Reiss Screen For Maladaptive Behavior Research Articles

Comparing psychopathology rates across autism spectrum disorders and intellectual disabilities

PurposeThe purpose of this paper is to compare the rates and patterns of comorbid anxiety, depression and ADHD across people with: autism spectrum disorder (ASD) plus intellectual disability (ID), ASD/no ID (AS/HFA) and ID only.Design/methodology/approachData were obtained using structured file review and two psychometric screening instruments. File reviews used a modified version of the Case Review Protocol from the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities. Screening employed the Reiss Screen for Maladaptive Behaviour and the ASD-Comorbidity-Adults scale.FindingsLevels of anxiety, depression and ADHD were high for all three groups, and greater than in general population studies. Between groups, the AS/HFA sample had significantly higher anxiety, while the ASD/ID group had significantly greater ADHD. Groups did not differ on measures of depression or total psychopathology. Levels of ADHD, but not anxiety or depression, increased with severity of ID and ASD symptoms.Research limitations/implicationsMore research is needed on the relationship between ASD and both anxiety and ADHD, particularly the identification of these comorbid conditions and their treatment.Practical implicationsRigorous screening for comorbid mental health conditions is required to achieve the best outcomes for adults with ASD.Originality/valueThe study used a broader community-based sample than previous comorbidity research. Including adults with ID but without ASD enabled a comparison of types and rates of disorder across three distinct but related groups with neurodevelopmental disorders.

Problem behaviours and Major Depressive Disorder in adults with intellectual disability and autism

The high prevalence of Problem Behaviours (PB) in persons with intellectual disability (ID) and Autism Spectrum Disorder (ASD) has been associated by some researchers to a proportionate frequency of Major Depressive Disorder (MDD), which have a different presentation in persons with ID and ASD than in the general population, mostly as behavioural changes. Nevertheless, evidence on this behavioural equivalency is still scarce.The present study aims at evaluating the rate of MDD in persons with ID and ASD presenting PB.Two groups of persons with mild-to-moderate ID and ASD, with and without PB underwent a complex clinical (Diagnostic Manual – Intellectual Disability) and instrumental (Reiss Screen for Maladaptive Behaviour; Mini Psychiatric Assessment Schedule for Adults with Developmental Disabilities).The prevalence of MDD was found to be significantly higher in the group with PB. The severity of depressive symptoms resulted to have a strong correlation with the scores of instrumental assessment of PB.Our findings support previous literature on a high association between PB and MDD in persons with ID and ASD. The level of the equivalency between specific MDD symptoms and different PB deserves further investigations.

The impact of caring for an adult with intellectual disability and psychiatric comorbidity on carer stress and psychological distress.

Given that carers of individuals with intellectual disability (ID) and carers of individuals with psychiatric disorders experience elevated levels of stress and psychological distress, carers of individuals with both ID and a comorbid psychiatric disorder are potentially at even greater risk for psychological difficulties. The aim of the present study was to investigate the psychological well-being of carers of adults with a dual diagnosis compared with carers of adults with intellectual disability alone. Four-hundred and forty-two questionnaires were sent to four community services and seventy-five family carers of adults with intellectual disability responded. Psychological well-being of carers was assessed using the Questionnaire on Resources and Stress - Friedrich edition (QRS-F) and the General Health Questionnaire (GHQ). Comorbid psychopathology for their family member with ID was assessed using the Reiss Screen for Maladaptive Behaviour (RSMB). Twenty-four percent of the individuals with ID were reported to have comorbid psychopathology. Between-group analyses compared carers of people with ID and comorbid psychopathology to carers of people with ID alone. Regression analyses examined the relationship between psychopathology and other care-related variables to carer stress and psychological distress. Carers of people with ID and comorbid psychopathology were found to have significantly higher levels of stress and psychological distress than carers of people with ID alone. Autism was found to be the only significant predictor of both stress and psychological distress among measures of psychopathology. Additional comorbid psychopathology in individuals with intellectual disability has a significant impact on their carers' psychological well-being.

