ABSTRACT Introduction Recent prevalence studies estimate that 5–10% of individuals with intellectual and developmental disabilities (IDD) experience depression. Despite these trends, few evidence-based mental health interventions have been designed specifically for this population. To address this gap, Jahoda et al. (2017) developed Beat It, a manualized therapeutic approach adapted from behavioral activation for individuals with IDD. Methods This single-arm feasibility study was designed to be conducted at two outpatient clinics; however, one site withdrew before recruitment commences, resulting in data collection at a single location. Pre- and post-intervention data were collected using the Glasgow Depression Scale for People with Learning Disabilities (GDS-LD). Results Participants who completed the Glasgow Depression Scale at both pre- and post-intervention (n = 6) reported significantly improved depressive symptoms following the intervention. Glasgow Depression Scale scores decreased from pre-intervention (M = 23.50, SD = 3.70) to post-intervention (M = 14.83, SD = 6.96). A paired samples t-test indicated that this reduction was statistically significant, t(5) = 4.73, p = .005, reflecting a large within-participant effect (Cohen’s dz = 1.93). Qualitative findings revealed that participants valued the structured, manualized format and the accompanying materials, which were perceived as helpful and accessible. Conclusion Feasibility outcomes suggest that with minimal modifications to the study protocols and intervention materials to enhance acceptability, a larger-scale study can be conducted to further evaluate the effectiveness of Beat It in U.S. outpatient settings.

ABSTRACT Introduction Research shows that parents of children with intellectual disability experience more mental health problems than those of children with typical development, which has been related to several factors such as sociodemographic characteristics, parenting attitudes, practices and styles, the presence of behaviors that challenge and the level of supports required by their child. To understand the relationship of these variables is crucial for the development of interventions and supports for this group. Methods One hundred and twenty-three Chilean mothers and fathers of children with intellectual disability between 7 and 17 years of age participated in our study. Results Participants reported higher levels of depression, anxiety, perceived stress, and parental stress compared to the general population. Cluster analysis identified two groups based on mental health symptoms (low vs. high), revealing differences in their child’s behavior, parenting styles, parental age, and socioeconomic status. Parents in the low symptoms group are older, from higher socioeconomic status and reported better parental attitudes, less behaviors that challenge and more prosocial behaviors in their child, that the participants in the high symptoms group. A conditional classification tree analysis highlighted limit setting and parental involvement as key predictors of these clusters. Conclusion Our findings emphasize the need to further explore the relationship between mental health and contextual factors in parents of children with intellectual disability to identify risk of mental health problems in the parents and develop effective interventions for this group.

ABSTRACT Introduction Individuals with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) are at heightened risk of exposure to traumatic events, including sexual abuse. While such experiences are known to increase the risk of PTSD in the general population, it remains unclear whether sexual abuse, gender, or age at first trauma are similarly predictive of PTSD symptom severity in individuals with MID-BIF. This study investigates whether sexual abuse, gender, and age at first A-criterion trauma are associated with the frequency of PTSD symptoms in adults with MID-BIF. Method Fifty-eight adults with MID-BIF were categorized into sexual abuse (SA) and non-sexual trauma (non-SA) groups based on the Diagnostic Interview Trauma and Stressors – Intellectual Disability. PTSD symptoms were assessed using the Trauma Screener-ID. Results No significant differences in PTSD symptom frequency were found between the SA and non-SA groups. Furthermore, sexual abuse, gender, and age at first trauma did not significantly predict PTSD symptom frequency. Conclusions Although a high prevalence of sexual abuse was observed among individuals with MID-BIF, it was not associated with increased PTSD symptom frequency. These findings suggest that factors such as poly-victimization may play a more central role in PTSD symptomatology in this population, highlighting the importance of comprehensive, trauma-sensitive assessment and care.

