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Hypertension is one critical health issue causing cardiovascular diseases. There has been a common concern among health researchers that the prevalence of hypertension, known as high blood pressure, has been more frequently observed among people with intellectual disabilities, compared to the general population. Thus, this study aims to identify which health-related physical fitness and body composition factors are significantly related to both systolic and diastolic blood pressures among people with intellectual disabilities. The data from 2180 people with intellectual disability who conducted the physical fitness tests from 2019 to 2020 were used for this study. Four physical fitness tests (i.e., 3-min step, grip strength, sit-up, and sit and reach) and two body compositions (i.e., body mass index and body fat %) used as predictors, and two blood pressures (i.e., systolic blood pressure and diastolic blood pressure) were used as outcome variables. A regression analysis was performed to examine the proposed associations. The regression test revealed that 3-min step, body mass index, and body fat % were significantly associated with both systolic blood pressure and diastolic body pressure. This research contributes to our understanding of the roles of body compositions and aerobic endurance in preventing hypertension among people with intellectual disability. [ABSTRACT FROM AUTHOR]

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Background: There is a critical need for the development of dependable and valid anxiety assessment tools suitable for people with moderate to severe intellectual disabilities, particularly those who speak few or no words. Distinguishing anxiety from distress caused by physical discomfort (pain) or characteristics associated with autism, prevalent in this population, necessitates specialised assessment tools. This study (a) developed a parent-report anxiety questionnaire tailored for individuals with severe to moderate intellectual disabilities, potentially with a co-diagnosis of autism, and (b) evaluated the psychometric attributes of this novel measure. Methods: A comprehensive approach involving literature reviews, inspection of existing tools, and interviews with clinicians and parents guided the creation of the Clinical Anxiety Scale for People with Intellectual Disabilities. The tool was completed by parents or caregivers (N = 311) reporting on individuals aged 4 or older with intellectual disabilities. Results: Exploratory factor analysis indicated a four-factor structure encompassing anxiety, pain, low energy/withdrawal, and consolability. The anxiety factor explained the most variance in scores (26.3%). The anxiety, pain, low energy/withdrawal subscales demonstrated robust internal consistency (α = 0.81-0.92), and convergent, divergent, and discriminant validity. Robustness of these subscales was further evidenced by test-retest reliability (ICC = 0.79-0.88) and inter-rater reliability (ICC = 0.64-0.71). Subgroup analyses consistently demonstrated strong psychometric properties among individuals diagnosed with non-syndromic autism (N = 98), children (N = 135), adults (N = 175), and across diverse communication abilities within the sample. Moreover, individuals diagnosed with both autism and anxiety exhibited significantly higher scores on the anxiety subscale compared to those without an anxiety diagnosis, while showing no difference in autism characteristic scores. Conclusions: The findings indicate that the Clinical Anxiety Scale for People with Intellectual Disabilities is a promising measure for use across diverse diagnostic groups, varying communication abilities, and with people with moderate to severe intellectual disabilities. [ABSTRACT FROM AUTHOR]

The aim of the creation of this cohort was to investigate patterns of health and health care utilisation before and during the COVID-19 pandemic, overall and in relation to specific diagnoses, among people with intellectual disabilities (ID) compared to the general population. People living in Skåne, the southernmost region of Sweden, on 1st of January 2014 with at least one diagnosis of ID (ICD-10 codes F70-F79) or Down syndrome (DS; Q90), or support and/or services according to the LSS act comprised the ID cohort (n = 14 716). People living in the same family and/or household as a person in the ID cohort constituted the ID family cohort (n = 31 688), and those remaining comprised the general population cohort (gPop; n = 1 226 955). Data has been collected for all three cohorts from several national and regional registers. These include registers for health care (2014–2021), deaths (2014–2021), COVID-19-related health care (vaccinations, intensive care, palliative care, 2020–2021). The prevalence of ID was 1.2%. In the ID cohort, 77.9% had at least one measure of support, 5.8% at least one Q90-diagnosis and 63.8% had at least one F7-diagnosis (26.9% mild (F70), 7.4% moderate (F71), 2.8% severe (F72), 1.4% profound (F73), and 25.4% other/unknown (F78/F79)). Compared to the gPop there were more people in the younger age groups in the ID cohort. At this point, no additional collection of data will be carried out. However, there is a possibility to add data from the registers to include years after 2021 or from additional registers. Future publications will explore relevant research questions and report key findings in relation to health among people with ID. Future results will be used to inform policy and practice on people with ID. [ABSTRACT FROM AUTHOR]

