Borderline Intellectual Functioning Research Articles

Development and evaluation of the Trauma Screener-Intellectual Disability: a post-traumatic stress disorder screening tool for adults with mild intellectual disability or borderline intellectual functioning.

This study aimed to evaluate the validity and reliability of the adult self-report and proxy version of the Trauma Screener-Intellectual Disability (TS-ID) in adults with mild intellectual disability or borderline intellectual functioning (MID-BIF). An optimal cut-off value was determined for the ratio of specificity to sensitivity for predicting the diagnosis of post-traumatic stress disorder (PTSD). The TS-ID was adapted from a Dutch Child and Adolescent Trauma Screener, for use with adults with MID-BIF. Outcomes based on the TS-ID were compared with the presence of PTSD, as classified using the Diagnostic Interview Trauma and Stressors-Intellectual Disability (Mevissen et al. 2018). The TS-ID adult version was administered to 97 participants with MID-BIF who lived in supported housing, whereas the TS-ID proxy version was administered to 92 family members or professional caregivers. The TS-ID adult version showed high internal consistency (Cronbach's α=.94) and excellent validity (AUC=.94) for distinguishing PTSD in adults with MID-BIF. Optimal specificity and sensitivity was found at a cut-off score of 18. Although the TS-ID proxy version demonstrated excellent internal consistency (Cronbach's α=.93), it showed no validity in statistically distinguishing PTSD in adults with MID-BIF. The TS-ID showed favourable psychometric qualities as a screening instrument of PTSD in the case for people with MID-BIF.

The association between aggressive behaviour and non-suicidal self-injury and shared risk factors in adults with mild intellectual disability.

Aggressive behaviour (AB) and non-suicidal self-injury (NSSI) are common in people with mild intellectual disability or borderline intellectual functioning, leading to adverse consequences for themselves and those around them. We investigated the relationship between AB (both total and physical in particular) and NSSI and risk factors in 125 residents in a treatment clinic using incident reports and standard clinical measurements. There was a weak correlation between AB and NSSI, as well as between impulsivity and total AB, and between coping and AB and NSSI. However, NSSI, impulsivity and coping skills did not predict AB. Results do not corroborate those of other studies in this area. In future studies impulsivity, coping, aggression and NSSI may be measured using other instruments, and differences between people with and without intellectual disability regarding these variables may be explored.

Reliability and Validity of the Diagnostic Interview Trauma and Stressors- Intellectual Disability in Adults with Mild Intellectual Disabilities or Borderline Intellectual Functioning

ABSTRACT Objective To assess the reliability and construct validity of the Diagnostic Interview Trauma and Stressors- Intellectual Disability – Adult version (DITS-ID-adults) in adults with mild intellectual disabilities or borderline intellectual functioning (MID-BIF). Method The DITS-ID-adults, Brief Symptom Inventory–18 (BSI–18), and Impact of Event Scale-Intellectual Disability (IES – ID) were administered to 97 participants with MID-BIF who lived in supported housing. The Anxiety, Depression, and Mood Scale (ADESS) and Behavior Problems Inventory (BPI) were administered to their relatives. Results The interrater reliability of the DITS-ID-adults was good to excellent. The construct validity of the DITS-ID-adults was good, based on positive correlations between the BSI–18, IES-ID, ADESS and DITS-ID-adults, and mainly positive correlations between the BPI and DITS-ID-adults (r = .21 to r = .75). Reporting potentially traumatic events listed under the A criterium for PTSD was associated with fulfilling PTSD symptom criteria. In this sample, 58% were classified with post-traumatic stress disorder (PTSD) according to the DITS-ID-adults, while PTSD diagnosis on file was low (7%). Conclusion The present findings support the DITS-ID-adults as a reliable and valid basis for classifying PTSD in individuals with MID-BIF.

Psychometric Properties of the Symptom Questionnaire-48 in Adults with Mild Intellectual Disability or Borderline Intellectual Functioning in Mental Health Care

ABSTRACT Introduction Increasingly more self-report measures of psychological distress are used as screening tools in mental health care for treatment planning and routing outcome monitoring. Research on the psychometric properties and utility of these measures in individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF) are limited, even though this target group accounts for a large proportion of individuals treated in mental health care services. The aim of the present study was to explore the psychometric properties of the SQ-48, a self-report on psychological distress, when used in adults with MID-BIF. Methods The SQ-48 was administered to 213 patients of two specialist mental health services for MID-BIF in the Netherlands. A second administration took place after three weeks in a test–retest design (N = 24). Results: The SQ-48 has adequate internal consistency, discriminant validity, test–retest reliability, and factor structure when used in adults with MID-BIF. Conclusion This study provides preliminary evidence that the limitations in intellectual and adaptive functioning in people with MID-BIF do not influence the reliability and validity of the SQ-48 and can be used reliably in this population.