ABSTRACT Introduction This scoping review aimed to describe the literature on therapeutic alliance with youth with MID-BIF, focusing on how therapeutic alliance is conceptualized, operationalized, and studied in this population. Methods We systematically searched seven databases. We extracted and double-coded data on therapeutic alliance conceptualization and operationalization, study aims, methodology, and key findings. Results Of the 1521 studies assessed, 18 met our eligibility criteria. Most of these were published from 2020 onwards. Studies were diverse in terms of conceptualizations, disciplinary backgrounds, methodologies, nature of the samples, and findings. Most studies used qualitative methodologies (72.2%). Although most studies reported on interventions that directly targeted youth, therapeutic alliance with youth was assessed in only 33.3% of studies. Conclusion Research on therapeutic alliance with youth with MID-BIF is on the rise. We identify priorities for strengthening future research, such as a more unified conceptual framework, more explicit methodological decisions, and more quantitative research.

ABSTRACT Introduction A child’s disability, particularly Down syndrome, significantly impacts parents’ psychological well-being. This impact often manifests as stigma, inadequate social support, and diminished self-acceptance. However, the role of demographic factors (age, education, income, child’s age) in mediating this relationship is not fully understood. Methods Cross-sectional study with a quantitative design with a mediating factor method, involving 351 parents of children with Down syndrome residing in Riau, Indonesia. Data were collected through psychological scales that evaluated parents’ psychological well-being, demographics, stigma, social support, and self-acceptance. Data were analyzed using the mediator factor method, regression, and correlation analyses to understand the relationship between the variables studied. Results Negative correlation between age and psychological well-being, with a coefficient of −0.1491 and a p value of 0.0016. This suggests that as age increases, psychological well-being also declines. Education was also found to have a significant impact on self-acceptance, with a coefficient of 0.0119 and a p-value of 0.0004, and showed a moderating effect on psychological well-being with a coefficient of c’ −0.1519 and a p-value of 0.0016. Another influential factor was social support, with an R2 value of 0.1692, making it the strongest predictor, compared to self-acceptance which had an R2 value of 0.0341 and stigma with an R2 value of 0.0214. Conclusion Demographic factors have been demonstrated to play a significant role in mediating the relationship between child disability and parents’ psychological well-being. This finding underscores the necessity to consider socioeconomic and structural aspects in conjunction with direct psychological support. The results of the study highlight the importance of comprehending parents’ experiences of stigma, inadequate social support, and low self-acceptance. The study further emphasizes the potential of enhancing social support to improve parents’ psychological well-being

ABSTRACT Aim This study aimed to determine the effects of passive smoking and parental stress on challenging behaviors of autistic and neurodevelopmentally atypical children. Materials and Methods This descriptive-analytical cross-sectional study was completed by collecting data from 60 parents of children with special needs in a provincial center in Turkiye between May and September 2024. Data were collected with the Child’s Challenging Behavior Scale (CCBS), the Parenting Stress Scale (PSS), Fagerstrom Test for Nicotine Dependence (FTND), and a sociodemographic information form. Cotinine and creatinine levels were measured in urine samples obtained from the children participating in the study and cotinine/creatinine ratios were calculated. Data were analyzed using number, percentage, mean, standard deviation, and regression analysis. Findings The ratio of autism spectrum disorder (ASD) was 29.7%; the ratio of mild intellectual disability was 68.3%. The mean PSS score of the mothers was 15.67 ± 11.33 and the mean CCBS score of the children was 18.77 ± 4.49, which were at low levels. When the nicotine dependence scores of the parents were analyzed, it was determined that mothers had very low dependency (0.58 ± 1.27) and fathers had low dependency (2.83 ± 3.42). Mother’s opinion on stress increasing a child’s challenging behavior was 46.7%. Conclusion The participants’ parenting stress levels, smoking status, addiction levels of parents, urinary cotinine levels and cotinine/creatine levels of children had no significant effect on children’s challenging behavior. Thus, qualitative and mixed-method studies are needed to better understand the mechanisms underlying these conclusions. Practice implications In future research, it is recommended to examine the challenging behaviors of children of parents who cannot protect their children from passive smoking and/or have nicotine addiction and/or high stress. These studies could include children with severe challenging behavior, and/or data could be collected during the winter season.