Sexuality is a valuable part of people's lives, including people with intellectual disabilities (ID). Parents and social services personnel are significant parties for promoting the autonomy of people with ID regarding sexuality, although evidence reveals their actions tend to be in the opposite direction. Sexual attitudes do not emerge solely as personal or individual but evolve from interactions with others in a particular sociocultural environment. To explore the sexuality of people with ID, this study set out to understand the dynamic of people with ID, parents and social services personnel within the cultural context of Hong Kong. In total, 19 participants including people with mild ID, parents and social services personnel were recruited. Individual interviews were conducted, and the data were analyzed applying Interpretative Phenomenological Analysis and dramaturgy. Findings revealed the participants' experiences, obstacles, and underlying feelings regarding the sexuality of people with ID, and the phenomenon, "not taking action" formed by all the groups. Chinese Confucian culture was revealed as the factor influencing the dynamic on the issues of sexuality. With respect to cultural expectations, government and social services agency leadership should take the lead to adopt an evidence-based sex education protocol. [ABSTRACT FROM AUTHOR]

Support staff and relatives are uncertain about multiple aspects of the sexuality of people with intellectual disabilities. Given that their attitudes embody positive and negative views, they can respectively support and restrict free sexual expression among people with intellectual disabilities and their potential for (intimate) relationships. A qualitative systematic literature review was conducted on the attitudes of support staff and relatives toward the sexuality of people with intellectual disabilities. A systematic search strategy was deployed across seven databases. The identified articles were screened on predetermined inclusion and exclusion criteria, and assessed on quality, which resulted in 31 included studies. A metasynthesis of these studies resulted in two major themes emerging, namely (a) attitudes toward the sexuality of people with intellectual disabilities, and (b) attitudes toward the sex education and support. Themes represented both positive and restrictive attitudes among support staff and relatives. The findings suggest that despite a general acceptance of the sexual rights of people with intellectual disabilities, certain forms of sexuality were approached more cautiously. Moreover, the sexual needs of some subgroups of people with intellectual disabilities received scarce attention. Those support staff and relatives holding rather restrictive attitudes appear to emphasize sexual risks. Finally, support staff and relatives stressed the importance of providing sex education and support for people with intellectual disabilities, while, simultaneously, expressing insecurity over the subject. The findings can help to improve the support provided to support staff and relatives to promote sexual health among people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "Schizophrenia in Autistic People with Intellectual Disabilities. Treatment and Interventions" published in the Journal of Autism and Developmental Disorders. The correction addresses an error in the author's name and the order of authors in the original article. The corrected version of the article is available under a Creative Commons Attribution 4.0 International License. The authors are affiliated with Oslo University Hospital and Helse Fonna Health Trust in Norway. [Extracted from the article]

