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Improving the detection and assessment of mental health problems in people with learning disability
- Author:
- MOSS Steve
- Journal article citation:
- Focus, 19, October 1996, pp.1-11.
- Publisher:
- RNIB
Ensuring that people with learning disability get appropriate help for their mental health problems is not just a job for psychiatrists. All staff have an essential role in ensuring that people who have psychiatric problems are identified and referred for comprehensive assessment. This article introduces some of the major issues in recognising and assessing mental health problems in this population, and introduces some new developments designed to improve the targeting of psychiatric referrals.
A preliminary investigation into the utility of the adult behavior checklist in the assessment of psychopathology in people with low IQ
- Authors:
- TENNEIJ Nienke H., KOOT Hans M.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.391-400.
- Publisher:
- Wiley
Background Achenbach & Rescorla (2003) recently developed the Adult Behavior Checklist (ABCL) to assess psychopathology in the general population. The ABCL should be completed by a proxy informant. The use of proxy informants, instead of self-reporting, makes the ABCL potentially suitable for the assessment of psychopathology in adults with intellectual disability. The aim of the present study was to examine reliability and validity of the ABCL in 124 adults with mild intellectual disability or low IQ, and severe challenging behaviour referred for residential treatment in the Netherlands. The ABCL was completed by two independent informants to assess inter-rater reliability. To examine the validity of the ABCL, its relationship with three measures of functioning was assessed. Furthermore, association between scales of the ABCL and DSM-IV axis I disorders was examined. The ABCL was reliable in terms of internal consistency of its scales, and inter-rater reliability. Relationships between clusters of axis I DSM-IV disorders and scales of the ABCL were found as expected. Moreover, ABCL scales predicted different measures of functioning. The ABCL appears to be a reliable and valid measure to assess psychopathology in persons with mild intellectual disabilities or low IQ, admitted for treatment in facilities for adults with mild intellectual disability and severe challenging behaviour.
Assessing risks arising from challenging behaviours: a model and a brief review of existing resources
- Author:
- TURTON Raistrick W.
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 8(1), 2014, pp.32-42.
- Publisher:
- Emerald
Purpose: Challenging behaviours are defined in part by the risks of harm they present and the support of individuals who challenge would be improved with effective assessments of the risks posed by challenging behaviours. The purpose of this paper is to outline a model of risk assessment and review literature that provides relevant information. Design/methodology/approach: Literature review. Findings: Forensic risk assessment has a well worked-out and validated approach but tools used to assess challenging behaviours are not effective risk predictors. Applied Behaviour Assessment provides methods that can be more effectively used for risk assessment. Practical implications: There is a need to develop valid risk assessment procedures for assessing the risks presented by challenging behaviours. Originality/value: This is a fresh perspective on risk assessment in relation to challenging behaviours. (Publisher abstract)
Assessment of behavioral and psychiatric problems in people with Prader–Willi syndrome: a review of the literature
- Author:
- SPENDELOW Jason S.
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 8(2), June 2011, pp.104-112.
- Publisher:
- Wiley
Prader–Willi syndrome (PSW) is a rare genetic disorder that has a prevalence of 1 in 50,000 to 70,000 people and equal gender distribution. The clinical presentation of people with PWS involves a wide range of behavioural, psychiatric, neurocognitive, and medical problems. The aim of this review is to help clinicians make a comprehensive assessment of mental health problems with this population. People with PWS are particularly susceptible to the development of problems in the areas of hyperphagia, compulsions and repetitive behaviour, self-injury (especially skin-picking), and aggressive behaviours. The most common psychiatric features in people with PWS are psychosis, affective disorders, and obsessive–compulsive disorders. Assessment should involve consideration of how behavioural and psychiatric problems can be influenced by neurocognitive functioning and medical issues. The heterogeneous and progressive nature of many behavioural and psychiatric problems in this population presents significant challenges to psychological assessment and management. Comprehensive assessment requires an understanding of the phenotype of Prader–Willi syndrome, and associated issues that can impact upon clinical presentation.
Skin-Picking in individuals with Prader-Willi syndrome: prevalence, functional assessment, and its comorbidity with compulsive and self-injurious behaviours
- Authors:
- DIDDEN Robert, KORZILIUS Hubert, CURFS Leopold M G
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.409-419.
