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Depressive symptoms in older female carers of adults with intellectual disabilities
- Authors:
- CHOU Y. C., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 54(12), December 2010, pp.1031-1044.
- Publisher:
- Wiley
This study aimed to examine the prevalence and factors associated with depressive symptoms among primary older female family carers of adults with intellectual disabilities. In total, 350 female family carers aged 55 and older took part and completed the interview survey in their homes. The survey package contained standardised scales to assess carer self-reported depressive symptoms, social support, caregiving burden and disease and health, as well as adult and carer sociodemographic information. Multiple linear regressions were used to identify the factors associated with high depressive symptoms. The results showed that between 64% and 72% of these carers were classified as having high depressive symptoms. The factors associated with carer self-reported depressive symptoms were carer physical health, social support and caregiving burden; overall, the carer self-reported physical health was a stronger factor associated with depressive symptoms than their physical disease status. The level of the adult with intellectual disabilities' behavioural functioning and the carer age, marital status, employment status, education level and the family income level were not significantly associated with carer depressive symptoms. The results highlight the importance of addressing the healthcare of these carers, including physical care, mental care and support needs.
Screening for mental health problems in adults with learning disabilities using the Mini PAS-ADD Interview
- Authors:
- DEVINE Maurice, TAGGART Laurence, MCLORNIAN Paula
- Journal article citation:
- British Journal of Learning Disabilities, 38(4), December 2010, pp.252-258.
- Publisher:
- Wiley
Prevalence rates vary considerably regarding the mental health of people with learning disabilities. This variation is a consequence of the assessment methods used to identify such clinical conditions and also the different populations studied. The aim of this study was to establish the prevalence of mental health problems in 96 adults with mild-to-moderate learning disabilities receiving community-based services in Northern Ireland. Using the Mini PAS-ADD Interview schedule, a number of specifically trained interviewers interviewed staff who supported these adults with learning disabilities in their particular work or day care setting to determine whether or not participants had a potential mental health problem. This study found a 33.3% prevalence rate of mental health problems in this community sample. The results of this study fall between previous community prevalence studies that range from 14% to 50%. This sample was found to score higher on the sub-scales of depression and psychosis compared with other prevalence studies. In order to examine the agreement of these findings, a random sample of 27 of the participants were also interviewed by a psychiatrist specialising in learning disability regarding their mental health status. The results found that the Mini PAS-ADD Interview has an overall sensitivity of 1 (100%) and a specificity of 77%. The practical issues of the screening process are discussed. Methodological limitations are also highlighted in accurately predicting prevalence rates of mental health problems in the learning disability population by clinical staff.
Effectiveness of a stress-relief initiative for primary caregivers of adolescents with intellectual disability
- Authors:
- HU Jung, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 35(1), March 2010, pp.29-35.
- Publisher:
- Taylor and Francis
This study provides a perspective on the mental health status and analyses the effectiveness of a stress-relief programme for primary caregivers of adolescents with intellectual disability. Seventy-seven primary caregivers of people with intellectual disability living in Taiwan were recruited, of which 31 were in the intervention group, and 46 in the non-intervention group. The study involved participation in one stress management workshop (intervention group only) and both groups reading an education booklet on stress management. Findings revealed that 22% of caregivers in the study were at high risk of depressive stress and in need of mental health consultation. This prevalence was nearly six times that of the general population. The effectiveness of mental health initiatives resulted in a significant reduction in depressive stress for the intervention group. The authors concluded that face-to-face workshop were an effective way to decrease levels of depressive stress in the sample group.
Supported employment for people with intellectual disability: the effects of job breakdown on psychological well-being
- Authors:
- BANKS Pauline, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 23(4), July 2010, pp.344-354.
- Publisher:
- Wiley
The level of job breakdown is relatively high amongst people with intellectual disabilities. This paper focuses on the transition to supported employment for people with intellectual disabilities, paying particular attention to the impact of job breakdown on psychological well-being. The participants were 49 people with intellectual disabilities who had entered supported employment working at least 3 hours each week. They underwent semi-structured interviews within 3 months of entering supported employment and 9–12 months later. Where possible, someone who supported the participant, such as a relative or support work, was also interviewed at both time periods, and the employers were also interviewed on one occasion. Data collection included completion of a self-report measure of depression and anxiety (an adapted form of the Hospital Anxiety and Depression Scale), and a self-report measure of quality of life (the ComQol). The results showed that, by the time of the follow-up interviews, 13 of the 49 jobs had broken down. Analysis of scores measuring quality of life, anxiety and depression showed no effect for loss of employment. However, the interviews with participants indicated that job loss had a considerable impact on those affected. There were a wide range of reasons for job breakdown, many of which were particular to the circumstances of people with intellectual disabilities.
Maternal responses to child frustration and requests for help in dyads with fragile X syndrome
- Authors:
- WHEELER A.C., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 54(6), June 2010, pp.501-515.