Psychometric properties and normative data of the French Developmental Behavior Checklist – Adult version

The main aim of this study was to generate psychometric data for the French translation of the Developmental Behavior Checklist - Adult version (DBC-A). In addition, the score distributions were examined by using components of mean-based scores. The DBC-A was administered to 580 adults with intellectual disability recruited in the French-speaking regions of Switzerland and Belgium. A confirmatory factor analysis was performed to evaluate the adjustment of the collected data to the original six-factor model; the internal consistency of the factors was analyzed with Cronbach's alpha. The Reiss Screen for Maladaptive Behavior was used to evaluate the concurrent validity of the instrument. Psychopathology prevalence was also explored. The original factor structure of the DBC-A was replicated, with the internal consistency of the factors ranging from respectable to very good according to the alpha values. When the "screening" cut-off of the DBC-A was used, the DBC-A highlighted a psychopathology prevalence of 38%, which was close to the frequency provided by the Reiss Screen (36%). These results show the robustness of the DBC-A's psychometric properties. Thus, we recommend the use of this instrument to assess and screen psychopathology among French-speaking adults with intellectual disability.

The French version of the Reiss Screen for Maladaptive Behavior: Factor structure, point prevalence and associated factors

The main aims of the present study were to examine the factor structure and the internal consistency of the factors in the French version of the Reiss Screen of Maladaptive Behavior in a French-speaking European sample. The prevalence of psychopathology and the influence of associated factors were also examined. The Reiss Screen was administered to 467 adults (age range: 18-73) with intellectual disability living in the French-speaking regions of Switzerland and Belgium. A confirmatory factor analysis was performed to replicate the original factor structure. Internal consistency was examined by using Cronbach's alpha. Analyses of variance were computed to study the influence of gender, age and Down syndrome etiology. The original factor structure of the Reiss Screen was replicated. The overall rate of psychopathology in the sample was 37%. No linear relationship between age and psychopathology was found. However, adults aged less than 26 years had lower scores than older adults on several psychopathological domains. Males had higher scores than females on the Autism and the Avoidant Disorder subscales. Participants with Down syndrome had lower scores on all domains, with the exception of the Autism subscale. The results of this study suggest that the French version of the Reiss Screen can be a useful tool to detect psychopathology in adults with intellectual disability.

Psychometric evaluation of a Dutch version of the Mini PAS‐ADD for assessing psychiatric disorders in adults with different levels of intellectual disability

People with intellectual disabilities (ID) have an increased vulnerability to develop psychiatric problems. Moreover, the early recognition and the accurate diagnosis of psychiatric disorders in the population of persons with ID are challenging. A Dutch version of the Mini PAS-ADD, which is a screening instrument for identification of mental health problems in people with ID, was evaluated in terms of internal consistency, interinformant reliability, item grouping and criterion validity based on a large-scale random sample (n = 377) and a clinical sample (n = 99) of adults with ID. The Dutch version of the Mini PAS-ADD showed moderate internal consistency, and moderate concordance among informants. Both aspects of the reliability were comparable for different levels of ID. A factor analysis largely confirmed the scale structure. Concurrent validity with the Reiss Screen for Maladaptive Behavior was high for the Depression, Psychosis and Autism scale. The outcome of the criterion-validity analysis indicated high specificity. The sensitivity for specific psychiatric disorders by the corresponding scales was moderate, but the general sensitivity for the presence of psychopathology on the basis of any of the scales was satisfying. The present research reconfirmed the use of the Mini PAS-ADD as a primary screening device for the identification of mental health problems among people with ID.

