Profiles and correlates of aggressive behaviour among adults with intellectual disabilities

McGill University, Montréal, Québec, Canada, and Douglas Hospital Research Centre, Montréal, Québec, Canada.
Journal of Intellectual Disability Research (Impact Factor: 2.41). 11/2007; 51(Pt 10):786-801. DOI: 10.1111/j.1365-2788.2007.00953.x
Source: PubMed


Despite the heterogeneity in aggressive behaviours observed among individuals with intellectual disabilities (ID), little attention has been paid to the identification of typologies of aggression among individuals with mild or moderate ID and their associated factors.
The goal of the present study was to identify profiles of aggressive behaviour and their psychosocial correlates.
In this cross-sectional study of 296 adults with mild or moderate ID, information was gathered through interviews with the ID participants, their case manager and a significant other. Client files were also reviewed.
Multiple correspondence analysis followed by hierarchical cluster analysis generated six distinct profiles of aggressive behaviour in this sample. The 'violent' group clearly stood out as lacking social and vocational involvement, having more severe mental health problems, high levels of impulsivity and antisocial tendencies compared with all other groups.
The identification of distinct profiles of aggressive behaviour offers new possibilities for studying risk factors and eventually targeting specific risk prevention strategies.

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    • "Recent studies have investigated the prevalence of the main psychiatric disorders in the ID population (Tsiouris et al. 2011; Cooper et al. 2007) and their association with aggressive behaviors (Crocker et al. 2007; Hurley 2008; Cooper et al. 2009; Myrbakk and von Tetzchner 2008; Tsiouris et al. 2011). It is now recognized that people with ID often suffer from anxiety, impulse control and mood disorders (and from all other psychiatric disorders observed in the rest of the population) and not only from psychotic or behavior disorders as had been the opinion of clinicians in the past (Tsiouris 2010; Tsiouris et al. 2011). "
    • "Barriers that impede RNIDs in implementing effective behavioural interventions are well documented. These include the absence of an organisational ethos supporting behaviour supports (Ager and O'May, 2001), the absence of adequate performance management systems for the implementation of behavioural interventions (Reid et al., 2005), negative staff perceptions of aggressive behaviour and behavioural interventions (Ager and O'May, 2001), and the lack of consistency in classifying aggressive behaviour achieved through specific prevalence rates (Crocker et al., 2007). The latter of these barriers is particularly relevant in Ireland where there is a paucity of studies carried out to identify the prevalence of aggressive behaviours. "
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    ABSTRACT: Purpose ‐ Despite the high incidence of aggressive behaviours among some individuals with intellectual disability, Ireland has paid little attention to the prevalence of aggressive behaviours experienced by Registered Intellectual Disability Nurses (RNID). Within services the focus is mainly on intervention and management of such behaviours. Therefore a disparity occurs in that these interventions and management strategies have become the exclusive concern. Resulting in aggressive behaviour being seen as a sole entity, where similar interventions and management strategies are used for ambiguously contrasting aggressive behaviours. Consequently the ability to document and assess-specific behaviour typologies and their prevalence is fundamental not only to understand these behaviour types but also to orient and educate RNIDs in specific behaviour programme development. The paper aims to discuss these issues. Design/methodology/approach ‐ This study reports on a survey of the prevalence of verbal aggression, aggression against property and aggression against others experienced by RNIDs' within four residential settings across two health service executive regions in Ireland. A purposeful non-random convenience sampling method was employed. Totally, 119 RNIDs responded to the survey which was an adaptation of Crocker et al. (2006) survey instrument Modified Overt Aggression Scale. Findings ‐ The findings of this study showed the experienced prevalence rate of verbal aggression, aggression against property and aggression against others were 64, 48.9 and 50.7 per cent, respectively. Cross-tabulation of specific correlates identifies those with a mild and intellectual disability as displaying a greater prevalence of verbal aggression and aggression against property. While those with a moderate intellectual disability displayed a higher prevalence of aggression against others. Males were reported as more aggressive across all three typologies studied and those aged between 20 and 39 recorded the highest prevalence of aggression across all three typologies. The practice classification areas of challenging behaviour and low support reported the highest prevalence of aggression within all typologies. Originality/value ‐ The health care of the person with intellectual disability and aggressive behaviour presents an enormous challenge for services. In-order to improve considerably the quality of life for clients, services need to take a careful considered pragmatic view of the issues for the person with intellectual disability and aggressive behaviour and develop realistic, proactive and responsive strategies. To do this, precise knowledge of the prevalence of aggressive behaviours needs to be obtained. This study is the first of its kind in the Republic of Ireland.
    05/2014; 8(3):174-187. DOI:10.1108/AMHID-03-2013-0016
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    • "A cross-sectional study of 296 adults with mild/moderate IDD who exhibited aggression found that increased levels of mental health problems (psychosis, autism, and mood disorders), impulsivity, antisocial tendencies, less ability to tolerate frustration, and lower levels of social and vocational involvement were associated factors (Crocker, Mercier, Allaire, & Roy, 2007). Although the people with IDD who demonstrate behavior problems are a heterogeneous group, it appears that emotion and cognitive regulation skills deficits (Janssen et al., 2002; Nezu et al., 1991; F. Tyrer et al., 2006; Whitman, 1990) and mental health issues (Crocker et al., 2007; Reiss & Rojahn, 1993; F. Tyrer et al., 2006) contribute to their behavioral dysregulation. Given that emotion dysregulation appears to be a key contributing factor to CBs, it is essential that a treatment of behavior problems build self-regulation capacities. "
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    ABSTRACT: Approximately one third of adults with intellectual and developmental disabilities have emotion dysregulation and challenging behaviors (CBs). Although research has not yet confirmed that existing treatments adequately reduce CBs in this population, dialectical behavior therapy (DBT) holds promise, as it has been shown to effectively reduce CBs in other emotionally dysregulated populations. This longitudinal single-group pilot study examined whether individuals with impaired intellectual functioning would show reductions in CBs while receiving standard DBT individual therapy used in conjunction with the Skills System (DBT-SS), a DBT emotion regulation skills curriculum adapted for individuals with cognitive impairment. Forty adults with developmental disabilities (most of whom also had intellectual disabilities) and CBs, including histories of aggression, self-injury, sexual offending, or other CBs, participated in this study. Changes in their behaviors were monitored over 4 years while in DBT-SS. Large reductions in CBs were observed during the 4 years. These findings suggest that modified DBT holds promise for effectively treating individuals with intellectual and developmental disabilities.
    Journal of Mental Health Research in Intellectual Disabilities 10/2013; 6(4):280-303. DOI:10.1080/19315864.2012.700684
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