Enhancing daily life for children with cognitive developmental delay through insights into brain development.

Cognitive developmental delay, including severe intellectual disability (IQ below 70) and borderline intellectual functioning (IQ 70-85), poses significant challenges, including high costs and emotional burden. Early diagnosis and interventions might improve adaptive behavior and daily life functioning. High-risk groups include children with neonatal complications, congenital anomalies, genetic disorders, or metabolic errors, yet over 50% of cases have unknown causes. To provide timely diagnosis and intervention for children with cognitive developmental delay, it is important to increase our understanding and ability to prognosticate their level of functioning. The pivotal role of brain development in the first few years of life presents a window of opportunity for these goals. By detailed investigation of common patterns in structural brain development and connectivity by MRI in relation to cognitive and executive functioning, this review aims to identify potential factors that might improve understanding and prognostication of children with cognitive developmental delay. Exploring similarities among diverse patient groups with childhood cognitive developmental delay, this review intends to provide a nuanced perspective. IMPACT: This review identified several MRI brain developmental markers, especially in the white matter, that might hold potential to be a prognostic marker for intellectual and executive functioning in children with cognitive developmental delay. Bringing together information on aberrant brain developmental trajectories and connectivity across different patient childhood populations with cognitive developmental delay might improve our understanding and prognostication.

Does adapting a self-report instrument to improve its cognitive accessibility for people with intellectual disability result in a better measure? − A cognitive interview study

Background and aimsWe investigated whether improving the cognitive accessibility of a widely used self-report measure leads to better understanding and more accurate answers in a sample of adults with mild intellectual disability and borderline intellectual functioning. Methods and proceduresWe undertook a series of cognitive interviews before and after adaptation of the instructions and selected items of an existing self-report measure of adaptive functioning. Interview results and participant feedback were supplemented with quantitative comparisons between participant and carer scores. Outcomes and resultsAdaptation based on participant experiences and preferences combined with evidence-informed guidelines improved understanding and accuracy. Self-report and carer-report scores showed greater convergence after adaptation; this occurred because people with intellectual disabilities appeared to understand the self-report measure more effectively. Conclusions and implicationsThe results show that adaptation of the self-report instrument to suit the needs and preferences of people with mild intellectual disability or borderline intellectual functioning leads to a more accessible measure and more reliable and valid results. Results also highlight the importance of complementing proxy reports with a first-person perspective in assessment as clients and informants may differ in their assessment of behavior and skills.

병영생활 전문상담관의 경험에 대한 질적 사례 연구: 경계선급 지능 병사 상담 경험을 중심으로

This study aimed to explore the experiences of military counselors from various perspectives and to deeply explore their experiences focusing on meeting and counseling borderline-level intelligence soldiers while working as military counselors. To this end, three military counselors with experience counseling borderline-level intelligence soldiers were selected and the study was conducted using a qualitative case study method. The research results yielded three primary categories, five middle categories, and 16 subcategories. The three primary categories were: ‘Military life of soldiers with borderline intellectual functioning as perceived by military counselors,’ ‘Counseling experiences of military counselors with soldiers who have borderline intellectual functioning,’ and ‘Areas for improvement identified by military counselors through their counseling experiences with soldiers with borderline intellectual functioning.’ Military counselors met borderline-level intelligence soldiers through the initial counseling process and observation of those around them, and during the counseling process, they came to recognize the various difficulties they experienced in military life. The military counselors felt rewarded by the fact that they played a supporting role through continuous counseling for soldiers with borderline intelligence during their military life. However, they experienced various difficulties in counseling due to the characteristics of borderline intelligence, and they recognized that efforts were needed to support soldiers with borderline intelligence at the individual and institutional levels. Based on these research results, practical and institutional supplements that should be considered in the future to support soldiers with borderline intelligence adapting to military life were proposed.