- Publisher:
- Wiley
Individuals with Prader-Willi syndrome (PWS) are at increased risk for mental health and behaviour problems, such as skin-picking and compulsive behaviours. Prevalence and functional assessment of skin-picking, and its association with compulsive behaviour and self-injury, were investigated in a large group of individuals with PWS (n = 119) from the Netherlands. Data on demographic characteristics, skin-picking and compulsive and self-injurious behaviours were collected by questionnaires. Behavioural function of skin-picking was assessed by administering the Questions About Behavioral Function scale. Skin-picking was found in 86% of the sample, and correlated positively with compulsive behaviours. No associations were found between skin-picking and other variables. Functional assessment suggest that in most cases (i.e. 70%) skin-picking primarily had non-social functions. Skin-picking and compulsive behaviours are common in PWS. In most cases, skin-picking may be maintained by contingent arousal reduction. Controlled studies on behavioural treatment are lacking. Implications for treatment selection are discussed.
Developmental Behaviour Checklist (DBC) in the assessment of psychopathology in Finnish children with intellectual disability
- Authors:
- KOSKENTAUSTA Terhi, ALMQVIST Fredrik
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 29(1), March 2004, pp.27-39.
- Publisher:
- Taylor and Francis
This study evaluates the Developmental Behaviour Checklist (DBC) in the assessment of psychopathology in a Finnish population of children with intellectual disability. Disruptive behaviour was more common in children with mild intellectual disability, and problems with social interaction and communication in those with moderate, severe or profound intellectual disability. The frequency of psychiatric disturbances was approximately 34 percent, with the highest rate occurring in children with moderate intellectual disability. Compared with the original standardisation data published by Einfeld and Tonge (1994), the mean Total Behaviour Problem Score (TBPS) and frequency of psychiatric disturbance were lower. This study suggests that the DBC is a good instrument for discriminating between children with intellectual disability with and without emotional or psychiatric disturbance.
Intensive community assessment and intervention for challenging behaviour: a case study
- Authors:
- FINLAY W. Mick, DUCKETT Stephanie, ELIATAMBY Anna
- Journal article citation:
- British Journal of Learning Disabilities, 23(1), 1995, pp.18-23.
- Publisher:
- Wiley
Describes the intensive assessment of a man's challenging behaviour in the community and the interventions developed as a result. There were found to be many contributing factors, and interventions led to a marked improvement in the man's quality of life, communication and behaviour in the community. The process enabled community staff members to develop competence in supporting people who challenge, and allowed the man to remain in his normal environment.
Mental handicap and mental health: a community service
- Authors:
- BOURAS Nick., et al
- Publisher:
- Lewisham Hospital. National Unit for Psychiatric Research and Development
- Publication year:
- 1988
- Pagination:
- 47p., tables, bibliog.
- Place of publication:
- London
Results from a survey into the extent of mental health problems in the mentally handicapped, and the provision of services to them.
Assessment and treatment units for people with intellectual disabilities and challenging behaviour in England: an exploratory survey
- Authors:
- MACKENZIE-DAVIES N., MANSELL J.
- Journal article citation:
- Journal of Intellectual Disability Research, 51(10), October 2007, pp.802-811.
- Publisher:
- Wiley
Evaluative studies have shown that special units for people with intellectual disabilities (ID) who have challenging behaviour have advantages and disadvantages. There has been no survey of their number or characteristics for nearly 20 years. A questionnaire was sent to all National Health Service trusts that had ID inpatient beds, and all private or voluntary healthcare establishments providing services for people with mental health problems or ID. This asked for information about the unit, its residents and the views of the unit manager. Forty-four agencies confirmed that they provided assessment and treatment units, of which 38 returned questionnaires. These units served 333 people, of whom 75% had mild or moderate ID. A quarter had been there for more than 2 years. Forty per cent of residents had a discharge plan, and 20% had this and the type of placement considered ideal for them in their home area. The main strengths of the units were identified as the knowledge and experience of the staff and having sufficient staff; the main problems as inappropriate admissions, bed-blocking and the relationship with other services; difficulties with recruiting and retaining staff; the location and environment of the unit; and the mix of residents. There has been an increasing rate of provision of special units, which now predominantly serve people with moderate or mild ID. This model of service provision is becoming more widespread, but the potential problems identified 20 years ago are still present. Areas are identified for further research.
Fearful of help
- Author:
- GEORGE Mike
- Journal article citation:
- Community Care, 20.4.00, 2000, pp.30-31.
- Publisher:
- Reed Business Information
An elderly woman and her family were living in squalor and social isolation and repeatedly rejected the offers of help. The author talks to a social worker about the uphill struggle she faced when she tried to improve their lives.