Trauma and Life Events in Adults with Intellectual Disability

Abstract

Exposure to adverse life events and environmental stressors (e.g. violence, poverty, sexual abuse) has been found to be high in intellectual disability populations. Notwithstanding resilience, for some people with intellectual disability, adverse life events and environmental stressors may lead to PTSD and may affect well-being in more diffuse but potentially still clinically impactful ways (e.g. challenging behaviour, obesity, substance misuse). Advances have occurred in the field of trauma in intellectual disability. More specifically, a small number of assessment measures have been developed for PTSD and a small number of studies evaluated treatment interventions such as cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR). Awareness has also increased regarding the potential life course effects on mental health of exposure to environmental stressors. While these developments are promising, the field warrants more research and development. This paper considers recent developments in knowledge on the psychological effects of exposure to adverse life events and environmental stressors in adults with intellectual disabilities.

Multiple traumatisation and subsequent psychopathology in people with intellectual disabilities and DSM‐5 PTSD: a preliminary study

“…However, it was surprising that multiple traumatisation was not found to be associated with increased PTSD and anxiety symptomatology considering evidence suggesting this link from research in this population (Bonell‐Pascual et al . ; Mevissen & de Jongh ; Wigham & Emerson ) and in the non‐disabled population (e.g. Cloitre et al .…”

“…Individuals with intellectual disabilities (IDs) are at greater risk of being exposed to multiple traumatic events, particularly in childhood, and more likely to developing severe mental health problems following trauma (Hatton & Emerson ; Focht‐New et al . ; Wigham & Emerson ). Evidence suggests that individuals with ID are more likely than individuals without ID to experience traumatic events such as sexual and physical abuse, life‐threatening illness or injury and bereavement (Hatton & Emerson ; Focht‐New et al .…”

Sexuality issues and the voices of adults with intellectual disabilities: A systematic review of the literature

“…Access to education, LGBT networks of social support and opportunities to meet other LGBT people, are recurring issues that need to be addressed. This is necessary to minimise the potential for social isolation, mental illhealth and to develop resilience and build on positive strengths and capabilities (McClelland et al, 2012;Stoffelen et al, 2013;Elderton et al, 2014;Conder et al, 2015;Wigham & Emerson, 2015).…”

The association between challenging behaviour and symptoms of post‐traumatic stress disorder in people with intellectual disabilities: a Bayesian mediation analysis approach

“…People with ID have an increased vulnerability to potentially traumatic experiences, especially interpersonal violence (Mevissen and de Jongh ; Wigham and Emerson ; Mevissen et al . ), with one meta‐analysis reporting a 1.6‐fold higher risk of exposure to violence in adults with ID compared with adults without disabilities (Hughes et al .…”

“…A greater dependency on others in daily life, which leads to an elevated risk for carer‐perpetrated violence, is among the risk factors that contribute to this increased vulnerability for trauma exposure (Nosek et al . ; European Union Agency for Fundamental Rights ; Wigham and Emerson ). Furthermore, some of the most important risk factors for the development of PTSD following trauma exposure, which have been derived from the general literature, such as lower intelligence and a lower developmental level, are elevated in people with ID (Brewin et al .…”