Prevalence of Challenging Behaviour in Adults with Intellectual Disabilities, Correlates, and Association with Mental Health

Darren L Bowring,Richard P Hastings,Jon Painter

doi:10.1007/s40474-019-00175-9

Abstract

Purpose of ReviewTo summarise findings about the prevalence and correlates of challenging behaviour in adults with intellectual disabilities from robust research. We also describe findings on the interplay between challenging behaviour and mental health.Recent FindingsRecent studies that have utilised psychometrically evaluated tools, with clear operational definitions, show similar findings on the prevalence of challenging behaviour of about 1 in every 5–6 adults known to services. We describe common correlates identified such as communication impairments, severity of intellectual disability, and living in institutional settings or congregate care. We also describe the complex and multifaceted relationship between challenging behaviour and mental health.SummaryBased on recent studies, we propose a revised framework model to help understand challenging behaviour. We propose a number of areas where more research is required, particularly the development of risk tools clinicians can utilise in practice.

Highlights

There is a high prevalence of challenging behaviour (CB) [1, 2, 3] and mental health (MH) issues [4, 5] in adults with intellectual disabilities (ID)
Based on a review of recent studies, we propose a revised framework model for CB [14] that includes reference to MH issues, updates vulnerability factors, and refers to the impact of increased psychotropic medication use
This study revealed a prevalence rate of CB of 18.1% which was similar to other population studies that had used classification tools for adults with ID– 18.7% [1, 2]

Summary

Introduction

Existing research is inconclusive in relation to an association between CB and MH in adults with ID when the two constructs are examined in the context of correlation/ regression designs Whilst this may vary according to the combination of specific type of CB and MH conditions examined [48], there is some consistent evidence that CB and MH globally are more strongly associated in those with more severe to profound ID. Sheehan et al [23] found a 49% prevalence of psychotropic medication use with 21% of participants prescribed with antipsychotic medication These studies used population-based samples, but identified their participants from primary care services.

A Revised Framework Model for CB

Findings

Discussion

Conclusions