Introduction: Personal characteristics have been shown to influence the psychosexual development of people with intellectual disabilities. This study aims to evaluate the effectiveness of the SALUDIVERSEX program about affective-sexual education depending on gender, age, relationship status, and degree of autonomy. Methods: Two hundred fifty-four participants, clustered within 28 daytime support services, completed a battery of instruments before and after the intervention. The data was collected between January 2021 and April 2022. Results: Multilevel analyses, controlling for participant's dependence within the same center, confirm that the program is equally effective regardless of gender. Likewise, younger participants, who have greater autonomy and who have a partner, seem to benefit more from the intervention. Conclusions: This suggests that the SALUDIVERSEX program is a useful tool for educating adults with intellectual disabilities on sexuality, when they possess a high degree of autonomy. Policy Implications: The present study contributes to the successful replication of the intervention being tested, providing information on the aspects that may be more difficult to learn depending on the personal characteristics of the individuals. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities share the same human need for affectionate and intimate relationships as people without a disability. Limited research has investigated sexual issues and concerns among adults with intellectual disabilities, including dating, intimate relationships, and marriage. This study employed Interpretative Phenomenological Analysis to identify the understanding and needs regarding sexuality of people with intellectual disabilities. Five people with mild grade intellectual disabilities participated in face-to-face interviews in which they discussed their struggle to have romantic relationships and sexual encounters. Their "understanding" and "doing" on sex issues were identified. The lack of adequate sex education and Chinese culture potentially impact people with intellectual disabilities' beliefs and behaviors on sexuality. Various types of intervention were discussed. Further research is necessary to understand the cultural context of the challenges and experiences regarding sexuality faced by people with intellectual disabilities and their families. [ABSTRACT FROM AUTHOR]

The article explores the sexual rights of people living with mental disabilities as addressed in the study by C. Benoit and colleagues featured in the issue. It notes on the findings of a research which showed that sexuality of people with intellectual disabilities is limited by the attitudes and practices of paid support staff and teachers. The article also questions the inclusivity of sexual assistance services for people with disabilities.

The aim of this meta-analysis was to examine the effectiveness of sex education programs for people with intellectual disabilities, exploring the effects of possible moderating variables. 31 independent studies were identified, from 8 research reports published between 1988 and 2017. The results revealed mean effect sizes in favor of the experimental group, being of large magnitude for the components inappropriate behaviors (d = − 1.26) and Decision making (d = − 1.03), and of moderate magnitude for the global effect (d = − .64). The analyses revealed that single-sex groups, publications between 2000 and 2009 and a high degree of training and experience to deliver the programs were moderating variables that had a great effect on the effectiveness of the programs for the global effect component. Similar results were obtained for the decision making dimension while no significant moderating variables were found for the inappropriate behaviors dimension. Understanding how effective sex educational programs work is essential to this social group. Practical implications are discussed from the results obtained. [ABSTRACT FROM AUTHOR]

This review paper reflects on the existing literature on cognitive behaviour therapy for adults, adolescents and children with intellectual disabilities. People with intellectual disabilities have high rates of comorbid mental health disorders, but low rates of accessing treatments with limited treatment options available to them. Historically, they have been excluded from cognitive-based therapies such as cognitive behaviour therapy. However, recent research has shown that people with mild to moderate intellectual disabilities do have the capacity to engage in cognitive-based interventions. The review highlights the progress that has been made in the field of adapting CBT for people with intellectual disabilities, as well as the current gaps in the literature and suggestions for future research. [ABSTRACT FROM AUTHOR]

Self-injurious behavior (SIB) is one of the most detrimental behaviors for the person showing it, as well as for their environment. Nevertheless, structured clinical assessments of SIB are scarce. Staff completed a Self-Harm Scale (SHS) every time they witnessed SIB in clients with an intellectual disability (ID) and co-occurring psychopathology (N = 33). Descriptive statistics were conducted to explore the nature of the incidents of SIB and the characteristics of the people involved in the incidents. In 41 weeks, 104 SIB incidents were reported for 8 out of 33 clients (24%). Incidents were most prevalent on Mondays (23%). As far as the methods of SIB concerned, cutting was the most used method (63%). Clients who showed SIB differed significantly from clients who did not on gender, having a personality disorder and communicative abilities. This study was one of the few that used an incident-based record form to report SIB by direct observation. It is hoped that the SHS helps to gain more information about SIB, to improve individualized interventions. Further research is necessary to determine the psychometric properties and clinical utility of the scale. [ABSTRACT FROM AUTHOR]

