Post-traumatic stress disorder in young people with intellectual disability

Department of Clinical Developmental Sciences, St. George's Hospital Medical School, University of London, Cranmer Terrace, London, UK.
Journal of Intellectual Disability Research (Impact Factor: 2.41). 12/2005; 49(Pt 11):872-5. DOI: 10.1111/j.1365-2788.2005.00764.x
Source: PubMed


Post-traumatic stress disorder (PTSD) is common and treatable. There is extensive research on people of average intelligence yet little on individuals with developmental disabilities.
We report two people with intellectual disability (ID) who experienced PTSD. The relevance of their developmental difficulties, social and communication profiles, attentional skills, and causes of these, to their presentations is discussed.
Both individuals have fragile X syndrome and severe ID. One has Diagnostic and Statistical Manual - 4th Edition (DSM-IV) autistic disorder; the other DSM-IV attention deficit-hyperactivity disorder. They experienced developmental and psychological regressions, new challenging behaviours and exacerbations of existing ones coincident with emotional trauma. PTSD symptoms and phenomena were identifiable despite intellectual and communicatory impairments.
Presentation of PTSD is influenced by degree and cause of ID, social circumstances, social and communicatory skills, nature and timing of traumatic experience and subsequent management. The paucity of literature suggests it is missed frequently in individuals with ID who risk having problems misattributed to other causes with potential for inappropriate interventions.

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    • "The presentation of PTSD is influenced by the degree and cause of ID, social circumstances , social and communication skills, the nature and timing of the traumatic experience and its subsequent management. The paucity of literature suggests that PTSD is frequently undiagnosed in individuals with ID and may be misattributed to other causes, with the risk of inappropriate interventions (Turk et al. 2005). There is great diversity of functional abilities among individuals with autism, and ASDs make up one of the largest diagnostic subgroups within the population of individuals with ID. "
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    • "Cognitive limitations have been shown to be a significant risk factor for the onset of PTSD after traumatic events, for children and adolescents with a diagnosis of PDD. (Turk et al, 2005) Autistic children have a limited capacity to express affect verbally and may do so behaviorally (Howlin and Clements, 1995). When highly anxious, aggressive behaviors can increase, resulting in a " spiral effect " whereby additional medications are prescribed with little if any benefit. "

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