Post-traumatic stress disorder and substance use disorder in individuals with mild intellectual disability or borderline intellectual functioning: A review of treatment studies

Luteijn, Ilse; VanDerNagel, Joanne; Duijvenbode, Neomi van; Haan, Hein A. de; Poelen, Evelien A. P.; Didden, Robert

doi:10.1016/j.ridd.2020.103753

Cited by 7 publications

(8 citation statements)

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“…The present study used the classification of BIF rather than borderline intellectual disability, as the latter relies on additional measures of adaptive functioning and onset before 18 years of age. In addition, several studies investigated the clinical features of co-occurring BIF and SUD by combining the IQ ranges of BIF and mild ID ( 2 , 24 , 35 , 90 , 91 ). The risk factors and associations identified in these studies may result from the inclusion of a proportion of individuals with ID.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Borderline Intellectual Functioning in a Cohort of Patients With Polysubstance Use Disorder

Hetland

Braatveit²,

Hagen

et al. 2021

Front. Psychiatry

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Objective: To determine the prevalence and associated demographic and clinical features of borderline intellectual functioning (BIF) among individuals with polysubstance use disorder (pSUD).Methods: We applied a cross-sectional analytical design to data from the Norwegian STAYER study (n = 162), a cohort study of patients with a pSUD from the Stavanger University hospital catchment area. We used Wechsler Abbreviated Scale of Intelligence Full Scale IQ (FSIQ) to define BIF (FSIQ = 70–85) and non-BIF (FSIQ = >85) and collected demographic and clinical data using semi-structured interviews and self-reports on the Symptom Checklist 90-Revised (SCL-90-R) and the Satisfaction With Life Scale (SWLS).Results: The prevalence of BIF was 18% in the present study. The presence of BIF was associated with higher SCL-90-R GSI scores than in the non-BIF group. There were no significant differences between the BIF and non-BIF groups regarding age, gender, participation in meaningful daily activity, years of work experience, years of education, satisfaction with life, level of care, treatment attempts, age at substance-use onset, years of substance use, history of injecting drugs, or age of onset of injecting drugs.Conclusion: The present study confirmed a higher prevalence of BIF among patients with pSUD than expected from the distribution of IQ scores in a general population. Elevated SCL-90-R GSI scores suggested that BIF is associated with increased psychological distress in patients receiving treatment for pSUD. Further studies on this association, and its effect on treatment procedure and outcomes are strongly warranted.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Characteristics of Borderline Intellectual Functioning in a Cohort of Patients With Polysubstance Use Disorder

Hetland

Braatveit²,

Hagen

et al. 2021

Front. Psychiatry

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“…In addition, a supportive social network plays a role in preventing drop‐out. Drop‐out during treatment could potentially be reduced if the social network received psychoeducation on trauma‐sensitive support (Keesler, 2020; Kroese et al, 2016; Luteijn et al, 2020; Ooms‐Evers et al, 2021). Finally, trauma‐focused treatment can be expected to lead to fewer participant drop‐outs if it is short and intensive and takes place in a trauma‐sensitive environment (Hendriks et al, 2017; Ooms‐Evers et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…The literature suggests ways in which existing trauma treatments can be adapted for people with intellectual disabilities. A review study by Luteijn et al (2020) shows that various adaptations are made by therapists. Extra attention is paid to establishing the therapeutic relationship.…”

Section: Introductionmentioning

confidence: 99%

“…Comorbid disorders occur in 80%–90% of people with PTSD (Pizzimenti et al, 2017; van Minnen et al, 2015). The most common comorbid diagnoses with PTSD are substance use disorders, mood and anxiety disorders (Luteijn et al, 2020; Pizzimenti et al, 2017; van Minnen et al, 2015). The prevalence of comorbid disorders in people with intellectual disabilities is expected to be at least similar (Van Duijvenbode & Van der Nagel, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Prolonged exposure treatment for post‐traumatic stress disorder: Single case studies in a sample of adults with mild intellectual disabilities