In recent times, observers have noticed that people with intellectual disability (ID) experience increasing complexity in their older age. Many initiatives launched by healthcare organisations and government bodies are rigorously working to improve ID people's quality of life (QoL) and health status. The concept of QoL is rooted in a multidimensional framework comprising both universal (etic) and culture-bound (emic) components. It has objective and subjective features and is affected by individual and environmental factors. The professionals in QoL proposed eight dimensions to cover every aspect of ID people, including emotional well-being, interpersonal relationships, material well-being, personal development, physical well-being, self-determination, social inclusion, and rights. In the last decades in Catalonia, the professionals suggested the GENCAT scale predict these eight dimensions' values through a set of questionnaires containing 69 questions. The professionals use the beneficiary's response the heir to 69 questions based on four point frequency scale. The GENCAT scale tool converted these 69 questions' answers into eight values corresponding to the eight QoL dimensions. The GENCAT tool uses a set of rules and some correlatable tables to evaluate the eight dimensions of each beneficiary. In this work, we propose using machine and deep learning-based models instead of the GENCAT tool to estimate the eight dimensions values. Based on the private Newton One dataset, we train various machine learning (ML), such as Random Forest and Decision Trees, along with Deep Neural Networks (DNNs) models to predict the eight dimension values. The trained models predict the eight values by feeding with the 69 questions responses of the beneficiaries. We evaluate the performance of the various models using the Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and R 2 scores. The proposed model based on DNNs achieved the best results among all tested models with MAE of 1.5991, RMSE of 3.0561, and R 2 of 0.9565. The study shows the promise of the machine and deep learning-based models, particularly DNNs, as a more effective and precise substitute for the GENCAT scale for calculating the eight dimensions of QoL in people with ID. The results open the door for better QoL evaluations and individualised interventions to improve this population's well-being as they age. [ABSTRACT FROM AUTHOR]

Clinical tests for the assessment of postural balance in people with intellectual disability have been the most commonly used single or multi-item tests, but some tests have been developed, such as the BESTest. The purpose of the study was to evaluate the test–retest reliability and limits of agreement of the Balance Evaluation Systems Test (BESTest) in young people with intellectual disabilities. A descriptive cross-sectional study was conducted with 65 young people (ages 16–25 years) with intellectual disability. The participants completed the BESTest (27 items) twice. Intraclass correlation coefficients (ICC), 95% confidence intervals (CIs), and standard error of measurement (SEM) were calculated to determine the test–retest reliability of the BESTest. The BESTest overall scores' test–retest reliability was rated as excellent (≥ 0.75). Stability limits/verticality and reactive are fair to good (≥ 0.40– < 0.75). Biomechanical constraints, transitions and anticipatory movements, sensory orientation, and gait stability were excellent (≥ 0.75). Current evidence shows that young people with intellectual disabilities have impaired postural balance. However, there appears to be a lack of assessment tools that reliably evaluate the postural balance of this population. The results from this investigation show that BESTest provides "excellent reliability" (≥ 0.75) to assess postural balance in young people with intellectual disability. [ABSTRACT FROM AUTHOR]

More than four decades after the onset of deinstitutionalization in the Nordic countries, people with intellectual disabilities in Iceland are still being prevented from engaging in intimate and sexual relationships. There are changing attitudes towards sexuality based on people's rights to live free sexual rights. However, because people with intellectual disabilities often require daily support, they commonly lack opportunities for privacy and safe sexual expression and relationships. In this article, we present findings from qualitative research about the sexuality of Icelandic people with intellectual disabilities who require intensive support and communicate with non-spoken language. The aim is to demonstrate how the sexuality of people with intellectual disabilities who require intensive support is shaped by socio-cultural sexual scripts and the support they receive in every-day lives. Participant observations were carried out in the homes and daily lives of 25 individuals, demonstrating their reduced opportunity to make decisions. This can affect how they communicate their identity or the image of masculinity or femininity. As a group, they have limited access to education, work, and leisure and thus few resources to draw upon when forming their own sexual scripts. Therefore, they commonly rely on other people's sexual scripts, for example those of staff and family. We discuss the pathologization of sexual behaviors and how the sexual expressions of women with intellectual disabilities have remained hidden. The findings also describe the inabilities of social and legal systems in dealing with sexual abuse among people with intellectual disabilities who require intensive support. We suggest that people with intellectual disabilities who require intensive support are seldom consulted about issues relating their personal lives, such as menstruation suppression or who assists them with personal care. We conclude by arguing that it is of vital importance to respect people's self-determination and language. [ABSTRACT FROM AUTHOR]

