Purpose Emotion regulation is an ongoing multiprocess phenomenon and is a challenging developmental task to acquire in individuals with autism spectrum disorder (ASD) who have different neurobiological profiles and emotion regulation problems. The purpose of this paper is to review recent literature to understand the neurobiological and psychological perspective of emotion regulation in ASD, while converging themes of psychosocial interventions and existing best practices on emotion regulation within this heterogeneous population are reviewed and discussed in consideration of intellectual disability (ID). Design/methodology/approach Review of recent literature and common empirically supported interventions addressing emotional regulation implemented in individuals with and without ASD, and with and without ID were included in the electronic database search through PubMed, EBSChost, Science Direct, Wiley Online Library, GALE and SAGE. Search terms used included autism, ID, cognitive control, executive function, sensory processing/intervention, emotion regulation, cognitive behavior therapy, mindfulness, social stories, positive behavior support and behavior therapy. Findings Neural systems governing emotion regulation can be divided into “top-down” and “bottom-up” processing. Prefrontal cortex, cognitive and attentional control are critical for effective emotion regulation. Individuals with ASD, and with ID show impairments in these areas have problems with emotion regulation. Targeted psychosocial intervention need to consider bottom-up and top-down processes of emotion regulation, and that standardized interventions require adaptations. Originality/value There are limited studies looking into understanding the neurobiological and psychological perspective of emotion regulation in ASD and linking them to interventions. This review highlights psychosocial interventions that are important for further research, investigation and development as treatment in this population is limited.
Introduction: The Adult Neurodevelopmental Service in Singapore is the first service of its kind in South-East Asia for adults with intellectual disability (ID) and/or autism spectrum disorder (ASD). However, few studies have documented and compared the sociodemographic characteristics and clinical needs of this subpopulation group.Methods: Initial assessments conducted from 1 January 2015 to 31 December 2016 were retrospectively reviewed for this descriptive study.Results: A total of 272 patients were included in the study (mean age 28.3 ± 11.5; 200 males, 72 females). Adults with ID comprised the largest percentage (52.9%), followed by those with ASD (30.2%), and then those with cooccurring ASD and ID (16.9%). The ASD subgroup had the highest proportion of individuals with employment, postsecondary school education, functional capabilities, and a psychiatric disorder. In comparison, adults with only ID and adults with co-occurring ASD and ID shared similar lower levels of education and employment, and had a higher proportion of individuals with epilepsy and aggressive behavior.Discussion: In this study, adults with ASD had a unique social profile with different clinical needs compared to adults with only ID or to adults with co-occurring ASD and ID. Adults with only ID and those with co-occurring ASD shared many of the same social characteristics and high clinical needs. The analysis of these profiles will be useful in developing services that better meet the needs of this complex group. K E Y W O R D S adult, autism spectrum disorder, intellectual disability, mental retardation, neurodevelopmental disorder
Background: This research aimed to investigate the views and experiences of specialist mental health professionals working with adults with intellectual disabilities and mental health problems in Singapore in order to gain insight into the functioning of the local specialist intellectual disability mental health service and how it may be improved. Methods: Eight staff members from specialist service were interviewed. The transcriptions of the interviews were analysed using thematic analysis. Results: Analysis revealed four themes (1) Identifying their roles; (2) Ensuring continuity of care; (3) Disempowerment of service users and (4) Improving clinical practice. Conclusions: Participants identified the challenges they faced working with this population. They highlighted the importance of building therapeutic relationships during the treatment process and discussed the stigma that people with intellectual disabilities face in the community. Recommendations and implications are discussed in relation to service provision, improving staff knowledge and recruiting more staff to work in this field.
