Mental Health Aspects of Developmental Disabilities Journal Impact Factor & Information

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ISSN 1057-3291

Publications in this journal

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    ABSTRACT: This article discusses the concept of capacity, various relevant mandates, and a rationale for the assessment of capacity to execute a health care proxy. Some specific New York State regulations, pertaining to the execution of a health care proxy by persons who have intellectual disabilities, are presented and contrasted with regulations in some other jurisdictions. A standard that psychologists and physicians may use in assessing the capacity of a person with cognitive impairments to execute a health care proxy is reviewed. Additionally a protocol for assessing capacity to execute a simple health care proxy is in the appendix.
    Mental Health Aspects of Developmental Disabilities 10/2007; 10(4):145-156.
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    ABSTRACT: This paper addresses the topic of intellectual disability and psychiatric disorder among persons receiving Medicaid Home and Community-Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services. In June 2005 HCBS and ICF/MR programs financed long-term supports for nearly 545,400 persons with intellectual disabilities and other developmental disabilities at a fiscal year 2005 cost of $29.3 billion. This paper describes and compares characteristics and experiences of persons with and without diagnosed psychiatric conditions in addition to intellectual disability in a large, six state, 2720 person sample of HCBS and ICF/MR recipients. Nearly one-third (31.4%) of the sample had psychiatric disorders. Controlling for levels of intellectual disability, they were consistently more likely to be placed in ICF/MR programs and agency-operated congregate care settings, and were less likely to live with family members. They were much more likely to receive medications for mood, anxiety and/or behavior disorders than were persons with intellectual disability only (87% and 32%, respectively). Policy implications include the need to incorporate behavioral health services and supports into state Medicaid waivers for individuals with intellectual disabilities.
    Mental Health Aspects of Developmental Disabilities 07/2007; 10(3):78-90.
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    ABSTRACT: Attachment is a major factor during development throughout the life cycle. Most studies conclude that attachment is a complex interaction between brain development, temperament, and life experiences. This presentation addresses the role of attachment in psychiatric disorders in people with intellectual disabilities.
    Mental Health Aspects of Developmental Disabilities 04/2007; 10(2):53-63.
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    ABSTRACT: Anxiety is the result of a complex Interaction between environmental stimuli and a network of brain regions devoted to assessing and responding to threat, conflict, or potential danger. Focal seizures may present with a range of affective symptoms that may be difficult to distinguish from anxiety states. The process is complicated further among individuals with intellectual disabilities. In uncertain cases, clinicians need to consider not only the type of anxiety, but also the nature and duration of symptoms, associated neurocognitive changes, previous treatment response, and in some circumstances, more invasive neurodiagnostic procedures.
    Mental Health Aspects of Developmental Disabilities 11/2004; 7(4):124-130.
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    ABSTRACT: There has been a growing consensus about the importance of assessing capacity to give consent. A number of procedures (e.g., elective medical treatment, pharmacotherapy, electroconvulsive therapy), use of restrictive behavioral interventions, and signing a power of attorney) require informed consent. In the mental health system informed consent is very important relative to the issues of pharmacotherapy and electroconvulsive therapy. A protocol for assessing capacity has been developed and used by the Center for the Disabled in Albany, New York, a community-based agency that serves persons with intellectual disabilities or other developmental disabilities. The proposed Center for the Disabled protocol for assessing capacity to give informed consent is based upon three legal criteria-knowledge, rationality, and voluntariness.
    Mental Health Aspects of Developmental Disabilities 07/2004; 7(3):97-106.
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    ABSTRACT: We report the case of a 27-year-old woman who had mental retardation, multiple psychiatric disorders, and severe challenging behaviors that included aggression and self-injury. She had been admitted to and discharged from many hospitals and habilitation settings, received electroconvulsive therapy without therapeutic benefit, been prescribed in excess of 20 psychotropic medications, and experienced a protracted history of invasive interventions such as wearing protective equipment and being placed in mechanical restraint. Upon discharge from a psychiatric hospital where mechanical restraint had been imposed for as long as 11 hours in a single day, the woman entered a community-based center at which time mechanical restraint was terminated. At that time, she was exposed to a multicomponent behavior support intervention which featured (a) differential positive reinforcement, (b) nonexclusionary time-out, (c) environmental modifications, (d) lifestyle changes, and (e) contingent protective holding as a consequence for aggressive and self-injurious behaviors. Mechanical restraint was discontinued successfully, and the frequency of challenging behaviors and protective holding was reduced to near-zero levels during the course of a seven-year evaluation period. As an outcome from intervention, the woman gained greater independence and increased opportunities for community inclusion. This case is one of the few which documents extended (multi-year) follow-up from clinical intervention for persons with severe behavior disorders and restrictive treatment histories.
    Mental Health Aspects of Developmental Disabilities 07/2002; 5(3):69-77.
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    ABSTRACT: The comorbidity between autistic spectrum disorders and Tourette's syndrome (TS) raises intriguing questions about the neurobiology of both disorders. Repetitive movements, stereotypies, echophenomena, self-injurious behaviors and compulsive behaviors are common in autistic spectrum, and a subset of severe TS without autism. The appearance of this symptom in individuals with severe intellectual disabilities presents problems in differential diagnosis. This overlap also extends to treatment in which both developmental disorders respond to low doses of serotonin reuptake inhibitors and atypical antipsychotics drugs and display a narrow therapeutic index for these agents. These similarities suggest an overlapping fronto-stiatal substrate for at least some forms of autistic spectrum disorders and complex movement disorders like TS.
    Mental Health Aspects of Developmental Disabilities 01/2002; 5(1):7-15.
  • Mental Health Aspects of Developmental Disabilities 01/2002; 5:118-124.