Development and Psychometric Properties of an Assessment for Persons With Intellectual Disability—The interRAI ID

Abstract This paper describes the development of the interRAI‐Intellectual Disability (interRAI ID), a comprehensive instrument that assesses all key domains of interest to service providers relative to a person with an intellectual disability (ID). The authors report on the reliability and validity of embedded scales for cognition, self‐care, aggression, and depression. Four provider agencies volunteered to participate and assessed a total of 160 community‐dwelling adults with ID using the interRAI ID, Dementia Questionnaire for Persons with Mental Retardation, and Reiss Screen for Maladaptive Behavior. All scales had acceptable levels of internal consistency (Cronbach’s alpha 0.74–0.93) and good relationships with the criterion measures (r = 0.50–0.93, p < 0.0001). The development of the interRAI ID represents an important and successful first step toward an integrated, comprehensive, and standardized assessment of adults with ID. Use of this instrument may lead to more appropriate support planning, enhanced communication between various professionals supporting persons with ID, and a more seamless approach to supports across the health and social service systems.

A psychometric evaluation of a Swedish version of the psychopathology inventory for mentally retarded adults (PIMRA)

Given the difficulties with symptom identification and the assessment of mental health problems in persons with intellectual disabilities (ID) there has been a focus on the development of relevant assessment schedules for persons with ID. A Swedish version of the psychopathology inventory for mentally retarded adults (PIMRA, informant version), an instrument designed for identification of specific mental health problems in persons with ID, was evaluated in terms of inter-rater reliability, internal consistency, item grouping, criterion and concurrent validity based on a sample of 101 adults with different levels of ID. The Swedish version of the PIMRA had low inter-rater agreement on specific items but good agreement on low or high total score. In order to investigate internal validity, principal component analyses (PCA) were conducted in steps. Consequently, the majority of the 26 items, which remained after three PCA analyses, were grouped in a pattern approximating five of the original PIMRA subscales. The present analysis identified no item grouping matching the original Affective disorder subscale. Based on these results a revised Swedish version was developed. The concurrent validity analysis yielded a strong association between the total scores of the PIMRA and Reiss Screen for Maladaptive Behaviour (RSMB), between subscales on both instruments describing psychotic symptoms and between the RSMB subscale Aggressive behaviour and the PIMRA subscale Adjustment problems. The outcome of the criterion validity analysis indicated that individuals with a clinical diagnosis obtained higher total PIMRA scores than individuals without a clinical diagnosis and a comparison between the PIMRA subscale Psychosis and the clinical diagnosis indicating psychoses according to DSM-III-R or DSM-IV yielded a higher specificity than sensitivity measure. The results indicate that the PIMRA had a potential to identify individuals with mental health problems in persons with different levels (mild, moderate and severe) of ID and identify individuals with a specific mental disorder. Thus, professionals might use the PIMRA as a complement in the diagnostic process.

Caregiving burden of families looking after persons with intellectual disability and behavioural or psychiatric problems.

During the last decade, there has been a growing interest in outpatient support services for persons with intellectual disability (ID) and psychiatric and/or behavioural problems and their families. In this study, we explore the family burden that is associated with children or adults with ID and behavioural or psychiatric problems living at home. The research group consisted of 66 clients of In Casa, a project of outpatient treatment. Their average age is 18.97 years and their average IQ 55.37. The Reiss Screen for Maladaptive Behaviour (adults) or Reiss Scales for Children's Dual Diagnosis (children) and the Nijmegen Family Situation Questionnaire have been administered. About 62% of the children and 86% of the adults living at home and referred to In Casa have severe psychiatric or behavioural problems as measured by the Reiss scales. The dual diagnosis has a more negative impact on the family situation than the condition of ID only. Parents consider the psychiatric or behavioural problems of their child to be an extra burden and feel it more difficult to raise and manage such a child. This impels them to change the situation and to call on the help of external services. Some methodological questions and the implications of the findings in terms of support needs are discussed.

Occurrence of mental health problems in Swedish samples of adults with intellectual disabilities.