A Study on Customized Education AI Services for Employment Support of Individuals with Borderline Intellectual Functioning

A Study on Customized Education AI Services for Employment Support of Individuals with Borderline Intellectual Functioning

Mental Functions in People with Mild Intellectual Disability to Borderline Intellectual Functioning

ABSTRACT Introduction The first aim of this study was to explore the mental functions of patients with mild intellectual disabilities or borderline intellectual functioning (MID-BIF) in mental health care. The second aim was to examine the differences in mental functions between people with MID-BIF and those with higher educational levels (i.e. further education [FE] and higher education [HE]). Materials and methods Eleven mental functions were assessed using the Shedler-Westen Assessment Procedure (SWAP-200-NL). In total, 245 patients were included, divided into three groups (MID-BIF: N = 52; FE: N = 86; HE: N = 107). Results Results showed that the MID-BIF group scored relatively high on three mental functions (i.e. the capacity for impulse control and regulation, capacity for defensive functioning, and capacity to construct and use internal standards and ideals). One mental function scored relatively low (the capacity for adaptation, resiliency, and strength). Regarding group comparisons, similar patterns in average scores emerged, and the HE group scored higher than the MID-BIF and the FE groups on most mental functions. Discussion The mental functions of the HE group were most adaptive, whereas the mental functions of the FE and MID-BIF groups were less adaptive and on a similar level in each of these groups.

Stressful life events, post-traumatic stress disorder symptoms and mental health in individuals with intellectual disabilities: a scoping review.

Stressful life events are events that do not fulfil the A criterion of PTSD in the DSM-5(TR) but are perceived as negative by the person. There is an ongoing debate about the usefulness of the A criterion as a gate criterion for PTSD, and especially regarding which events qualify as traumatic or stressful life events. This debate is particularly important for individuals with intellectual disabilities (ID) or borderline intellectual functioning (BIF), as they seem to be more likely to experience traumatic and stressful life events than their peers without ID-BIF and appear to be more susceptible to the disruptive effects of these events. As a result, people with ID-BIF are more likely to develop mental health and behavioural problems. There is insufficient knowledge about how the relationship between stressful life events and PTSD symptoms should be interpreted, how traumatic and stressful life events are defined and distinguished in people with ID, and whether the A criterion should be broadened for individuals with ID-BIF. The aim of this scoping review was to understand stressful life events and their relationship with PTSD symptoms, other mental health and/or behavioural problems in individuals with ID-BIF. The scoping review was conducted in accordance with the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Thirty-eight studies were included. Five studies focused on stressful life events and PTSD symptoms. The other studies examined associations between stressful life events and other mental health and/or behavioural problems. Most of the studies did not clearly differentiate between stressful and traumatic events according to the A criterion of PTSD in the DSM-IV (TR) or DSM-5(TR). Of the six studies in which stressful life events were specified and could be distinguished from traumatic events, one found a positive association between PTSD symptoms and stressful life events and five showed weak to strong positive associations with other mental health and/or behavioural problems. PTSD symptoms following stressful life events in individuals with ID-BIF are underrepresented in the literature. The lack of a clear definition of stressful life events leads to a gap in the knowledge on whether and how stressful life events may lead to PTSD symptoms, other mental health and/or behavioural problems in individuals with ID-BIF. Therefore, no general conclusions or recommendations can be made regarding the appropriateness of the PTSD A criterion for individuals with ID-BIF. Further research is needed to establish the role of stressful life events in relation to PTSD symptoms and to inform the assessment and effective treatment in people with ID-BIF, as expert clinical experience studies suggest that broadening the PTSD A criterion should be considered for people with ID-BIF.

Fetal Gene Regulatory Gene Deletions are Associated with Poor Cognition and Altered Cortical Morphology in Schizophrenia and Community-Based Samples.

Schizophrenia spectrum disorders (SSDs) are characterized by substantial clinical and genetic heterogeneity. Multiple recurrent copy number variants (CNVs) increase risk for SSDs; however, how known risk CNVs and broader genome-wide CNVs influence clinical variability is unclear. The current study examined associations between borderline intellectual functioning or childhood-onset psychosis, known risk CNVs, and burden of deletions affecting genes in 18 previously validated neurodevelopmental gene-sets in 618 SSD individuals. CNV associations were assessed for replication in 235 SSD relatives and 583 controls, and 9,930 youth from the Adolescent Brain Cognitive Development (ABCD) Study. Known SSD- and neurodevelopmental disorder (NDD)-risk CNVs were associated with borderline intellectual functioning in SSD cases (odds ratios (OR) = 7.09 and 4.57, respectively); NDD-risk deletions were nominally associated with childhood-onset psychosis (OR = 4.34). Furthermore, deletion of genes involved in regulating gene expression during fetal brain development was associated with borderline intellectual functioning across SSD cases and non-cases (OR = 2.58), with partial replication in the ABCD cohort. Exploratory analyses of cortical morphology showed associations between fetal gene regulatory gene deletions and altered gray matter volume and cortical thickness across cohorts. Results highlight contributions of known risk CNVs to phenotypic variability in SSD and the utility of a neurodevelopmental framework for identifying mechanisms that influence phenotypic variability in SSDs, as well as the broader population, with implications for personalized medicine approaches to care.

