Issues in the taxonomy of psychopathology in mental retardation

Abstract

Several factors appear to impede the development of a valid taxonomy of psychopathology in children and adolescents with mental retardation. These include (a) the lack of a widely accepted definition of psychopathology in mental retardation, (b) disagreement on the nature of the relationship between mental retardation and psychopathology, and (c) insufficient evidence for the reliability and validity of current DSM or ICD systems in this population. In this article, we offer a definition of psychopathology in children with mental retardation; review concepts of the relationship between psychopathology and mental retardation; argue that in moving toward a valid taxonomy factors to be considered should include data from multivariate studies, findings related to behavior phenotypes, and diagnostic considerations with stereotypic behavior and self-injury, organic brain syndromes and pervasive developmental disorders. Finally, we outline a research strategy that may serve as a useful framework for developing a valid taxonomy of psychopathology in this population.

Psychopathology in Children and Adolescents with Intellectual Disability: Measurement, Prevalence, Course, and Risk

“…Second, confounding factors associated with both psychopathology and ID can make it difficult to decide whether certain behaviors are due to one or the other, referred to as diagnostic overshadowing (Borthwick-Duffy, 1994;Lovell & Reiss, 1993). Furthermore, children with ID may show deviant behaviors that are seldom reported for children without ID, such as self-absorbed behaviors (e.g., stereotyping, self-injurious behavior), communication disturbances (e.g., echolalia, confusing pronouns), and social relating problems (e.g., avoiding eye contact, not showing affection) (Einfeld & Aman, 1995;Einfeld & Tonge, 1995). Because of these qualitative symptom differences, there is an added value in using instruments designed specifically for children with ID rather than instruments used with children in general.…”

Validation of DSM-IV Model of Psychiatric Syndromes in Children with Autism Spectrum Disorders

“…For example, Einfeld and Aman (1995) proposed the following: multivariate statistical procedures, family history approach, pharmacological probes, markers associated with specific disorders, and the use of neuroimaging techniques to test for structural correlates of disordered behavior. None of these techniques will be fully satisfactory when used alone.…”

Self-injurious behavior among individuals with intellectual and developmental disabilities

“…There is general consensus that individuals with ID are at increased probability of receiving a psychiatric diagnosis [35][36][37][38][39][40]. However, data on the prevalence of mood, anxiety, and psychotic disorders are still not clear because of problems in methodology of the studies (i.e.…”

“…The application of psychiatric diagnostic classification systems originally designed for typically developing individuals to individuals with IDD has frequently been criticized and should be done with caution [34]. The communication deficits that often preclude self-report, and of the restricted behavioral repertoires that make difficult to ascertain the extent to which impairments in functioning are due to developmental/ intellectual disabilities versus a psychiatric condition [35,37,42]. In subjects with SIB, the comorbid diagnosis may be related to and contribute to SIB, or it may be independent of it.…”