The aim of this study was to investigate the occurrence of mental health problems in adults with intellectual disabilities (ID) and the number of adults with ID receiving care at general mental health clinics. The Reiss Screen for Maladaptive Behaviour and the Psychopathology Inventory for Mentally Retarded Adults were used to investigate mental health problems in samples from two Swedish counties. Adults with ID receiving psychiatric care at general mental health clinics were investigated via the mental health services register in one county. The overall occurrence of mental health problems in adults with ID ranged from 34% to 64%. The most common mental health problems were aggressive, self-injurious behaviours, signs of depression, anxiety or adjustment problems. The occurrence of adults with ID among patients receiving out- or in-patient psychiatric care was approximately 1%. Between 70% and 90% of these persons had a mild level of ID. The overall occurrence of mental health problems was similar to reported overall figures in comparable studies conducted in the US, UK and Denmark. The number of adults with ID registered for out- or in-patient psychiatric care was low compared with the occurrence of mental health problems based on the screening results.

Psychotropic drug use in intellectually disabled group-home residents with behavioural problems.

Little is known about psychiatric and behavioural factors associated with psychotropic drug use and how appropriately these drugs are prescribed in settings for people with intellectual disabilities. The aim of this study was to measure the point prevalence of psychotropic drug use in a problem-behaviour group (PBG) consisting of intellectually disabled residents of group homes compared to a random group (RG), and to gain insight in possible factors that are associated with group membership. From all group homes in the Netherlands, 573 problematic residents were selected by the staff (one resident from each home) and 1479 residents were randomly sampled from all of the homes. Mental health problems were measured using the Reiss Screen for Maladaptive Behaviour and the Psychopathology Instrument for Mentally Retarded Adults. The response rate in the PBG was 68.9 % and in the RG 71.7 %. Psychotropics (excluding anticonvulsants) were used by 52.6 % of the PBG and by 22.8 % of the RG. Young age, psychotic, anxiety, and aggression symptoms were significantly associated with the PBG, as was the use of antipsychotics and antidepressants. The PBG more often used multiple (three or more) drugs (17.3 %) than the RG (7.3 %). A low prevalence of antidepressants or mood stabilisers, antipsychotics, and anxiolytics was found in residents with affective, psychotic, or anxiety symptoms. We conclude that psychotropic drug use in the PBG compared to the RG was high. It is likely that the group-home staff finds it difficult to deal with young people with socially disruptive behaviour, which is underlined by our finding of high prevalence of antipsychotics and multiple-drug therapy in the PBG. Finally, our findings suggest that a considerable number of residents with psychiatric or behavioural symptoms are undertreated.

Problem behaviors associated with 15q- Angelman syndrome.

Caregivers of persons with Angelman syndrome completed the Aberrant Behavior Checklist and Reiss Screen for Maladaptive Behavior. Seventy-three replies were received, and comparisons were made with other published data. Responses indicated that 15q- Angelman syndrome is associated with such problems as lack of speech, overactivity, restlessness, and eating and sleep problems. Episodes of inappropriate laughter were only reported for 57%, despite being considered a cardinal feature of the syndrome; eating problems (64%) and a fascination with water (68%) were reported more frequently. Overactivity was more of a problem for children; Aberrant Behavior Checklist Factor IV (Hyperactivity) was negatively correlated with age. Scores were mostly lower than for previously studied etiological groups. Therapeutic effort should be put into programs to address these problems.

Areas of convergence and discordance between the MMPI-168 and the Reiss Screen for maladaptive behavior in mentally retarded clients

The Reiss Screen for Maladaptive Behavior and a modified version of the MMPI-168 were administered to 65 residents of a state mental institution diagnosed with mild or moderate mental retardation. Possible associations between the two screening instruments were then examined. Significant correlations were obtained between four scales of the Reiss Screen and Scales F, K, 1, 6, and 7 of the MMPI-168. These results support the clinical efficacy of both instruments in screening for behavioral pathology in mentally retarded persons. However, some scales purported to assess similar psychological constructs failed to show expected positive associations.