Intellectual Ability and Sexual Recidivism Risk Assessment: Comparing Predictive Accuracy in an Incarcerated U.S. Sample.

While studies indicate that individuals with intellectual disabilities (ID) and borderline intellectual functioning (BIF) are overrepresented among those incarcerated for sexual offenses, there is a paucity of research with respect to risk assessment for this population, particularly among incarcerated U.S. samples. This gap is concerning given that individuals perceived as high risk may be denied bail, given harsher sentences, or subject to civil confinement. The present study examined the predictive validity of the Static-99 and Static-99R, which rely on historical predictors, and the MnSOST-R, which includes a dynamic subscale. Archival records were used to compare individuals with (n = 459) and without (n = 459) ID/BIF released from New Jersey state prisons between 1996 and 2007, with an average follow-up period of 5.7 years. All three instruments demonstrated good predictive validity for those without ID/BIF, while only the MnSOST-R produced a significant AUC value for those with ID/BIF. Reincarceration rates for those with ID/BIF within high-risk groups ranged from 0% to 8%, similar to the overall recidivism base rate of 4%. Results highlight the need for additional research to determine which risk factors should be considered for those with ID/BIF.

Exploring the Clinical Characteristics and Comorbid Disorders of Borderline Intellectual Functioning.

Borderline intellectual functioning (BIF) is characterized by cognitive impairment and deficits in adaptive functioning. Despite affecting a significant proportion of the population, BIF still remains underdiagnosed and poorly understood. In addition to cognitive impairments across a range of domains, individuals with BIF face a greater risk of academic failure and often require special educational support. They suffer from emotional problems, such as difficulties with emotional awareness, anxiety, depressed mood, and unhappiness. Individuals with BIF are more likely to have an impairment of social and adaptive functioning. Furthermore, individuals with BIF are at higher risk of physical and mental health problems, often receive inadequate treatment, and have a poorer prognosis. This review aims to enhance the understanding of clinicians, educators, and policymakers by providing an overview of the characteristics of BIF and its associated challenges, ultimately contributing to the improvement of support systems for individuals with BIF.

Epidemiology and Diagnosis of Slow Learners (Borderline Intellectual Functioning).

The definitions of "slow learners" and "borderline intellectual functioning (BIF)" have not reached a consensus and have continually evolved in terminology. The criteria for diagnosing BIF include the Full-Scale Intelligence Quotient, adaptive functioning, and onset of symptoms from the developmental period; however, specific standards have not been provided. Until the Diagnostic and Statistical Manual of Mental Disorders-IV, a range for the Full-Scale Intelligence Quotient was provided, but due to its limitations in reflecting the actual functioning of individuals with BIF, this criterion was removed from the Diagnostic and Statistical Manual of Mental Disorders-5. The absence of specific diagnostic criteria complicates the identification of individuals with BIF, highlighting the need for a more precise classification and definition.

Psychogenic non-epileptic seizures in individuals with intellectual disability/borderline cognitive function: Characterization through a comparison study

PurposeWe set out to characterize psychogenic non-epileptic seizures (PNES) in individuals with either intellectual disability (ID) or borderline intellectual function (BIF) in comparison to those with normal cognitive function. We aimed to identify differences between the two groups to improve clinical management protocols. MethodsWe conducted a retrospective, observational, single-center study. The medical records of individuals (aged ≥ 14 years) diagnosed with PNES, confirmed through video-electroencephalography (vEEG) at a specialized epilepsy center between January 2008 and December 2021, were reviewed. We restricted our study to individuals who underwent comprehensive neuropsychological evaluations. Furthermore, demographic, clinical, and neuropsychological data with potential prognostic indicators, alongside the reevaluation of vEEG recordings were studied. We compared two study groups based on intelligence quotient (IQ): individuals without ID (IQ≥85; n = 25) and those with either mild ID or BIF (n = 25). ResultsNo statistically significant clinical differences were observed between the two groups. Individuals with mild ID/BIF didn't show a longer diagnostic delay, and the prescription of inappropriate antiseizure medications (ASMs) was comparable in both cohorts. Most individuals with mild ID/BIF were treated with behavioral psychotherapeutic approaches with similar outcomes in both subgroups. ConclusionsIndividuals with mild ID/BIF and PNES don't differ in clinical management. Demographic and clinical data, as well as semiology, were comparable to those of individuals with normal cognitive function. Cognitive behavioral therapy (CBT) appears to be an effective treatment approach for individuals with and without mild ID/BIF. Further studies are needed to validate and ascertain their possible applicability in individuals with moderate/severe ID.

