Individuals with Mild Intellectual Disability or Borderline Intellectual Functioning in a Forensic Addiction Treatment Center: Prevalence and Clinical Characteristics

Ilse Luteijn,Robert Didden,Joanneke Van Der Nagel

doi:10.1007/s41252-017-0031-7

Abstract

Knowledge regarding substance-related problems and offending behavior in individuals with mild intellectual disability or borderline intellectual functioning (MBID; IQ 50-85) has increased over the last years, but is still limited. The present study examined differences in prevalence and clinical characteristics of individuals with and without MBID in a forensic addiction treatment center. Participants were 190 court mandated male clients of a low to high security forensic addiction treatment center in the Netherlands (aged between 21 and 59 years old, 82% of Dutch origin). Of the total sample 39% could be identified with MBID which is much higher than the estimated 12% to 15% of the general population. Results showed that clients with MBID reported significantly lower scores on desire for help, compared to clients without MBID (F (1, 73) = 5.12, p = .027). Against expectations, no significant group differences were found for aggression during treatment while controlling for impulsivity, treatment duration and type of substance use and offense. As results of the present study showed that clients with MBID are overrepresented in the forensic addiction treatment center, future research should further explore characteristics and responses to treatment of these clients. More knowledge about the characteristics of clients with MBID will not only help to better identify these clients, but will also to improve treatment for this group

Highlights

It is generally acknowledged that substance use and offending behavior are closely intertwined (Kopak et al 2014; Vaughn et al 2016)
The present study examined the prevalence and characteristics of clients with mild intellectual disability or borderline intellectual functioning (MBID; IQ 50–85) in a forensic addiction treatment center
This result confirms the hypothesis that more than 15% of the clients in a forensic addiction treatment center could be identified with MBID, based on the 12 to 15% found in the general population (Emerson et al 2010)

Summary

Introduction

It is generally acknowledged that substance use and offending behavior are closely intertwined (Kopak et al 2014; Vaughn et al 2016). As motivation for treatment is one of the most important factors contributing to the success of treatment (Kopak et al 2016; Stevens et al 2015), it is important to study whether motivation differs for clients with MBID compared to those without MBID This holds true for aggression during treatment, as this behavior is associated with more dropouts from addiction programs with more risk at relapse in substance use and offending behavior as a result (Bali et al 2006; Liu et al 2013). As research has shown that MBID is related to higher expressions of overt and covert aggression, it was hypothesized that clients with MBID are more likely to report covert and overt aggression than clients without MBID, while controlling for impulsivity, treatment duration, and type of substance use and index offense. It was expected that for clients with MBID, more aggression incidents are reported by the clinical staff during treatment than for clients without MBID, while controlling for impulsivity, treatment duration, and type of substance use and index offense

Participants

Procedure

Results

Motivation for Treatment

Discussion