Psychopathology In People Research Articles

The PAS–ADD Checklist: independent replication of its psychometric properties in a community sample

The development of reliable, valid measures of psychopathology in people with intellectual disabilities is an important task. However, independent replication studies are rarely reported. To report data on the psychometric properties of the Psychiatric Assessment Schedule for Adults with Developmental Disabilities (PAS-ADD) Checklist. The PAS-ADD Checklist was completed for 226 adults as part of the assessment process for a specialist mental health service for people with intellectual disabilities. Internal consistency was acceptable. Factor analysis revealed one main factor that was characterised by items related to mood. The Checklist was sensitive to differences between diagnostic groups and had an overall sensitivity of 66%; its specificity was 70%. The PAS-ADD Checklist is a quick and easy to use screening tool. Although at present it is the best measure available, it should not be the only method used to identify psychiatric disorders in people with intellectual disabilities.

The Factor Structure of the DASH-II

There have been few studies on the assessment of psychopathology in people with severe and profound mental retardation. In this study we report the factor structure of the Diagnostic Assessment for the Severely Handicapped-II (DASH II) in a large sample of adults in an institutional setting. We found 5 factors that were named Emotional Lability/Antisocial, Language Disorder, Dementia/Anxiety, Sleep Disorder, and Psychosis. Scales derived from this factor analysis were internally consistent and showed good evidence of convergent and discriminant validity with the Aberrant Behavior Checklist (ABC), MESSIER, and Vineland Adaptive Behavior Scales (VABS). The factor structure observed here was broadly similar to that of the original DASH. Implications for future research are identified.

Descriptive psychopathology in people with mental retardation.

This article considers variables associated with the presence of a psychiatric diagnosis in those referred to a specialist mental health service for people with mental retardation (MR). Data were collected on 752 newly referred clients. The presence of a psychiatric diagnosis was assessed by two psychiatrists based on International Classification of Diseases, 10th Revision, criteria. A series of binary logistic regression analyses were conducted. Older age, mild MR, admission to an inpatient unit, referral from generic mental health services, and detention under current mental health legislation were associated with an increased presence of any psychopathology. Severe MR, the presence of epilepsy, and residence with the family were associated with a lower incidence of any psychopathology. Findings relating to specific psychiatric diagnoses on the whole supported previous research. Clear service arrangements are necessary for people with mild MR who have a high incidence of psychiatric disorders.

Psychopathology in people with epilepsy and intellectual disability; an investigation of potential explanatory variables

Objectives:There are few studies on epilepsy and psychopathology in people with intellectual disability (mental retardation) despite epilepsy prevalence rates that are thirty times higher than in the general population. The...

Challenging behaviours should not be considered as depressive equivalents in individuals with intellectual disability.

Depression is one of the most common forms of psychopathology in people with intellectual disability (ID). The present study evaluated the utility of an expanded assessment of psychiatric symptoms and challenging behaviours, as measured by the Clinical Behavior Checklist for Persons with Intellectual Disabilities (CBCPID). The CBCPID was administered to 92 people with ID, 35 of whom were diagnosed with a depressive disorder. Item and factor analysis of the scale indicated that depression was best assessed using the core DSM-IV symptoms of depressive disorder. Challenging behaviours such as self-injury or aggression were not closely associated with depression. Short scales using the core DSM-IV symptoms of depression were highly internally consistent. There was also evidence of the validity of these scales. This study found no evidence that challenging behaviours were depressive equivalents in this population. The present authors conclude that the assessment of depression in people with ID should focus on the core DSM-IV symptoms of depression.

Psycho-educational therapy among Nigerian adult patients with epilepsy: a controlled outcome study

Psychological interventions in relation to epilepsy are worthy of empirical investigation since there is broad agreement that the psycho-social problems of epilepsy are often more disabling than the seizure attacks. The present study using a controlled outcome design evaluated the efficacy of a 2-day psycho-educational program among patients with epilepsy in Nigeria. The psycho-educational program is the consequence of a two-stage study design, which set out to identify and evaluate psycho-social factors that determine interictal psychopathology in people with epilepsy. Thirty out-patients matched according to seizure type and frequency of seizures were randomly assigned to treatment ( n=15) or waiting-list control ( n=15) groups. The major outcome measures used were knowledge about illness schedule, the Becks depression inventory and the Crown–Crisp experiential index. Significant differences between the two groups were found on the three major scales used. The treatment group by within-group analyses, showed a substantial significant decrease in level of depression, a significant increase in the knowledge about epilepsy as well as a significant decrease in all measures of neurotic disorders except for hysterical sub-scale.

Composite versus multiple‐rating scales in the assessment of psychopathology in people with mental retardation

This study tested the hypothesis that separate ratings of frequency and duration add significant information to ratings of problem severity in the assessment of psychopathology in people with mental retardation. The Reiss Screen was modified to require ratings of problem severity, frequency and duration for each of 38 maladaptive behaviours. The 171 adolescents and adults were rated by caretakers and supervisory staff on the modified Reiss Screen. The three ratings were found to be very highly intercorrelated. Moreover, multiple linear regression analyses revealed that the ratings of frequency and duration did not add significant information to that provided by ratings of problem severity in the prediction of psychiatric diagnosis in the person's case file. The results support the use of composite scaling over multiple-ratings in the assessment of psychopathology in persons with mental retardation.