Etiology of Borderline Intellectual Functioning.

Borderline intellectual functioning (BIF), characterized by intelligence quotient scores between 70 and 85, can lead to challenges in daily life. This review explored the multifaceted nature of BIF by examining the interplay between genetic predisposition, prenatal/perinatal factors, environmental influences, and underlying medical conditions.

Exploring the Challenges of Implementing the Integration Plan of Students With Borderline Intellectual Functioning in Ahvaz City Ordinary Schools: A Qualitative Study

Background and Aims Integrated education is a movement towards educational justice and integration of the education program for all, the implementation of which is still facing challenges. The present study aimed to explain the challenges of implementing the integration plan for students with borderline mental functioning in the ordinary schools of Ahvaz City, Iran. Methods The present study was conducted using a qualitative approach in primary schools in Ahvaz City using conventional content analysis based on the approach of Lundman and Graneheim from December 2020 to August 2021. Data were collected through field notes and 17 in-depth semi-structured interviews with 12 individuals, including 7 teachers, 2 principals and 3 assistants. Data coding and analysis were performed using MAXQDA software, version 18. Results Data analysis led to the emergence of 28 codes, including 3 categories of educational system challenges (with two subcategories of lack of planning and poor system of appraising borderline students), teachers’ challenges (with 5 subcategories of annoyance and objection of ordinary students, not following educational calendar program, high workload in integration classes, crowding and confusion of integration classes, and the teacher’s emotional reaction to not learning of the borderline students), and the attitude and response to integration plan (with 3 subcategories of reaction of ordinary students’ parents toward the integration plan, negative attitude of educational staff toward integration plan, and teachers’ objection toward integration plan). Conclusion The results showed that the administrators have a negative attitude toward implementing the integration plan and are against it. The successful implementation of the integration plan depends on solving the challenges in the path of this plan. It seems that the results of the present study can help education managers and policymakers design suitable and desirable programs to solve the challenges and facilitate the integration of students with borderline mental functioning in ordinary schools.

Increasing the Duration of On-Task Behavior in Children with Borderline Intellectual Functioning through Shaping Techniques

This study aims to investigate and apply behavior modification principles, specifically using shaping techniques, to increase the duration of on-task behavior in children with Borderline Intellectual Functioning (BIF). The techniques used include antecedent control, reinforcement through token economy, and providing prompts to the participant. This study uses a single-subject design conducted over a total of 22 intervention sessions. The participant in this study is an 8-year and 7-month-old boy with BIF. The results of the study indicate an increase in the average duration of on-task behavior from 19 minutes in the initial measurement (pre-test) to 64 minutes in the final measurement (post-test) and 54 minutes in the follow-up measurement. It can be concluded that behavior modification principles, specifically using shaping techniques, can help to improve on-task behavior duration in children with Borderline Intellectual Functioning.

Physical Activity Status and Body Composition of Adolescents with Borderline Intellectual Functioning in South Korea

The Article Abstract is not available.

Comparing Correlates of Quality of Life in Borderline and Average Intellectual Functioning

Background: Borderline intellectual functioning (BIF) is associated with deficits in cognitive functions and effective communication or interpersonal skills, impacting socio-occupational functioning in adulthood. Aims: The current study compared individuals with BIF and average intellectual functioning (AIF) on executive functioning, emotion dysregulation, and interpersonal communication competence in relation to the quality of life. Settings and Design: The data were collected via a face-to-face interview conducted in the tertiary care hospital in an urban locality. A cross-sectional and comparative matched-group research design using purposive sampling was used. Materials and Methods: An estimated sample size of 80 was split into BIF and AIF groups. The participants were recruited as per the defined criteria. The measures used were Raven’s Standard Progressive Matrices, General Health Questionnaire, Mini-International Neuropsychiatric Interview, Stroop Test (ST), Difficulties in Emotion Regulation Scale (DERS), Interpersonal Communication Competence Scale (ICCS), and World Health Organization Quality of Life- Brief (Qol). Statistical Analysis: The differences, between BIF and AIF groups as well as males and females within each group, on measures, namely, ST, DERS, ICCS, and QoL were compared using the independent t-test. Further, the relationship among the measures was examined using Pearson correlation and regression analysis. Results: Independent t-test analysis revealed significant differences between groups on execution functioning (t = 11.83, P = 0.000), all domains of emotional dysregulation (P < 0.000), and many domains of interpersonal communication, and quality of life (P < 0.000). Significant correlations were found between domains of DERS and ICCS, DERS and QOL; ICCS and QOL. Conclusions: Emotional dysregulation predicted physical and psychological health and the environment, while interpersonal communication predicted social relations.