Areas of convergence and discordance between the MMPI‐168 and the Reiss Screen for maladaptive behavior in mentally retarded clients

Areas of convergence and discordance between the MMPI‐168 and the Reiss Screen for maladaptive behavior in mentally retarded clients

Emotion recognition as a function of social connpetence and depressed mood in Individuals with intellectual disability

The present study was designed to test whether social competence and mood were predictive of the performance by adults with mild or moderate intellectual disability on a matching-to-sample task using facially expressed emotions as stimuli. Thirty-eight subjects were assigned to either a depressed mood group or a non-depressed mood group based on their scores on the two depression sub-scales of the Reiss Screen for Maladaptive Behavior. The groups were matched on sex, age and level of intellectual disability. Each group consisted of 10 women and nine men; 12 participants in each group had mild and seven had moderate intellectual disability, respectively. Social competence was assessed with the Social Performance Survey Schedule (SPSS). Performance on the matching-to-sample task correlated positively with the subjects' level of intellectual disability, their mood scores and the scores on the Appropriate Skills sub-scale of the SPSS. The implications of these findings for social skills training programmes and limitations of this study are discussed.

The Reiss Screen for Maladaptive Behavior: Confirmatory factor analysis

We tested the factorial stability of the Reiss Screen for Maladaptive Behavior (Reiss, 1988a, The Reiss Screen for Maladaptive Behavior test manual). Reasonable fit was demonstrated in a geographically diverse sample of 448 individuals with mild, moderate, severe and profound mental retardation according to four measures of overall fit: RMSEA, ECVI, NNFI, and NFI. The results confirm Reiss' (1988a) factor solution of this widely used dual diagnosis (mental retardation and mental illness) screening instrument.

The factor structure of the Reiss screen for maladaptive behaviors in institutional and community populations

The Reiss Screen for Maladaptive Behavior was factor analyzed in two institutional samples and one community sample of persons with mental retardation. In Sample 1 a general factor was found.In Samples 2 and 3 a three-factor structure was found. These three factors were named Intra-personal Maladaptive Behavior, Psychotic Behavior, and Extra-personal Maladaptive Behavior. None of the factor solutions bore any close resemblance to a factor structure implied by the seven scales on the Reiss Screen. The implications for the future development of assessments of dual diagnosis are discussed.

THE FREQUENCY OF REISS SCREEN DIAGNOSES IN A COMMUNITY SAMPLE OF ADULTS WITH MENTAL RETARDATION

One hundred and eighty adults with mental retardation who were actively using community services were assessed with the Reiss Screen for Maladaptive Behavior (Reiss, 1988). The proportion of persons exceeding the cutoff on the 26-item total was 49%. The proportions of persons exceeding cut-off on the eight scales ranged from 8.4% (Avoidant Personality Disorder) to 19.4% (Aggressive Behavior). Multiple diagnoses were found in 27% of subjects. There were no associations with age but a small number of gender differences were observed.

The Reiss Screen for Maladaptive Behaviour: its reliability and internal consistencies

The inter-rater and test-retest reliabilities, and internal consistencies of the Reiss Screen for Maladaptive Behavior (Reiss 1987) were evaluated on a random sample of adults with moderate through profound mental retardation living in an institutional setting. Generally, the Reiss Screen showed good inter-rater reliability, modest to good test-retest and good internal consistency. This suggests that the Reiss Screen has moderate to good psychometric robustness.

A Dutch version of the Reiss Screen of Maladaptive Behavior

The Reiss Screen for Maladaptive Behavior, an instrument used to identify mentally retarded persons with mental health problems, was evaluated with 89 mentally retarded adults. Reliability and validity of the Reiss Screen, as well as the relationship with subject characteristics, is reported for a Dutch population. Internal consistency on the total score was good and modest on most subscales. The subscale autism had inadequate internal consistency. Interrater reliability was low to modest. Further, the Reiss Screen had good criterion validity. Last, few relationships were found between Reiss Screen scores and subject characteristics.