Dating agencies are a small, but growing sector of social care provision for people with intellectual disabilities. The research reported here is the first to explore, with 10 specialist agencies in the UK, why they were set up, how they operate, the barriers and problems they encounter and their success or otherwise in facilitating relationships for people with intellectual disabilities. A strong case is made for the proliferation of such services. [ABSTRACT FROM AUTHOR]

The figure of the sexual assistant is increasingly demanded as a right in the disabilities field. This figure requires debate, adaptation to the characteristics of countries and cultures, as well as to the characteristics of people with intellectual and developmental disabilities. This study presents the work carried out with representatives of Spanish organizations of people with intellectual disabilities to develop a proposal for the figure of support staff for sexual behavior. Together with a rights perspective, this proposal is aligned with the Supports paradigm to better meet the health and behavior needs of users. The figure is framed within the auto-erotic and therapeutic model of sexual assistance. This figure excludes characteristics of the erotic model that involves interaction or sexual exchange between the sexual assistant and the individual with a disability. Several advantages and disadvantages need to be carefully considered before implementing this support in a delivery service model. We argue that the proposed figure requires specific accreditation, training, and monitoring. [ABSTRACT FROM AUTHOR]

Background: Approximately one quarter of people with an intellectual disability (PwID) have epilepsy of whom nearly three-quarters are pharmaco-resistant. There are higher reported neuropsychiatric side-effects to anti-seizure medication (ASM) in this group. Levetiracetam (LEV) is a first-line ASM with a stronger association with neuropsychiatric symptoms for PwID than other ASMs. Brivaracetam (BRV) is a newer ASM. Recent studies suggest a beneficial effect of swapping people who experience neuropsychiatric events with LEV to BRV. However, there is limited evidence of this for PwID. This evaluation analyses real world outcomes of LEV to BRV swap for PwID compared to those without ID. Methods: We performed a multicentre, retrospective review of clinical records. Demographic, clinical characteristics and reported adverse events of patients switched from LEV to BRV (2016–2020) were recorded at 3 months pre and 6- and 12-month post-BRV initiation. Outcomes were compared between PwID and those without and summarised using cross-tabulations and logistic regression models. A Bonferroni correction was applied. Results: Of 77 participants, 46 had ID and 52% had a past psychiatric illness. 71% participants switched overnight from LEV to BRV. Seizure reduction of > 50% was seen in 40% patients. Psychiatric illness history was predictive of having neuropsychiatric side-effects with LEV but not BRV (p = 0.001). There was no significant difference for any primary outcomes between PwID versus without ID. Conclusions: Switching from LEV to BRV appears as well tolerated and efficacious in PwID as those without ID with over 90% still on BRV after 12 months. [ABSTRACT FROM AUTHOR]

Involving and engaging people with intellectual disabilities on issues relating to their mental wellbeing is essential if relevant tools and solutions are to be developed. This research explores how inclusive and participatory co-design techniques and principles can be used to engage people with intellectual disabilities in designing innovations in mental wellbeing tangible technologies. In particular, individuals with intellectual disabilities participated in a co-design process via a series of workshops and focus groups to design tangible interfaces for mental wellbeing as their wellbeing challenges are often diagnostically overshadowed. The workshops helped participants explore new technologies, including sensors and feedback mechanisms that can help monitor and potentially improve mental wellbeing. The adopted co-design approach resulted in a range of effective and suitable interfaces being developed for varying ages. [ABSTRACT FROM AUTHOR]

