Latent Profile Analysis of Challenging Behaviour in Individuals With Intellectual Disabilities: Examining Associated Factors and Life Satisfaction

Editorial: Introduction to Special Section on Evidence-Based Practices for Persons With Intellectual and Developmental Disabilities

This study examined empirically derived symptom cluster profiles among patients who present with insomnia using clinical data and polysomnography. Latent profile analysis was used to identify symptom cluster profiles of 175 individuals (63% female) with insomnia disorder based on total scores on validated self-report instruments of daytime and nighttime symptoms (Insomnia Severity Index, Glasgow Sleep Effort Scale, Fatigue Severity Scale, Beliefs and Attitudes about Sleep, Epworth Sleepiness Scale, Pre-Sleep Arousal Scale), mean values from a 7-day sleep diary (sleep onset latency, wake after sleep onset, and sleep efficiency), and total sleep time derived from an in-laboratory PSG. The best-fitting model had three symptom cluster profiles: "High Subjective Wakefulness" (HSW), "Mild Insomnia" (MI) and "Insomnia-Related Distress" (IRD). The HSW symptom cluster profile (26.3% of the sample) reported high wake after sleep onset, high sleep onset latency, and low sleep efficiency. Despite relatively comparable PSG-derived total sleep time, they reported greater levels of daytime sleepiness. The MI symptom cluster profile (45.1%) reported the least disturbance in the sleep diary and questionnaires and had the highest sleep efficiency. The IRD symptom cluster profile (28.6%) reported the highest mean scores on the insomnia-related distress measures (eg, sleep effort and arousal) and waking correlates (fatigue). Covariates associated with symptom cluster membership were older age for the HSW profile, greater obstructive sleep apnea severity for the MI profile, and, when adjusting for obstructive sleep apnea severity, being overweight/obese for the IRD profile. The heterogeneous nature of insomnia disorder is captured by this data-driven approach to identify symptom cluster profiles. The adaptation of a symptom cluster-based approach could guide tailored patient-centered management of patients presenting with insomnia, and enhance patient care.

Using Latent Profile Analysis and Related Approaches in Adolescent Health Research

The goal of this communication is to provide clinicians and behavioral scientists with a scoping perspective on the diverse array of impacts of the COVID-19 pandemic on individuals with intellectual and developmental disabilities (IDD) in the U.S. It is our hope that this will stimulate subsequent scientific and advocacy efforts to ameliorate the disproportionate burden of the pandemic on people with IDD.We begin with the assertion that among non-infected persons in the U.S. few are more adversely affected by COVID-19 than individuals with IDD, given that a vast proportion require in-person care or critical therapeutic support within their living environments, with little back-up or systematic coverage for prolonged interruption of services.Many have temporarily lost access to trained caregivers or community service providers, and now face evolving threats to the return of baseline service, given uncertainties in State and agency budgets.Therefore, a first priority relates to restoration of in-person support services or comparable alternatives.There have been emerging guidelines on the safe care and support of individuals with IDD during the COVID pandemic-see Supplementary Table (ST) 1 which lists resources and documentation of early success of such strategies, however guidance is still evolving, has not permeated all reaches of the community where the information is desperately needed, and is not always presented in ways that can be fully comprehended by those with IDD.It must be

The present study aimed to use a latent profile analysis to distinguish between populations in terms of life domain importance and satisfaction profiles. Then, a multinomial logistic regression was used to determine how background variables (e.g., gender, living areas, and school levels) and self-perceived health predict each latent quality of life (QoL) profile. We also investigated how the latent groups of adolescents predicted negative and positive well-being indicators (e.g., problem behaviors and overall life satisfaction). The sample consisted of 720 Taiwanese secondary school students. Three latent groups were established as follows: “unimportant-unsatisfied,” “important-unsatisfied,” and “important-satisfied.” The results indicate the following: (a) boys were more likely to fall into the “unimportant-unsatisfied” group than were girls; (b) better health increased the likelihood of being in the “important-satisfied” group; (c) high school students were more likely to be in the “unimportant-unsatisfed” group than were middle school students; and (d) no relationship was found between latent groups and living areas. The function of importance rating was not present when evaluating the importance-satisfaction profiles and their relationship with problem behaviors and overall life satisfaction. The problems of the “unimportant-unsatisfied” profile among youth are discussed.

Entirely revised and updated, this edition of a very well-received and successful book provides the essentials for all those involved in the fields of intellectual, developmental and learning disabilities and mental retardation, drawing both on clinical experience and the latest research findings. An international, multidisciplinary team of experts cover the available literature in full and bring together the most relevant and useful information on mental health and behavioural problems of people with intellectual, developmental and learning disabilities and mental retardation. In addition, this book highlights the principles behind clinical practice for assessment, management and services. It offers hands-on, practical advice for psychiatrists, psychologists, nurses, therapists, social workers, managers and service providers

Burnout, intrinsic motivation, and emotion regulation profiles among pediatric nurses in Turkey: A latent profile analysis.