- Publisher:
- Wiley
Variability in the behaviour of children with fragile X syndrome (FXS) may be partially attributable to environmental factors such as maternal responsivity. This study explored variables associated with maternal behaviour during a task designed to elicit frustration in their children with FXS. Forty-six mother–child dyads, in which the child had full-mutation FXS (mean age 61.64 months), were observed in their homes. The child was given a wrong set of keys and asked to open a box to retrieve a desired toy. Mothers were provided with the correct set and told to intervene when they perceived their child was getting too frustrated. Child-expressed frustration and requests for help and maternal behaviours (comforting, negative control, and encouraging/directing) were recorded. Maternal variables (depression, stress, education levels), child variables (autistic behaviours, age, medication use) and child behaviours (frustration, requests for help) were explored as predictors of maternal behaviour. Almost all mothers intervened to help their children and most used encouraging/directing behaviours; very few used comforting or negative control. Child age and behaviours during the exercise were significant predictors of encouraging/directing behaviours in the mothers. Children whose mothers reported higher depressive symptomology used fewer requests for help, and mothers of children with more autistic behaviours used more negative control. It is concluded that child age and immediate behaviours are more strongly related to maternal responsivity than maternal traits such as depression and stress.
Living with stigma and the self-perceptions of people with mild intellectual disabilities
- Authors:
- JAHODA Andrew, et al
- Journal article citation:
- Journal of Social Issues, 66(3), September 2010, pp.521-534.
- Publisher:
- Wiley
Drawing on two case studies from a larger study, this article illustrates how people with mild or moderate learning disabilities experience and deal with stigma. It illustrates that even when individuals have difficulty expressing their views verbally, their actions can provide evidence of how they struggle to establish or maintain positive social identities – sometimes at the cost of their mental health. The implications of these and other findings are discussed in relation to social constructionist theories of self-perception. This in turn will be linked to a discussion about the kind of support that might be required by people with intellectual disabilities, and how stigma might increase vulnerability to emotional and other problems.
The association between self-report and informant reports of emotional problems in a high secure intellectual disability sample
- Authors:
- LEWIS Claire, MORRISSEY Catrin
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 4(2), June 2010, pp.44-49.
- Publisher:
- Emerald
The study explored the relationship between self and informant reports of emotional problems in a forensic intellectual disability sample. The instrument used was the Emotional Problems Scales (EPS), which comprises a Self Report Inventory (EPS-SRI) and an informant Behaviour Rating Scale (EPS-BRS). This was routinely administered to 30 men with intellectual disability in a secure forensic setting, as part of a standard clinical assessment procedure over a 1 year period. The patients were assessed using the EPS-SRI by interview over 1 or 2 sessions. Members of the nursing staff completed the EPS-BRS based on observations over the last 30 days. It was hypothesised that there would be a moderate relationship between corresponding scores on the EPS-SRI and EPS-BRS. However, there were no significant relationships between corresponding scales of the EPS-SRI and EPS-BRS, apart from the scales measuring anxiety. The results continued to be non-significant, even when positive impression management was controlled for. The findings suggest little relationship between self and informant ratings in a forensic intellectual disability sample, and it appears that nursing staff may over-report these problems. The results support the need to gather information from multiple sources when assessing such individuals.
Active support, participation and depression
- Authors:
- STANCLIFFE Roger J., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 23(4), July 2010, pp.312-321.
- Publisher:
- Wiley
Active Support is a model of support intended to bring about meaningful everyday activities by people with intellectual disabilities. The aim of this study was to examine the medium-term effect of implementation of Active Support on domestic participation, adaptive behaviour, challenging behaviour and depression in adults with intellectual disabilities who lived in community group homes. It investigated the effect of staff training in Active Support in 9 group homes. Outcome data were obtained for 41 clients. The effectiveness of Active Support was evaluated with a pre-test:post-test design, using a number of standardised assessments and other questionnaires, with group home staff as informants. These assessments were conducted before Active Support training and an average of 6.5 months later. The results showed that following implementation of Active Support residents experienced significant increases in domestic participation and adaptive behaviour. There were significant decreases in internalised challenging behaviour, overall challenging behaviour and depression. There was no significant pre–post change in other forms of challenging behaviour.
Detecting and treating depression in people with mild intellectual disability: the views of key stakeholders
- Authors:
- McGILLIVRAY Jane A., McCABE Marita C.
- Journal article citation:
- British Journal of Learning Disabilities, 38(1), March 2010, pp.68-76.
- Publisher:
- Wiley
There is a pressing need for the development of programmes for the early identification and treatment of depression in individuals with mild intellectual disability. The aim of this study was to ascertain the perspective of 64 key stakeholders (people with intellectual disability, healthcare professionals, family/carers and support workers) regarding the risk factors and characteristics of depression, the support and service needs of individuals with intellectual disability/depression and those who care for them. Findings enhance our understanding of depression and its risk factors in people with mild intellectual disability and endorse the need for the development of screening and intervention programmes suitable for delivery by staff in agencies providing services to people with mild intellectual disability.