Treatment of Psychopathology in People with Intellectual and other Disabilities

Abstract

Objective: To review the psychosocial, pharmacological, and other treatments of psychopathology in people with intellectual disabilities (IDs), autism, and other developmental disabilities (DDs).Method: Systematic reviews and meta-analyses of psychosocial, pharmacological, and other treatments for people with DDs are reviewed. Results:There is strong evidence for applied behaviour analysis (ABA) and other behavioural treatments of some forms of psychopathology. There is little good evidence to support the effectiveness of cognitive-behavioural therapy, cognitive therapy, sensory interventions, and other forms of psychosocial interventions. Recently, more randomized controlled trials (RCTs) of psychopharmacology have been published, especially with people with autism spectrum disorders. Most RCTs were for externalizing behaviour problems, rather than for psychopathology. These RCTs offer only preliminary support for the effectiveness of pharmacotherapy. No evidence was found for the effectiveness of other biological treatments. Conclusions:Current research supports the use of ABA and other behavioural interventions for some forms of psychopathology. Evidence for the effectiveness of other interventions is limited or absent.

Aetiology Based Diagnosis and Treatment Selection in Intellectually Disabled People with Challenging Behaviours

“…To this end, several treatment programs based on operant learning and cognitive models with documented efficacy can be employed such as differential reinforcement strategies (e.g. to reduce inappropriate vocalisations), low level problem solving, assertiveness and goal management training [115][116][117][118]. In certain genetic disorders like Noonan syndrome and Turner syndrome, specific impairments in affective information processing and social interaction can be identified and may be modulated by means of targeted social-cognitive training [119][120][121].…”

Self-injurious behavior among individuals with intellectual and developmental disabilities

“…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. validity issues), and features of the studied populations [41]. 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].…”

Comorbid Conditions in Individuals with Intellectual Disabilities

“…ABA relies on the principles established in learning to modify behavior (Baer et al 1968). Most often used in treating symptoms of autism spectrum disorder, researchers have found that ABA is also effective in treating psychiatric disorders, maladaptive behaviors, self-injurious behaviors, pica, and phobic avoidance (Didden et al 1997(Didden et al , 2006Mafifei-Almodovar and Sturmey 2012;McAdam 2012;Sturmey 2012;Sturmey et al 2012).…”

“…Other areas where further research would be beneficial include reliable diagnosis of psychiatry disorders in person with ID, combined psychopharmacological and psychosocial treatment, and social validation of behavioral changes. First, the reason that research to examine medication to treat comorbid conditions in persons with ID is limited is because of the difficulty of making reliable psychiatric diagnoses in individuals with ID (Sturmey 2012). Thus, as touched on previously, researchers must continue focusing on studying the symptom presentation of comorbid conditions in individuals with ID to support better research.…”

“…Researchers have found that combination therapy can be very beneficial in treating disorders in those without ID, therefore, exploring combination therapy in individuals with ID is promising (Keeton et al 2009;Walkup et al 2008). Finally, little attention has been paid to evaluating the social validity of behavioral changes from pharmacological treatments (Sturmey 2012). Researchers must weigh the pros and cons of pharmacological treatments and determine if the effects of treatment significantly improve quality of life (Sturmey 2012).…”