The Aberrant Behavior Checklist (ABC) was originally developed to evaluate interventions, and is a well-established assessment tool for challenging behaviours in people with intellectual disabilities and autistic people. However, whether the ABC displays longitudinal measurement invariance (i.e., whether it captures the same constructs over time) has been sparsely explored. The aim of the current study is to explore the factor structure, longitudinal measurement invariance, and clinical correlates of the ABC in autistic individuals with intellectual disabilities. Using data from a multicentre study of mental health assessment and treatment in autistic people with intellectual disabilities, the intake ABC scores of 200 autistic individuals with intellectual disabilities were used to explore the ABC factor structure, internal consistency, and clinical correlates (age, gender, level of intellectual disability, autism characteristics, communication skills). Scores across three time points (intake, post-intervention, follow-up) were used to explore longitudinal measurement invariance and internal consistency over time. The original five-factor structure showed a non-optimal but acceptable fit, which was similar or slightly improved compared to previous studies. Associations for some ABC subscales were found to be positive for autism characteristics and negative for communication skills. Four of the five subscales (irritability, social withdrawal, stereotypic behaviour, inappropriate speech) showed residual levels of longitudinal measurement invariance, while one subscale showed noninvariance (hyperactivity/noncompliance). The current study demonstrates the construct validity and applicability of the ABC in autistic individuals with intellectual disabilities, while also indicating that caution is advised for one of its subscales in comparisons across time. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities (PID) experience the same range of sexual thoughts, feelings, desires, and activities as anyone else. However, the public's view, especially about stereotypes, is noticeable to have an impact on sexuality and people with disabilities, thereby influencing the population which includes the families of PID, healthcare professionals, and policymakers. This review aims to analyze the opinions of public, family of PID or care staff on the sexuality of PID and the methodology applied. Eleven quantitative peer-reviewed papers were identified. Participants' attitude could be evaluated as a binary classification of either "Restrictive" or "Acceptance" in four aspects. Demographic background and the conditions of the PID were found to have an influence on people's attitudes. People acknowledge that PID are not asexual but generally the public holds a more accepting attitude towards the sexuality of PID when compare with family of PID or care staff. Further research on this attitude gap is particularly essential, as this will contribute valuable information and provide insight to policymakers on handling the social, legal and ethical concerns about the sexuality of PID. [ABSTRACT FROM AUTHOR]

Introduction: Sexuality is an important aspect of comprehensive care for patients with disabilities. However, for many healthcare professionals in clinical practice, sexuality is not usually an issue discussed with patients. The aim of this study was to explore and describe physiotherapists' perceptions of sexuality in people with disabilities. Methods: This study follows a qualitative approach with a descriptive design. Two focus groups were carried out, and twelve interviews were conducted with 24 physiotherapists involved in the care of persons with physical and intellectual disabilities. Data were audio-recorded, transcribed, and analyzed with the help of qualitative software. Results: Two main themes and five subthemes emerged from the data: (1) Silenced and denied sexuality in the lives of people with disabilities, with the subthemes "sexuality in people with intellectual disabilities: a human right not exempt from risks" and "the sexual challenges of living with a physical disability"; (2) the management of the physiotherapist is key for healthy sexuality, with the subthemes "physiotherapist-patient trust: an essential element in dealing with sexuality," "physiotherapists' barriers to addressing sexuality," and "the role of physiotherapy in sexual health of people with disabilities." Conclusions and Policy Implications: Physiotherapy plays an important role in the treatment of sexual dysfunctions, the sexual education of people with disabilities, and their relationship to their environment. Physiotherapists' lack of training and their excessive workload make it difficult for them to give advice on sexuality. Providing sex education to disabled people and their caregivers is essential to avoid risks. [ABSTRACT FROM AUTHOR]