Prins,

Nijhof

2024

Research Intellect Disabil

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BackgroundPost‐traumatic stress disorder (PTSD) is common in adults with intellectual disabilities. Often there are additional disorders such as substance use, mood and anxiety disorders. The current study focuses on the feasibility and initial efficacy of prolonged exposure (PE) for PTSD in adults with mild intellectual disabilities. The secondary effect of PE on additional mood, anxiety and substance use disorders is also examined.MethodsA single case experimental design (N = 12) with an A (baseline)‐B (intervention) phase including a follow‐up measurement after 3 months was conducted. Time series and single time points measurements were performed.ResultsSix participants dropped‐out. The results showed a significant decrease in PTSD symptoms and a significant decrease in additional symptoms (social avoidance, anxiety and stress), among participants who completed treatment.ConclusionPE appears to be a feasible and effective treatment for PTSD in some adults with mild intellectual disabilities. Suggestions emerge from this study to make standard PE treatment more appropriate for adults with mild intellectual disabilities. Further research is needed to reduce drop‐out in trauma treatment. Some suggestions for this are made in this study. Treatment of PTSD with PE did not appear to affect comorbid mood disorders. Further research is needed.

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“…There is, therefore, an increasing interest in risk and protective factors that might moderate the direct impact of stress and war-related trauma exposures on mental health. Research suggests that genetics, gender, adverse childhood experiences (ACEs), and lower intellectual processing capacity are moderators [7][8][9][10][11]. Moreover, Arnetz et al found that only two of the five subscales of the commonly used war-related trauma exposure assessment instrument, the Harvard Trauma Questionnaire (HTQ), "physical trauma to self" and "lack of necessities", predicted PTSD in a large, prospective study of Middle Eastern refugees displaced to the United States [6].…”

Section: Introductionmentioning

confidence: 99%

Association Between Inflammatory Biomarkers and Mental Health Symptoms in Middle Eastern Refugees in the US

Ghandour¹,

Yamin²,

Arnetz³

et al. 2022

Cureus

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Introduction: Refugees are at increased risk for trauma-related mental health disorders, including anxiety, depression, and post-traumatic stress disorder (PTSD). The underlying biological mechanisms linking trauma to mental disorders need additional study, and the possible pathophysiological role of the immune system is attracting increasing interest. In this study, we investigated whether two well-known proinflammatory cytokines (interleukin (IL-8) and IL-6) are associated with mental health symptoms in Middle Eastern refugees displaced to the United States.Methods: Refugees (n=64, mean age=37.6 years) ages ranged from 21 to 74 years (mean=37.62, SD=11.84) were interviewed one month after arrival in Michigan, United States, using a validated survey in Arabic. Questions covered pre-displacement trauma, current anxiety, depression, and PTSD symptoms. Blood, collected immediately following the interview, was analyzed for the levels of interleukins. Multivariate linear regression was used to determine the association between mental health symptoms and IL-6 and IL-8.Results: In multivariate modeling, older age (β=0.37; p<0.01) and anxiety (β=0.31; p<0.05) were positively associated with IL-8. Age (β=0.28; p<0.05) and pre-displacement trauma (β=0.40; p<0.05) were positively associated with IL-6. Depression (β=-0.38) was negatively associated with IL-6.Conclusion/relevance: This study of inflammatory biomarkers suggests the possibility of differential associations between mental health symptoms (anxiety and depression) and pro-inflammatory markers (IL-6 and IL-8). To enhance our ability to prevent and more effectively treat trauma-exposed refugees, we need to better understand the neuroinflammatory mechanisms contributing to mental disorders.

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Post-traumatic stress disorder and substance use disorder in individuals with mild intellectual disability or borderline intellectual functioning: A review of treatment studies

Cited by 7 publications

References 63 publications

Prevalence and Characteristics of Borderline Intellectual Functioning in a Cohort of Patients With Polysubstance Use Disorder

Prevalence and Characteristics of Borderline Intellectual Functioning in a Cohort of Patients With Polysubstance Use Disorder

Prolonged exposure treatment for post‐traumatic stress disorder: Single case studies in a sample of adults with mild intellectual disabilities

Association Between Inflammatory Biomarkers and Mental Health Symptoms in Middle Eastern Refugees in the US

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