OBJECTIVESIncreasing interest has emerged in the use of subjective well-being as a development indicator and for the evaluation of public policies. The aim of this study was to assess life and health satisfaction and their determinants in the adult population of Iran.METHODSWe conducted a survey of a sample of 3,150 adults at least 18 years of age in Tehran, the capital of Iran. The subjects were selected using a stratified random sampling method, and they were interviewed face-to-face at their usual residence by trained interviewers. Life satisfaction was used as a measure of subjective well-being. We used ordinary least square regression models to assess the associations of life and health satisfaction with socio-demographic variables.RESULTSOn a 0-10 scale, the mean (standard deviation) scores for life and health satisfaction were 6.93 (2.54) and 7.18 (1.97), respectively. The average score for life satisfaction in females was 0.52 points higher than in males. A U-shaped relationship was found between age and life satisfaction, with respondents 35 to 44 years of age having the lowest average level of life satisfaction. Satisfaction with life and health among divorced respondents was significantly lower than among never-married and married participants. The scores for life satisfaction in respondents who rated their health status as poor were 3.83 points lower than in those who rated their health status as excellent.CONCLUSIONSThe majority of the population of Tehran was satisfied with their life and health. Self-rated health status had the greatest impact on life satisfaction.

Challenging behaviors are among the most serious and studied problems in the field of developmental disabilities (Matson et al. 2011). An increasing number of studies are being published that have provided more insight into the nature, prevalence, and characteristics of challenging behaviors in this target group. Results of these studies have shown that challenging behaviors are common in children and adults with autism spectrum disorders (ASD) and/or intellectual disabilities (ID). Population studies have shown that between 5 and 15% of individuals with ID show some type of challenging behavior, like self-injury, aggression, stereotypic behavior, and other problem behaviors. Studies also show that rates of challenging behaviors are increased if individuals also have ASD. For example, Holden and Gitlesen (2006) found that among over 900 individuals with ID, 11% showed one or more types of challenging behavior. Of the study sample, 6% had been diagnosed with autism, and 36% of this subgroup showed challenging behavior. Rojahn, Matson, Lott, Esbensen, and Smalls (2011) employed the Behavior Problem Inventory-01 (BPI-01) in a sample of individuals with ID (n = 432) who lived in a residential facility and who were between 14 and 19 years old. Results showed that individuals with ASD had higher rates of aggression, self-injury and stereotypy than those with ID without ASD. These findings were corroborated by results from a meta-analysis by McClintock, Hall, and Oliver (2003) who have explored risk factors for challenging behaviors in individuals with developmental disabilities. They have published a meta-analysis of 22 studies conducted over 30 years, and the results showed that children and adults with ASD were more likely than other individuals with ID to exhibit challenging behaviors such as self-injury and aggression. These results indicate that ASD itself may be a risk factor for challenging behavior in individuals with ID. However, other researchers failed to find an association between challenging behavior and ASD. For example, Tyrer et al. (2006) investigated prevalence rate of physical aggression in over 3,000 adults with profound to mild ID, and they failed to find a relationship between challenging behavior and the presence of autism.

Purpose – The purpose of this paper is to determine the extent to which mental health, physical health, communication, learned function of the behaviour(s), severity of disability, living arrangement, age, and gender, alone or in combination, predicted challenging behaviours in adults with intellectual disability. Design/methodology/approach – In total, 74 adults with intellectual disability and their paid carers were recruited into the study from adult disability services in Victoria, Australia. Paid carers provided information about participants with intellectual disability on a range of measures targeting each variable of interest. Findings – Based on principle components analyses of three challenging behaviour measures, two topographies of challenging behaviour emerged: contact and non-contact behaviours. Multiple regression analysis revealed that contact behaviours were predicted by anxiety scores and severity of disability. In addition to severity of disability and anxiety scores, non-contact behaviours were also predicted by sensory scores. Practical implications – The results of the current study indicate that contact and non-contact behaviours were determined by multiple factors. Clinicians and others who work with people who display challenging behaviour may, therefore, find it helpful to utilise the biopsychosocial model in their formulations of possible reasons that motivate a person to engage in challenging behaviour. Originality/value – These results contribute to the evidence base available to clinicians and researchers to guide future assessment for challenging behaviour. Expansion of functional assessment methods to explore factors not traditionally included, such as mental health and severity of intellectual disability, as causes of challenging behaviour, may prove helpful.