Composite versus multiple-rating scales in the assessment of psychopathology in people with mental retardation

Composite versus multiple-rating scales in the assessment of psychopathology in people with mental retardation

DSM-III-R and persons with dual diagnoses: conceptual issues and strategies for future research.

Diagnosis of mental health needs in people with mental retardation using the DSM-III-R manual was critically reviewed. Conceptual issues included the interaction of different diagnosis categories; the cognitive and linguistic competencies often required for diagnosis; the potential mismatch between psychopathology in people with mental retardation and the DSM-III-R nosology; and issues relating to multi-axial classification. Strategies identified to explore and resolve these issues include better documentation of the frequency and nature of these problems when using unmodified DSM-III-R criteria, better empirical piloting of modified diagnostic criteria with people with severe and profound mental retardation, and the use of social validity data to identify potential mismatches between psychopathology in people with mental retardation and DSM-III-R diagnoses.

Epidemiology and prevalence of psychopathology in people with mental retardation.

Epidemiology and prevalence of psychopathology in people with mental retardation.

Epidemiology and prevalence of psychopathology in people with mental retardation.

There is a general consensus that, for several reasons, people with mental retardation are at an increased risk of developing emotional disorders. Numerous research studies have examined the prevalence of psychiatric disorders among people with mental retardation, and a wide range of rates have been reported. Reasons for the variability in these results are discussed, including definitional and identification issues, and sampling issues. A summary of representative studies is presented and discussed in light of the above-mentioned issues. The need for updated epidemiological studies in this area is emphasized.

Mental illness‐mental retardation in the United States: policy and treatment challenges

The purpose of this paper is to present an overview of current trends in the field of dual diagnosis in the United States. Policy, programme, diagnostic and treatment issues are reviewed. The paper will examine the effects of the social policy of deinstitutionalization on people who have a dual diagnosis and will offer policy ideas for ameliorating some of the significant obstacles facing this population. Exemplary programme models are briefly discussed to illustrate the development of effective services. The challenges of assessing psychopathology in people with mental retardation are addressed. Several therapy and treatment modalities that have proven to be effective with people who have a dual diagnosis are also discussed. Lastly, this paper mentions a new community ideology driven by the values of consumers choice and satisfaction.

Cognitive therapy for depression with individuals with intellectual disabilities.

The increase in research into psychopathology in people with intellectual disability has recently spread to include depression. Several reports have appeared on the assessment of depression in the client group and there is a pressing need for research into treatment of depression in people with intellectual disability. The present paper reviews cognitive behaviour therapy for depression and reports on its adaptation for people with intellectual disability. Two case studies of individuals with mild intellectual disability illustrate the clinical applications. All the elements of cognitive behaviour therapy for depression were maintained and simplified. Both subjects were able to monitor their feelings of depression and subject 2 monitored the frequency of suicidal thoughts. Improvements were seen in both cases on the Zung Depression Inventory and daily monitoring of depressive feelings.

Psychopathology of People with Mental Handicap and Epilepsy III: Personality Disorder

A group of 75 mildly to moderately mentally handicapped people with epilepsy, resident in both a hospital and the community, were studied together with an individually matched control group of non-epileptic patients. Their carers were interviewed to gather information for two observer-rated personality questionnaires, the Standardised Assessment of Personality (SAP) and the T-L Personality Behaviour Inventory. The two groups were compared with respect to the prevalence rates of various personalities. An abnormal personality score according to the SAP schedule was reported in 26% (n = 39) of the cohort, of which 28 (18.6% of the cohort) were personality disorders. A diagnosis of SAP abnormal personality was made in 46% of the in-patients and 6.5% of the community-based population. Of the cohort, 15% had an abnormal personality score according to the T-L schedule. No statistically significant difference emerged between the epileptic and the non-epileptic groups in the prevalence of either the SAP or T-L personality.

Psychopathology of People with Mental Handicap and Epilepsy I: Maladaptive Behaviour

One hundred and fifty mentally handicapped people (100 from hospital and 50 from the community) with epilepsy were studied along with an individually matched control group of 150 (100 from hospital and 50 from the community) non-epileptic mentally handicapped people. Behaviour was studied using the Profile of Abilities and Adjustment Schedule. Of the total population, 55.3% showed some type of severe behaviour problem. Although the epileptics showed slightly more severe behaviour problems than the non-epileptic group, there was no statistically significant difference between the two groups. Some differences emerged between the groups when subgroups of epileptics were studied.

Psychopathology of People with Mental Handicap and Epilepsy II: Psychiatric Illness

The prevalence of psychiatric illness was studied in 150 epileptic mentally handicapped people (both hospital in-patients and living in the community) and a matched group of 150 non-epileptic controls. The Profile of Abilities and Adjustment (PAA) scale was used for the initial screening of psychiatric illness. Mildly to moderately handicapped individuals who had good communication skills and scored positively on the PAA schedule for psychiatric illness were interviewed using the PSE interview schedule. Severely mentally handicapped individuals who scored positively on the PAA's psychiatric illness subscale were observed and information was gathered from their medical notes and carers. A psychiatric diagnosis was made using DSM-III-R criteria. The non-epileptic group showed significantly more psychiatric illness than the epileptic group. Psychiatric illness was diagnosed in 25% of the cohort.