Purpose: While positive contributions of religion and spirituality (R/S) to quality of life (QOL) are confirmed by a growing body of evidence, only limited research has involved people with intellectual disabilities and so far, no studies included prelingually deaf individuals with intellectual disabilities. This study explores the role of R/S in people with intellectual disabilities and deafness living in three therapeutic living communities specifically adapted to their needs. Methods: Forty-one individuals (mean age: 46.93 years, 43.9% female) with prelingual deafness and mild to moderate intellectual disability participated in structured sign language interviews adapted to their cognitive–developmental level, regarding their QOL, individual spirituality and participation in spiritual practices in the community. Participants' QOL was assessed with an established short measure for QOL (EUROHIS–QOL) adapted to easy-to-understand sign language. With 21 participants, qualitative interviews were conducted. In addition, proxy ratings from caregivers were obtained. Results: The participants' ratings of their individual spirituality (r = 0.334; p = 0.03) and spiritual practices-in-community (r = 0.514; p = 0.00) correlated positively with their self-reported QOL. Qualitative findings illustrate the importance of R/S and give insights into R/S concepts and practices. Conclusions: Personal spirituality and participating in spiritual practices are positively related to self-reported quality of life in deaf individuals with intellectual disability (ID). As a consequence, access to spiritual and religious services should be included in comprehensive programs and society at large. [ABSTRACT FROM AUTHOR]

Recently, with the increase in demand, multiple intervention proposals aimed at improving the sexual health of people with intellectual disabilities have emerged. Among them is the SALUDIVERSEX program, which takes a positive approach to sexuality. It has an extended version, consisting of 16 sessions and whose efficacy has already been proven, and a reduced version of 10 sessions. Thus, the present study aimed to test the differential efficacy of the two versions. A total of 208 participants (103 women and 105 men) aged between 19 and 67 years (M = 37.23, SD = 10.66) completed a battery of instruments before and after the intervention. Statistical analyses showed that users who participated in the reduced version of the program presented a significantly higher rate of improvement in their sexual behaviors compared to those who participated in the extended version (Sexual response: β10 = − 0.46 ± 0.19, p =.034; Sex practices: β10 = − 0.52 ± 0.23, p =.037; Use condoms: β10 = − 1.56 ± 0.59, p =.017), as well as a significantly higher decrease in the risk of suffering sexual abuse (β10 = 3.95 ± 0.64, p <.001). However, no statistically significant differences in sexuality knowledge were obtained with respect to the improvement between the two versions (β10 = − 0.09 ± 1.21, p =.94). Meanwhile, the professionals who applied the program found that those who participated in the reduced version, although they presented a significantly greater increase in their knowledge about privacy (β10 = − 0.48 ± 0.08, p <.001), did not improve their concerns about their inappropriate sexual behaviors as much as the users of the extended version (β10 = − 1.35 ± 0.21, p <.001). Thus, although both versions were effective, the reduced version seems to do so to a greater extent and in a shorter time, which makes it the more recommendable option. [ABSTRACT FROM AUTHOR]

People with intellectual disability face a variety of epistemic injustices—systems of knowledge and educational inequality—related to their access to sex education and perceptions of their sexuality. Sex educators are in a position to address these injustices; however, they may not be fully aware of their own epistemic ethics. Furthermore, there is little theoretical understanding of how sex educators provide instruction within an environment that exhibits hostility toward the sexual expression of those with intellectual disability. This grounded theory study of interviews with 58 people who taught sex education to people with intellectual disability sought to understand the role of educators in perpetuating and resisting epistemic injustice by utilizing sex education to either facilitate or restrict the sexual expression of people with disabilities. We identified four micro-contexts: centralizing capacity to consent, emphasizing risk, desexualizing (through) sex education, and acknowledging gender identity. In each micro-context, we explore mechanisms of how educators were either allied in support of autonomy (person-centered values, expertise, access to curricular resources, self-advocates as teachers and partners, subversiveness, and de-problematizing normative sexual behavior) or reified sexual stigmas (fear of sexual abuse and sexual perpetration, conscripting to asexuality, the paternalistic service system, and complex ethical dilemmas) in the context of hostility to sex education and sexual expression. These findings have implications for promoting prosocial sexual expression and access to sex education for people with intellectual disability. [ABSTRACT FROM AUTHOR]

