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Adult adjustment of survivors of institutional child abuse in Ireland
- Authors:
- CARR Alan, et al
- Journal article citation:
- Child Abuse and Neglect, 34(7), July 2010, pp.477-489.
- Publisher:
- Elsevier
Institutional child abuse is perpetrated by adults working in, or peers within, institutions serving children in the community, such as residential care centres, schools, reformatories, churches, and recreational facilities. This study focused on the adjustment of adults who suffered institutional abuse in childhood within the context of Irish religiously-affiliated residential reformatories and industrial schools, aiming to document the rate of psychological disorders and difficulties. 247 adult survivors of institutional abuse were recruited from those who had attended the Commission to Inquire into Child Abuse (a statutory body established by the Irish Government in 2000), and were interviewed and completed versions of the Childhood Trauma Questionnaire. The study found that the prevalence of psychological disorders among participants was over 80%, with anxiety, mood and substance use disorders being the most prevalent diagnoses. The researchers concluded that there was an association between the experience of institutional abuse in childhood and the prevalence of adult mental health problems.
Child maltreatment and adult psychopathology in an Irish context
- Author:
- FITZHENRY Mark
- Journal article citation:
- Child Abuse and Neglect, 45, 2015, pp.101-107.
- Publisher:
- Elsevier
One-hundred-ninety-nine adult mental health service users were interviewed with a protocol that included the Childhood Trauma Questionnaire, the Structured Clinical Interviews for Axis I and II DSM-IV disorders, the Global Assessment of Functioning scale, the SCORE family assessment measure, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Compared to a U.S. normative sample, Irish clinical cases had higher levels of maltreatment. Cases with comorbid axis I and II disorders reported more child maltreatment than those with axis I disorders only. There was no association between types of CM and types of psychopathology. Current family adjustment and service needs (but not global functioning and motivation for psychotherapy) were correlated with a CM history. It was concluded that child maltreatment may contribute to the development of adult psychopathology, and higher levels of trauma are associated with co-morbid personality disorder, greater service needs and poorer family adjustment. A history of child maltreatment should routinely be determined when assessing adult mental health service users, especially those with personality disorders and where appropriate evidence-based psychotherapy which addresses childhood trauma should be offered (Publisher abstract)
Application of DC-LD to an intellectual disability population
- Authors:
- TULLY John, SCHIRLIU Diana, MORAN Maria
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(5), 2012, pp.259-264.
- Publisher:
- Emerald
The Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD), introduced in 2003, was designed to improve accuracy of diagnosis in individuals with intellectual disability. An Irish study aimed to investigate its usefulness in a clinical setting. It involved interviews and review of chart notes with a sample of 50 patients within an intellectual disability service. This article describes the study methodology and results, and discusses the findings. It reports that there was considerable discrepancy between the rates of psychiatric diagnoses after application of DC-LD and rates of previously documented diagnoses within the sample, and that use of DC-LD led to the reclassification of many previously documented diagnoses, mainly as behavioural disorders. It concludes that the study adds to the evidence regarding the usefulness of the criteria, and highlights the shortcomings of non-systematic methods of diagnosis.
Low mood and challenging behaviour in people with severe and profound intellectual disabilities
- Authors:
- HAYES S., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 55(2), February 2011, pp.182-189.
- Publisher:
- Wiley
“Diagnostic overshadowing” has been an obstacle for people with intellectual disabilities (ID) exhibiting symptoms of a mental illness. Progress has been made but there remains a tendency to assume that challenging behaviour stems from the ID rather than being symptomatic of mental illness. This study investigated the relationship between low mood and challenging behaviour in people with severe and profound ID, while controlling for the presence of potentially confounding variables such as diagnosis of autism, physical and sensory problems and ill health. The key workers of 52 people with severe and profound ID, living in residential care in Ireland, completed measures of depression, communication, challenging behaviour and provided information on demographic and health variables. Using the Mood, Interest and Pleasure Questionnaire, a significant difference was found between a ‘low mood’ and ‘normothymic’ group in the reported occurrence of challenging behaviour. This difference remained after confounding variables such as the presence of autism, health and sensory difficulties were controlled. The frequency and severity of challenging behaviour was predicted by measures indicating the presence of low mood. The authors conclude that people with severe and profound ID show clear and measurable signs of low mood, and in this relatively small sample of institutionalised individuals, low mood was associated with challenging behaviour.
Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland
- Authors:
- FITZPATRICK Mark, et al
- Journal article citation:
- Child Abuse Review, 19(6), November 2010, pp.387-404.
- Publisher:
- Wiley
In this research funded by the Commission to Inquire into Child Abuse, 247 adult survivors of severe institutional abuse in Ireland were interviewed with a standard assessment protocol which included instruments which assessed history of child abuse and current psychological functioning. Participants were aged 40 to 83 years, 54.7% were male; on average they had spent 10 years living in an institution and it had been 22-65 years since they had suffered institutional abuse. Profiles were identified for subgroups that described severe sexual (n=60), physical (n=102), or emotional (n=85) abuse as their worst forms of maltreatment. Significant intergroup differences were found for gender, age, length of time living with family before entering an institution, reasons participants believed they were placed in institutions and institutional management. Survivors of severe sexual abuse were found to have the most abnormal profile, which was characterised by higher rates of all forms of child maltreatment and higher rates of post-traumatic stress disorder, alcohol and substance abuse, antisocial personality disorder, trauma symptoms and life problems. Survivors of severe emotional abuse were better adjusted than the other two groups. The profiles of survivors of severe physical abuse occupied an intermediate position between the other two groups. Implications for future research, practice and policy are discussed. The authors comment that a thorough assessment of abuse history and current functioning should be conducted when providing services to adult survivors of institutional abuse. Survivors of severe sexual abuse may require more intensive services.