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A general practice-based study of the relationship between indicators of mental illness and challenging behaviour among adults with intellectual disabilities

Felce, David John, Kerr, Michael Patrick and Hastings, R. P. 2009. A general practice-based study of the relationship between indicators of mental illness and challenging behaviour among adults with intellectual disabilities. Journal of Intellectual Disability Research 53 (3) , pp. 243-254. 10.1111/j.1365-2788.2008.01131.x

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Abstract

Background Existing studies tend to show a positive association between mental illness and challenging behaviour among adults with intellectual disabilities (ID). However, whether the association is direct or artefactual is less clear.The purpose was to explore the association between psychiatric status and level of challenging behaviour, while controlling for adaptive behaviour and occurrence of autistic spectrum disorders. Methods Data were collected on the age, gender, adaptive and challenging behaviour, social impairment and psychiatric status of 312 adults with ID. Participants were divided according to psychiatric status, group equivalence in adaptive behaviour and the presence of autistic spectrum disorders achieved, and differences in challenging behaviour explored. In addition, multiple regression was used to examine the association between psychiatric status and challenging behaviour after controlling for other participant characteristics and to test whether the interaction between psychiatric status and adaptive behaviour added significantly to explanation. Results Challenging behaviour was higher among participants meeting threshold levels on the psychiatric screen. The regression analysis confirmed the association and demonstrated an interaction between total score on the psychiatric screen and level of adaptive behaviour.This moderated effect showed the relationship between psychiatric status and challenging behaviour to be stronger at lower adaptive behaviour. Conclusions This study reinforces previous findings that psychiatric morbidity among people with ID is associated with higher levels of challenging behaviour and supports predictions that this association is more pronounced for people with severe ID. The precise nature and causal direction of the association requires further clarification. However, the understanding of how psychiatric problems might contribute to challenging behaviour needs to be part of the clinical appreciation of such behaviour.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Uncontrolled Keywords: challenging behaviour; intellectual disabilities; psychiatric status
Additional Information: Special Issue: Mental Health and Intellectual Disability: XXV
Publisher: Blackwell Publishing
ISSN: 0964-2633
Last Modified: 30 Jun 2017 02:23
URI: http://orca.cf.ac.uk/id/eprint/27038

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