Compared to their nonautistic peers, lower levels of life satisfaction have been reported by autistic individuals. It is unclear, however, whether autistic individuals with intellectual disability report similar levels of life satisfaction as autistic individuals without intellectual disability or which characteristics are associated with life satisfaction. This study sought to examine differences in levels of self-reported life satisfaction across those with and without intellectual disability and explore correlates of life satisfaction in a sample of 35 autistic youth with intellectual disability and 99 autistic youth without intellectual disability. No difference in self-reported life satisfaction was detected between autistic youth with and without intellectual disability. Greater self-reported life satisfaction was associated with higher self-determination for autistic youth without intellectual disability. For autistic youth with intellectual disability, greater self-reported life satisfaction was related to more frequent social participation, lower parent stress, and fewer unmet service needs. Unmet service needs and parent stress were significantly stronger correlates of life satisfaction for youth with intellectual disability compared to youth without intellectual disability. Although the sample size of autistic youth with intellectual disability was small, these findings suggest the importance of considering heterogeneity among individuals on the autism spectrum when seeking to understand their well-being.Lay abstractAutistic people report lower life satisfaction compared to people without autism. It is unclear whether autistic people with intellectual disability report similar levels of life satisfaction to autistic people without intellectual disability. In this study, we did not find a difference in levels of life satisfaction for autistic youth with intellectual disability compared to autistic youth without intellectual disability. We also identified factors that might promote better life satisfaction. Higher self-determination was related to higher life satisfaction for autistic youth without intellectual disability. For autistic youth with intellectual disability, more frequent social participation, lower parent stress, and fewer unmet service needs were associated with higher life satisfaction. Unmet service needs and parent stress were more strongly related to life satisfaction for youth with intellectual disability compared to youth without intellectual disability. Our findings suggest that taking a more individualized approach to support the well-being of autistic youth is important.

Objective: The use of psychotropic medication to address challenging behavior in individuals diagnosed with intellectual disabilities is common practice; however, very few studies have examined how multiple medication use (or combination treatment) impacts the behaviors these medications are prescribed to treat.Method: The current study followed eight individuals over a two-year period as they experienced changes in their psychotropic medication regimens. During that time, data from functional analyses and indirect assessments of challenging behavior were collected.Results: The results suggest that changes in psychotropic medication regimens can produce changes in functional assessment outcomes, suggesting a need for continued behavioral assessment to better inform medication practices and behavioral treatment. Of the eight participants in the study, five participants’ behaviors varied in rate of responding in functional analysis (FAs) across all medication changes. Additionally, three participants’ FAs produced changes in outcomes; however, those changes were not consistent across all medication changes, that is, not every medication change yielded different outcomes from previous assessments.Conclusion: This study demonstrates how the outcome of an FA can be used to monitor the effects of psychotropic medication changes, specifically when medications are combined, on challenging behavior in individuals with intellectual and developmental disabilities.

BackgroundIn this study, the effects of individuals’ digital obesity and phubbing behaviors on their life satisfaction were investigated by latent profile analysis (LPA) method. LPA is a statistical technique used to identify unobserved subgroups within a population based on individuals’ responses to various observed variables.MethodsThe present study was conducted in a correlational cross-sectional descriptive design between November 2023- January 2024. Digital obesity scale, phubbing scale, life satisfaction scale were used in this study.ResultsAs a result of LPA, Class 1 (Low Digital Addicts) has the lowest arithmetic mean in all indicators. When life satisfaction was analyzed on the basis of the classes, it was found out that Class 2 (High Digital Addicts), which was collected in the group with high levels of digital obesity and phubbing, had lower life satisfaction. Considering the demographic levels of individuals according to class level, it was concluded that high digital addiction was more common among individuals with secondary and postgraduate education.ConclusionsIn the present study, two classes were found as a result of LPA. In the analysis, Class 1(Low Digital Addicts) was found to have the lowest arithmetic mean in all indicators. On the other hand, when life satisfaction was analyzed according to the classes, it was detected that Class 2 (High Digital Addicts) life satisfaction was lower in the group with high levels of digital obesity and phubbing. In the study, the life satisfaction of class 1, which is characterized as low digital addicts, was found to be higher. Longitudinal studies on digital addictions affecting life satisfaction are recommended.

PurposeTo analyze changes in life satisfaction (LS) scores over time in persons with spinal cord injury (SCI) and to interpret what these changes mean.MethodsMulticenter, prospective cohort study of persons with SCI (n = 96) classified into 3 life satisfaction trajectories identified earlier. Assessment took place 6 times from the start of active rehabilitation up to 5 years after discharge. Three LS scores were compared: (1) LS ‘now’ score, (2) ‘comparison’ score between LS ‘now’ and LS ‘before the SCI’, and (3) retrospective score of LS ‘before the SCI’.ResultsPersons in the low LS trajectory showed increase in the LS ‘now’ score, but not in the LS ‘comparison’ score and retrospective score. Persons in the recovery trajectory showed increase in the LS ‘now’ and LS ‘comparison’ scores, but not in the retrospective score. Persons in the high LS trajectory showed increase in the ‘comparison’ LS score and decrease in the retrospective score, but no change in the LS ‘now’ score.ConclusionsDiverging patterns of change were found and that were interpreted as adaptation or scale recalibration. Recalibration could also be considered healthy rebalancing after SCI. Being able to compare different LS ratings can facilitate the interpretation of change in and stability of LS.

Academy of Nutrition and Dietetics: Standards of Practice and Standards of Professional Performance for Registered Dietitians (Competent, Proficient, and Expert) in Intellectual and Developmental Disabilities