ABSTRACT Introduction Adults with mild intellectual disability (MID; IQ 50–70) or borderline intellectual functioning (BIF; IQ 70–85) are at elevated risk for posttraumatic stress disorder (PTSD). Evidence for intensive trauma-focused treatment in this group is scarce, whereas studies in people without intellectual disabilities suggest that intensive formats improve treatment efficiency and reduce drop-out. This study examined the feasibility, potential effectiveness, and safety of intensive Eye Movement Desensitization and Reprocessing (EMDR) for adults with MID-BIF, PTSD, and complex comorbidities in tertiary mental health care. Methods A nonconcurrent single-case A – B – A design was applied. Six adults received up to 16 EMDR sessions across four weeks, delivered by rotating therapists during a brief inpatient admission including an activation program. PTSD symptoms, diagnosis, and adverse events were assessed. Results Five participants showed significant PTSD symptom reduction; three no longer met diagnostic criteria. All completed treatment without drop-out or adverse events. Conclusion Intensive EMDR appears feasible, safe, and potentially effective for adults with MID-BIF and PTSD in tertiary care.

ABSTRACT Introduction Service users with intellectual disabilities (SUID) represent a complex healthcare population at high risk for involuntary mental health admissions (IMHA). We aimed to explore experiences with IMHA among SUID from the perspectives of both SUID and healthcare professionals. Methods A qualitative study, informed by the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies, was conducted. Results Following the analysis, three main themes and one sub-theme emerged: (1) Need for a professional, equitable and honest encounter; (2) SUID as a pawn in disjointed cooperation; (3) Inadequacy of the healthcare system for SUID; and (3.1) Challenges of having an intellectual disability diagnosis. Conclusion SUID face significant risks of inadequate mental health care due to insufficiently tailored approaches to their needs. Addressing this requires enhanced professional competence and interdisciplinary collaboration. Further research is needed to deepen understanding of SUID experiences to validate and generalize these insights in the context to IMHA.

ABSTRACT Background People with intellectual disabilities face considerable barriers to accessing appropriate mental health assessment and treatment. These barriers have been sparsely explored beyond a few countries, and the specific actions needed to address them remain unclear. Methods As part of a Norwegian service development project, 46 participants (33 professionals, 13 family members) with experience of mental health services for people with intellectual disabilities, reported barriers based on their experience. Their responses were analyzed using thematic analysis. Results The analysis identified a core theme; the participants perceived the mental health of people with intellectual disabilities to be viewed as less important compared to people without intellectual disabilities across the healthcare system, resulting in a host of entangled and complex barriers affecting all levels of the system. Conclusion Comprehensive action is required across all levels of the healthcare system to ensure equitable and appropriate mental health services for people with intellectual disabilities.

ABSTRACT Introduction The functional dependence of older adults with intellectual disabilities can significantly affect both their own quality of life and that of their caregivers. This study analyzed the impact of functional dependence on caregivers’ stress and quality of life in Southern Brazil. Methods A quantitative observational study was conducted with 605 informal caregivers of older adults with intellectual disabilities. Instruments included the Functional Independence Measure, WHOQOL-Bref, and Perceived Stress Scale. Data were analyzed using Pearson correlation and multiple linear regression (p < .05). Results Caregivers had a mean age of 57.8 years and reported moderate stress levels. Functional dependence explained a small proportion of variance in stress (R2 = 0.02), with locomotion showing a paradoxical effect: greater independence in locomotion was linked to higher caregiver stress. For quality of life, functional dependence explained between 3% and 13% of the variance. Mobility/transfer was negatively associated with all domains, while locomotion showed positive associations only with relationships (β = 0.17) and environment (β = 0.22). Conclusion Functional dependence in older adults with intellectual disabilities is a relevant but limited explanatory factor for caregiver outcomes. Its effects are differentiated: mostly negative for quality of life, but positive in specific domains such as relationships and environment. These findings underscore the complexity of caregiving dynamics and the need for tailored interventions to support caregivers.