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Identification of PTSD in adults with intellectual disabilities in five patients in a specialised psychiatric inpatient unit
- Authors:
- BAKKEN Trine Lise, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(2), 2014, pp.91-102.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to describe and discuss assessment of post-traumatic stress disorder (PTSD) in adults with intellectual disabilities. Existing research in this area encompasses case studies, and includes, for the most part, persons with mild intellectual disabilities. Design/methodology/approach: The aim of this study is to investigate symptom presentation and subsequent identification of PTSD in persons with more severe intellectual disabilities; 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 the patients was collected through case files and interviews with key informants: family, milieu therapists, and caregivers in community settings, and observations through inpatient admission. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients. The five patients all met criteria for PTSD according to the Diagnostic Manual – Intellectual Disability. Findings: Previously, it was not suspected that the five patients suffered from PTSD, although they had experienced terrifying incidents. All patients displayed severe changes in behaviour, which may have overshadowed symptoms of PTSD. PTSD in persons with more severe intellectual disabilities may be interpreted as challenging behaviour, or other psychiatric disorders such as psychosis. Research limitations/implications: The limitation of the study is the small number of participants. Practical implications: Practical implication is linked to clinical practice related to identification of PTSD in persons with intellectual disabilities. Originality/value: The paper may encourage more research into how PTSD can be identified in persons with moderate and severe intellectual disabilities. The case reports may help clinicians to look for traumatic experiences in persons with intellectual disabilities who have experienced terrifying incidents. (Publisher abstract)
The relative influence of childhood sexual abuse and other family background risk factors on adult adversities in female outpatients treated for anxiety disorders and depression
- Authors:
- PELEKIS Dawn E., MYLETUN Arnstein, DAHL Alv A.
- Journal article citation:
- Child Abuse and Neglect, 28(1), January 2004, pp.61-76.
- Publisher:
- Elsevier
This study from Norway examines the relative influence of child sexual abuse (CSA) and family background risk factors (FBRF) on the risk for current mental disorders and the quality of current intimate relationships in women with CSA treated for anxiety disorders and/or depression. 112 women, who were treated with outpatient psychotherapy by female therapists for anxiety disorders and/or depression were included. CSA had been admitted at the start of treatment start in 56 women, while no CSA was admitted among the 56 women of the comparison group. Systematic and detailed retrospective information about childhood as well as data on current functioning and current mental disorders were collected by questionnaires and structured interviews done by an independent female psychiatrist. The women of the CSA group reported significantly more FBRF than the comparisons. CSA increased the risk for posttraumatic stress disorder (PTSD), non-suicidal self-inflicted harm, and rape after 16 years. Major depression, dysthymia, and their comorbidity were not associated with CSA. The five indicators of quality of current intimate relationship were not associated with CSA. Women with CSA who have been treated for anxiety disorders and/or depression, also frequently have been exposed to FBRF. Increased risk for PTSD, self-inflicted harm before therapy, and rape after 16 years of age was influenced by CSA, while mood disorders and the quality of current attachment are not associated with CSA, but with FBRF or other factors not examined in this study.