Development of a Direct Aggression and Restriction Observation Checklist (AROC) for Routine Observation in Residential and Inpatient Services for Adults with Intellectual Disabilities

Nagy, Erzsébet; Wehmeyer, Meike; Gaese, Franziska; Nicolai, Elisabeth; Schweitzer-Rothers, Jochen

doi:10.1080/19315864.2019.1595232

Cited by 6 publications

(2 citation statements)

References 34 publications

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“…Similarly, a systemic training programme for clinical staff failed to produce significant effects on aggressive behaviour or psychotropic medication (Nagy et al . 2019). The implementation of a training course to reinforce staff empathy resulted in a small positive but non‐significant outcome (Hastings et al .…”

Section: Introductionmentioning

confidence: 99%

Impact of the emotional development approach on psychotropic medication in adults with intellectual and developmental disabilities: a retrospective clinical analysis

Barrett,

Wehmeyer,

Kolb

et al. 2024

J intellect Disabil Res

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BackgroundCompared with the general population, adults with an intellectual developmental disorder (IDD) are more likely to develop mental health problems and to receive high levels of psychotropic medication, particularly antipsychotics. The emotional development (ED) approach may help to better understand the nature of challenging behaviour (CB) and tailor treatment and support accordingly. The aim of this retrospective study was to investigate the impact of the ED approach on the prescription of psychotropic medication during inpatient psychiatric treatment.MethodsThe clinical data of 1758 patients were analysed within a retrospective study design over a period of 12 years. ED level was assessed (1) for the first time (INITIAL‐SEO), (2) during a previous hospital stay (PAST‐SEO) or (3) not at all (NO‐SEO). The effects of the ED assessment and the respective intervention during the current admission on the number of psychotropics and the number and dosage of antipsychotics were analysed for the total sample, including those with CB, autism spectrum disorders and psychosis. Group differences were analysed by a chi‐square test and a one‐factorial analysis of variance. For analysing the impact of the application of the ED approach on psychotropic medication, a covariance model was applied. Changes between the subsamples were analysed by t‐tests for dependent samples.ResultsThe ED approach had a significant impact on reducing the overall amount of psychotropic medication and the dosage of antipsychotics in all patients with IDD. These effects were mainly attributable to those showing CB. In patients with autism spectrum disorders, the developmental approach reduced the number of antipsychotics. No effects could be observed in patients with psychosis; in this subsample, both the number and dosage of antipsychotics increased.ConclusionsThe application of the ED approach in the current hospital stay reduced the number of psychotropic drugs and the number and dosage of antipsychotics, especially in those patients with IDD and CB, but also in those with autism spectrum disorders.

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Section: Introductionmentioning

confidence: 99%

Impact of the emotional development approach on psychotropic medication in adults with intellectual and developmental disabilities: a retrospective clinical analysis

Barrett,

Wehmeyer,

Kolb

et al. 2024

J intellect Disabil Res

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“…Eine mehrjährige Begleitforschung untersuchte zum einen die Häufigkeit aggressiver Vorfälle sowie die Frequenz freiheitseinschränkender Maßnahmen im zeitlichen Verlauf [12], zum anderen wurden Facetten der seelischen Gesundheit von SYMPA-geschulten Mitarbeitern über die Zeit und im Vergleich mit einer Kontrollgruppe aus demselben klinischen Bereich analysiert. Die hier präsentierte gesonderte Studie zeichnet die Lebenswelten und Entwicklungen von Erwachsenen mit IM, die in einer Heimeinrichtung leben und aufgrund aggressiver Verhaltensweisen vermehrt stationär-psychiatrische Dienste in Anspruch nehmen, über einen längeren Zeitraum nach.…”

Section: Introductionunclassified

Erwachsene mit Intelligenzminderung und psychischer Störung respektive problematischem Verhalten: Systemrelevante Strategien zur Reduktion aggressiver Eskalationen

Wehmeyer

Schweitzer

Nagy³

et al. 2020

Psychiatr Prax

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ZusammenfassungIm Kontext des Praxisforschungsprojekts SYMPA-GB (Systemtherapeutische Methoden in der psychiatrischen Akutversorgung von Menschen mit geistiger Behinderung) fokussierte eine Interviewstudie auf die Analyse der Interaktionen im Multi-Helfersystem von Personen mit geistiger Behinderung, die im Heim leben und aufgrund aggressiven Verhaltens gehäuft psychiatrische Dienste in Anspruch nehmen. Eine via Inhaltsanalyse ermittelte Strategiesammlung bündelt das Handlungswissen aller Akteure im Umgang mit herausforderndem Verhalten und unterstreicht die Bedeutung einer (multi-)systemischen Herangehensweise.

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The Prevalence and Correlates of Self-restraint in Individuals with Autism and/or Intellectual Disability: a Systematic Review and Meta-analysis

Marlow,

Agar,

Jones

et al. 2024

Rev J Autism Dev Disord

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Purpose Self-restraint, purposeful restriction of one’s own bodily movements is observed in individuals with neurodevelopmental conditions. Case studies and cross-sectional investigations have reported that self-restraint co-occurs with self-injurious behaviour; however, small sample sizes limit understanding of prevalence and function. We aimed to synthesise the existing literature and estimate the pooled prevalence of self-restraint in autistic individuals and/or individuals with intellectual disability, and the pooled effect size with self-injury. Methods Six databases were systematically searched in accordance with PRISMA guidelines. Results A total of 21,567 papers were retrieved, with 15 samples from 13 records included in the analyses. The pooled prevalence estimate of self-restraint in individuals with autism and/or intellectual disability was 39%, 95% CI [26.25, 51.59]. Age and presence of autism significantly increased prevalence rates. Pooled prevalence estimates were consistent across gender, presence of intellectual disability, and type of measurement of self-restraint. Meta-analyses of 31 topographies of self-restraint revealed ‘holds or squeezes objects’ and ‘holding onto others, holding onto others’ clothing’ were the most prevalent behaviours amongst those who self-restrained (both 32%). The least prevalent behaviour was ‘chooses mechanical restraint’ (1%). Pooled prevalence estimates of self-restraint in individuals known to self-injure were 34%, 95% CI [21.36, 46.97], and 13%, 95% CI [5.01, 21.43], in individuals who did not self-injure. Self-restraint and self-injurious behaviour were positively correlated, r = 0.21, 95% CI [0.14, 0.27], K = 13. Conclusions Findings highlight that on average, over one third of individuals with autism and/or intellectual disability show self-restraint. Clinical and theoretical implications of findings are discussed.

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Development of a Direct Aggression and Restriction Observation Checklist (AROC) for Routine Observation in Residential and Inpatient Services for Adults with Intellectual Disabilities

Cited by 6 publications

References 34 publications

Impact of the emotional development approach on psychotropic medication in adults with intellectual and developmental disabilities: a retrospective clinical analysis

Impact of the emotional development approach on psychotropic medication in adults with intellectual and developmental disabilities: a retrospective clinical analysis

Erwachsene mit Intelligenzminderung und psychischer Störung respektive problematischem Verhalten: Systemrelevante Strategien zur Reduktion aggressiver Eskalationen

The Prevalence and Correlates of Self-restraint in Individuals with Autism and/or Intellectual Disability: a Systematic Review and Meta-analysis

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