IntroductionThe challenges of providing caregiving that impacts the caregiver have been attributed to high levels of intensity and physical strain, burden and distress. This is likely to include emotional and psychological distress as manifested in post-traumatic stress symptoms (PTSS). As this is a new area of investigation among caregivers of individuals with neurodevelopmental, neurocognitive and psychiatric disorders, the extent of the literature for PTSS in these groups of caregivers is limited and unclear. This scoping review aims to map the existing research focusing on key concepts and identifying gaps in relation to PTSS among these caregivers.Methods and analysisThe scoping review will be guided by Arksey and O’Malley’s proposed 5-stage framework. A search for published and unpublished grey literature between years 2005 to 2020 in the electronic databases of CINAHL, SCOPUS, PsychInfo, OVID PubMed and ProQuest Dissertation, and Thesis Global electronic databases was conducted using keywords to identify relevant studies. Articles will be limited to the English language. Endnote 20 software will be used to eliminate duplicates, and results will be exported into Abstrackr for the review screening process consisting of two stages: title and abstract reviews and full-text reviews. Selection process of eligible studies will follow the recommendations in the Preferred Reporting Items of Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. A data chart will be used to capture relevant information from all included studies, and results will be presented in tabular form and in a narrative report.Ethics and disseminationThis scoping review consists of reviewing and collecting data from publicly available materials and hence does not require ethics approval. The scoping review results will be disseminated via publications in peer-reviewed journals and conference presentations. The results will also guide the design of a mixed method research study to examine the extent of trauma symptomatology and potentially traumatising experiences, and how they relate to the mental health of caregivers of adults with intellectual and developmental disability from different cultural backgrounds.
Background: There is a lack of studies that explore the views and experiences of people with neurodevelopmental disorders of their mental health. This study explored the experiences of five adults with neurodevelopmental disorders who receive outpatient mental health services in Singapore.Method: Two participants attended one-to-one semi-structured interviews and three participants attended a focus group. The data were analyzed using interpretative phenomenological analysis.Results: Four master themes emerged: (1) Sense of self, (2) people who matter to me, (3) having choice and autonomy, and (4) hopes and dreams. Three subthemes were further identified in the second master theme. Conclusion:The themes identified the negative impact of mental illness on self-esteem and their experiences of receiving specialist mental health service in Singapore. Participants also specified desirable traits of professional staff and expressed a wish to have greater participation in the community through employment. Implications of the findings are discussed in the context of improving services for this population and addressing their psychosocial needs during the treatment process.
Purpose This study aims to explore the experiences of people with intellectual disabilities in Singapore receiving inpatient mental health treatment. To date, there has not been any research that examines the views and experiences of this population in Singapore. The research examines how the participants view their mental health problems and their experiences of the services they received. Design/methodology/approach A qualitative design was chosen to address the research question. Six adult men with intellectual disabilities were recruited from the tertiary hospital and interviewed. The transcripts of these interviews were analysed using interpretative phenomenological analysis. Findings Four super-ordinate themes were identified; awareness of mental health problems; yearn for a life outside the ward; interacting with other people and finding purpose. Originality/value The participants reported that they struggled with being segregated from their families and communities following an inpatient admission. They were able to report on the emotional difficulties that they experienced and hoped to find employment after their discharge from the hospital. They talked about reconstructing their self-identity and forming friendships to cope with their hospital stay. This research is one of its kind carried out in a non-western society and the findings are discussed in the light of how mental health professionals can best support people with intellectual disabilities during their inpatient treatment.
Background: Generic mental health staff often have contact with people with intellectual disabilities when they access mainstream mental health services. To date, there has not been any research conducted in non-western countries to explore their views. This paper investigates the views and experiences of mainstream mental health professionals regarding the mental health services for people with intellectual disabilities in Singapore. Methods: Eight staff members from generic mental health services were interviewed. Thematic analysis was used to identify main themes. Findings: The main themes are related to their work experiences, perceptions of people with intellectual disabilities, ideal staff characteristics and service recommendations. Conclusions: Participants identified a lack of experience and knowledge when working with this population. They highlighted the challenges they face promoting choice and autonomy for people with intellectual disabilities. The discussion includes recommendations for improving staff knowledge through training opportunities, consideration of non-pharmacological approaches and early collaboration with caregivers during the treatment process.
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