95% sensitive and 65% specific. The positive predictive value was 95%, the negative predictive value was 65%, and the overall diagnostic accuracy was 91%. These preliminary findings suggest that the LID tool may help to identify adults with moderate to profound intellectual disability among those with potential need for specialist care. Further evaluation is recommended.
Correspondence between self-ratings and key-workers' ratings of depression in adults with mild learning disabilities
- Authors:
- GORDON Michael S., et al
- Journal article citation:
- British Journal of Clinical Psychology, 46(4), November 2007, pp.491-495.
- Publisher:
- Wiley
This study assessed the association between self-ratings and key-worker ratings of depression in people with mild learning disabilities. The Zung Depression Scale was completed by 74 adults with mild learning disabilities and a modified version of the questionnaire was completed by two key-workers at two periods in time. The correlations between ratings of depression by key-workers were high and key-worker ratings correlated significantly with self-rating. The depression scores were found to be temporally stable. The findings suggest that proxy raters appear to be able to make reliable and valid judgements about other people's self-reported levels of depression.
Perspectives on pain and intellectual disability
- Authors:
- SYMONS F.J., SHINDE S.K., GILLES E.
- Journal article citation:
- Journal of Intellectual Disability Research, 52(4), April 2008, pp.275-286.
- Publisher:
- Wiley
Historically, individuals with intellectual disability (ID) have been excluded from pain research and assumed to be insensitive or indifferent to pain. The weight of the evidence suggests that individuals with ID have been subject to practices and procedures with little regard for their ability to experience or express pain. A number of issues central to improving understanding of pain in ID will be introduced and current research related to the definition of pain and its social context, underlying sensory and metabolic systems and factors influencing judgments about the ability to experience pain will be reviewed. Accumulating evidence from interdisciplinary research designed to improve assessment, understand individual differences, and evaluate bias and beliefs about pain suggests that new perspectives are emerging and beginning to shape an innovative frontier of research that will ultimately pay tremendous dividends for improving the quality of life of individuals with ID.
The distribution of scaled scores and possible effects on the WISC-III and WAIS-III
- Authors:
- WHITAKER Simon, WOOD Christopher
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 21(1), March 2008, pp.136-141.
- Publisher:
- Wiley
It has been suggested that, as the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) and the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) give a scaled score of one even if a client scores a raw score of zero, these assessments may have a hidden floor effect at low IQ levels. The study looked for indications of this in a sample of assessments that had been given for clinical and diagnostic reasons. The degree to which a hidden floor effect could be present was assessed by looking at the proportion of scaled scores of one in IQ bands: 50–59, 60–69 and 70 plus and by plotting the distribution of scaled scores in these bands for both the WISC-III and WAIS-III. Fifty WISC-III and 49 WAIS-III assessments were obtained from records and analysed. The distribution of scaled scores in the WAIS-III was approximately normal with very few scale scores of one, suggesting that a hidden floor effect would only be a potential problem for IQs in the 40s and 50s. The WISC-III had a skewed distribution of scaled scores with more scaled scores of one than any other scaled score. Scaled scores of one were shown in all IQ levels up to 70 plus. There is potentially a significant floor effect on the WAIS-III at IQs in the 40s and 50s and on the WISC-III up to IQs in the 70s. There are also indications that the WISC-III has a much harder criterion for gaining a scaled score of two than the WAIS-III, resulting in it producing lower IQs.
Exploratory factor analysis and convergent validity of the Dundee Provocation Inventory
- Authors:
- ALDER Lucy, LINDSAY William R.
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 32(3), September 2007, pp.190-199.
- Publisher:
- Taylor and Francis
The prevalence and consequences of anger and aggression in people with intellectual disability (ID) are of great concern. It is essential that appropriate assessment tools are developed to aid formulation of treatments and to evaluate progress and outcomes. This study evaluates the Dundee Provocation Inventory (DPI), a 20-item assessment measure for anger provocation. A group of 114 participants were administered the DPI, and 62 of these were also administered the Novaco Anger Scale (NAS) and NAS Provocation Inventory (NAS-PI), two well-validated measures. Preliminary analysis revealed that the DPI correlated significantly with the NAS and NAS-PI. The DPI had high internal consistency and moderate to high inter-item and item-to-total score correlations. Factor analysis revealed a 5-factor solution which accounted for 63% of the variance and was most easily interpreted. The analysis suggests that the DPI is a suitable tool for assessing anger in people with ID. Further replication of the factor structure would be valuable.
