Mental illness with intellectual disabilities and autism spectrum disorders

Bakken, Trine Lise; Helvershou, Sissel B.; Høidal, Siv Helene; Martinsen, Harald

doi:10.1017/cbo9781107588714.012

Cited by 31 publications

(48 citation statements)

References 37 publications

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“…Forty-five percent of individuals with Autism Spectrum Disorder (ASD) are estimated to have an Intellectual Disability (ID) (Lai, Lombardo & Baron-Cohen, 2014). These individuals seem particularly vulnerable to developing psychiatric disorder (Bakken et al, 2010;Bakken, Helverschou, Høidal & Martinsen, 2016), while assessments are challenging. Because individuals with ASD and ID have difficulties in self-report (Helverschou, Bakken & Martinsen, 2011), assessments frequently have to rely on information from family members or professional carers, along with observation and interpretation of behavioral equivalents of psychiatric symptoms (Underwood, McCarthy, Chaplin & Bertelli, 2015;Bakken, Friis, Lovoll, Smeby & Martinsen, 2007).…”

Section: Introductionmentioning

confidence: 99%

Identification of Post-Traumatic Stress Disorder in Individuals with Autism Spectrum Disorder and Intellectual Disability: A Systematic Review

Kildahl

Bakken

Iversen

et al. 2019

Journal of Mental Health Research in Intellectual Disabilities

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Introduction Autism Spectrum Disorder (ASD) and Intellectual Disability (ID) seem to influence risk of and vulnerability to exposure to trauma and adverse events. While assessment of psychiatric disorder in ASD and ID generally is challenging, identification of Post-traumatic stress disorder (PTSD) seems particularly so, and knowledge does not seem easily accessible. Methods This article provides a systematic review of studies describing trauma reactions in individuals with both ASD and ID, including studies involving any single case with the combination of 3 ASD, ID, and PTSD. To systematically explore PTSD symptom presentation in the group, all reported symptoms from studies were assigned by DSM 5 criteria. Results Eighteen studies met the inclusion criteria, eight group studies and ten case studies. Assessment methodology in studies varied, as did the format of symptom report. DSM 5 criteria provided a useful framework for integrating findings across studies, indicating that PTSD may be identified in individuals with ASD and ID. However, symptoms involving alterations in arousal and negative alterations in thought and behavior seem more easily identified than symptoms of re-experiencing and avoidance. Conclusions There is an urgent need to identify behavioral equivalents to PTSD symptoms in this group, making it possible to identify warning signs of trauma and abuse even if such incidents are not known to family or professional carers.

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Section: Introductionmentioning

confidence: 99%

Identification of Post-Traumatic Stress Disorder in Individuals with Autism Spectrum Disorder and Intellectual Disability: A Systematic Review

Kildahl

Bakken

Iversen

et al. 2019

Journal of Mental Health Research in Intellectual Disabilities

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“…Identification of psychiatric disorder in individuals with autism spectrum disorder (ASD) and intellectual disability (ID) is generally challenging (Rosen et al 2018, Bakken et al 2016a, Helverschou et al 2011a. Individuals with ASD and ID often have difficulties in self-report of symptoms, and even use of multiple informants may not compensate for this with regard to intra-psychic phenomena (Helverschou et al 2020, Santore et al 2020.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, there is a risk of diagnostic overshadowing (Reiss et al 1982), where symptoms of psychiatric disorder are misinterpreted and misattributed to the underlying condition(s) rather than a co-occurring disorder. These challenges are increased for individuals with ASD and co-occurring ID (Bakken et al 2016a), in particular in cases of severe or profound levels of ID, and are present for the entire range of psychiatric disorders, including anxiety-and traumarelated disorders (Kildahl et al 2020a, 2019a, Appleton et al 2019, Kerns et al 2015, 2014, Mevissen et al 2016, Bakken et al 2016a, Helverschou et al 2011a.…”

Section: Introductionmentioning

confidence: 99%

Case study: identification of anxiety and subsequent intervention in an adolescent male with autism, severe intellectual disability and self-injurious behaviour

Kildahl

Bakken

Matre

et al. 2020

International Journal of Developmental Disabilities

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Introduction : Anxiety disorders are highly prevalent in individuals with autism spectrum disorder (ASD), but knowledge is limited regarding identification and treatment of these disorders in individuals with ASD and more severe levels of intellectual disability (ID). The current case study aims to explore and describe the inpatient, psychiatric assessment in an adolescent male with ASD, severe ID and self-injurious behaviour (SIB) who was diagnosed with a co-occurring anxiety disorder. The study further aims to explore the implications of this diagnosis for subsequent intervention and care, including management of SIB. Materials and methods : Case study including multimodal, psychiatric assessment and subsequent intervention. Results : Following changes in care strategies attempting to incorporate the understanding of anxiety/trauma as contributing to SIB, a reduction of SIB was observed, and this reduced frequency was maintained when the patient was discharged from the inpatient setting. Conclusions : Though no causal inferences are possible, these experiences indicate that further research is needed regarding possible associations between SIB and anxiety in individuals with ASD, including implications for treatment. Experiences from the current case further indicate that it is possible to recognize and diagnose anxiety disorder in complex cases involving ASD, severe ID, limited verbal language skills, and severe SIB.

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“…When autism spectrum disorder is also present with ID, mood dysregulation may be exacerbated by communication difficulties, hypersensitivity to sensory stimulation, and cognitive inflexibility. 15 …”

Section: Introductionmentioning

confidence: 99%

Recognition and treatment of mood dysregulation in adults with intellectual disability

Noel

2018

Mental Health Clinician

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Mood dysregulation is a common feature in the psychopathology of people with intellectual disability (ID) and co-occurring behavioral/psychiatric disorders. It can present with a host of dangerous behaviors, including aggression, self-injury, and property damage. There are special techniques that are used to assess these behaviors in people with ID, that can eventually inform an appropriate approach to pharmacologic and nonpharmacologic treatment. Two case studies are presented that illustrate the elements in the assessment and treatment of mood dysregulation in ID.

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Mental illness with intellectual disabilities and autism spectrum disorders

Cited by 31 publications

References 37 publications

Identification of Post-Traumatic Stress Disorder in Individuals with Autism Spectrum Disorder and Intellectual Disability: A Systematic Review

Identification of Post-Traumatic Stress Disorder in Individuals with Autism Spectrum Disorder and Intellectual Disability: A Systematic Review

Case study: identification of anxiety and subsequent intervention in an adolescent male with autism, severe intellectual disability and self-injurious behaviour

Recognition and treatment of mood dysregulation in adults with intellectual disability

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