The assessment of Basic Learning Abilities Test for persons with intellectual disability: a valuable clinical tool
- Authors:
- VAUSE Tricia, YU C. T., MARTIN Garry L.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.483-489.
- Publisher:
- Wiley
The Assessment of Basic Learning Abilities (ABLA) test requires a tester to attempt to teach to a person, using standard prompting and reinforcement procedures, six tasks that are hierarchically ordered in difficulty. Performance on the test provides valuable information for teachers and rehabilitation workers to match the difficulty of training tasks with the learning ability of persons with profound, severe and moderate intellectual disabilities. This paper summarizes the characteristics of the test, outlines the testing procedures, and reviews supporting data and practical guidelines for clinicians.
Inter-rater reliability of the diagnoses of psychosis and depression in individuals with intellectual disabilities
- Authors:
- EINFELD S, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.384-390.
- Publisher:
- Wiley
There is a history of over-prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under-prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study examining one aspect of validity, namely whether skilled clinicians can agree on whether an individual with an ID is psychotic or depressed. Pairs of clinicians assessed 52 individuals. Agreement was assessed using Cohen’s kappa statistic and agreement proportion. Overall agreement was high for both psychosis and depression. Whether the individual had mild ID or moderate/severe ID did not have a significant impact on agreement. Experienced clinicians achieved a high level of agreement as to whether a person with ID was psychotic or depressed similar to that found for those without ID. The findings provide some support for treatment interventions based on diagnosis.
A preliminary evaluation of the adaptation of four assessments for offenders with special needs
- Authors:
- KEELING Jenny A., ROSE John L., BEECH Anthony R.
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 32(2), June 2007, pp.62-73.
- Publisher:
- Taylor and Francis
Appropriate assessment is an essential part of treating sexual offenders. Few assessments exist that can be used with offenders who have lower levels of intellectual functioning and/or literacy deficits. This study describes the adaptation of four self-report assessments for sexual offenders with special needs: (i) the Social Intimacy Scale; (ii) the Relationship Scales Questionnaire; (iii) the Criminal Sentiments Scale; and (iv) the Victim Empathy Distortion Scale. Each scale was adapted in an effort to simplify content and language and to improve readability. Preliminary data are presented on the comparability of each adapted measure to the original, as well as the internal consistency, reliability, and concurrent validity of the adapted tests. The SIS and the QVES were identified as appropriate assessment measures, comparable to the original with good reliability and validity. One subscale of the RSQ had fair reliability and validity, while the remaining subscales had varied psychometric properties. The adapted CSS had poor psychometric qualities and the adaptation of this test appears not to have been successful. The relevance of these findings to an understanding of offending by this population is discussed.
Modifying the clinical outcomes in routine evaluation measure for use with people who have a learning disability
- Authors:
- MARSHALL Keith, WILLOUGHBY-BOOTH Simon
- Journal article citation:
- British Journal of Learning Disabilities, 35(2), June 2007, pp.107-112.
- Publisher:
- Wiley
There are few reliable self-report measures suitable for people with a learning disability in reporting psychological distress. This study examines the modification of the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), exploring its reliability, using two different presentation styles. One style included a sequencing task then use of a visual histogram scale to facilitate rating; the other prompted participants to indicate presence or absence of symptoms before using the histogram. The study was conducted on a small sample of people with mental health problems who have a mild learning disability. The modified CORE-OM was found to have an excellent test–retest correlation with the group who completed the sequencing task, then the histogram scale, but the other group produced less favourable results. The preliminary results are encouraging, highlighting the need to conduct a larger study after further modifications of the measure.