Purpose: The level of support needed for adaptive functioning and behavioral problems of individuals with intellectual disabilities (ID) can be a source of stress for caregivers. The aim of this study was to explore the moderating role of caregivers' age on the associations between these stressors and quality of life (QoL) of the family caregivers. As these sources of stress in people with ID can coexist, the triple interaction between stressors and age was also examined.Methods: 208 relatives (mean age = 50.98 years, SD = 12.86) of people with ID participated in the research. Participants answered a questionnaire with sociodemographic variables, measures of stressors (level of support for adaptive functioning of the people with ID and behavioral problems) and measures of QoL (WHOQOL-BREF).Results: The association between the level of support needed for adaptive functioning and lower QoL was only significant among older relatives, whereas the association between behavioral problems and lower QoL was only significant among younger relatives. A three-way interaction between behavioral problems, level of support needed, and age indicated that the association between the level of support for adaptive functioning and QoL in older relatives was greater when there were higher levels of behavioral problems.Conclusions: The role of caregivers' age in their QoL differs depending on the nature of the stressor, and an accumulation of stressors can have a particularly negative impact on older caregivers. Interventions should be adapted for caregivers of different ages and take into account the particular sources of stress they have to cope with. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities (PID) share the same needs for affectionate and intimate relationships as other people. In this study, a review of the literature was performed to (a) examine the opinions reported in the peer-reviewed literature regarding the sexual experiences of PID and (b) identify factors that contribute to the promotion or restriction of sexual expression by PID. Sixteen qualitative articles were identified from electronic databases and reviewed. People with PID were found to exhibit the same spectrum of sexual life as the general population, and three major themes were identified: abstinence, regulation, and autonomy. Some PID preferred to abstain from sex, whereas others considered engagement in sexual activity to have a hand that affects and influences the rights of PID to engage in sexual activity. Further empirical research on the empowerment of sexual expression of PID and the formation of the unintended invisible hand is needed, as this will provide information to families and welfare systems and thus enhance the self-determination and rights of PID to pursue sexual expression and satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life (QoL) of patients with mental illness has been examined internationally but to a lesser extent in developing countries, including countries in Africa. Improving QoL is vital to reducing disability among people with mental illness. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of QoL and associated factors among people living with mental illness in Africa. Methods: Using the PICOT approach, Scopus, MEDLINE, PsycINFO, CINAHL, Embase, the Web of Science, and Google Scholar were searched. A structured search was undertaken, comprising terms associated with mental health, mental illness, QoL, and a list of all African countries. The Joanna Briggs Institute Quality Appraisal Checklist is used to evaluate research quality. Subgroup analysis with Country, domains of QoL, and diagnosis was tested using a random-effect model, and bias was assessed using a funnel plot and an inspection of Egger's regression test. A p value, OR, and 95% CI were used to demonstrate an association. Results: The pooled prevalence of poor QoL was 45.93% (36.04%, 55.83%), I2 = 98.6%, p < 0.001). Subgroup analysis showed that Ethiopia (48.09%; 95% CI = 33.73, 62.44), Egypt (43.51%; 95% CI = 21.84, 65.18), and Nigeria (43.49%; 95% CI = 12.25, 74.74) had the highest mean poor QoL prevalence of the countries. The pooled prevalence of poor QoL by diagnosis was as follows: bipolar disorder (69.63%; 95% CI = 47.48, 91.77), Schizophrenia (48.53%; 95% CI = 29.97, 67.11), group of mental illnesses (40.32%; 95% CI = 23.98, 56.66), and depressive disorders (38.90%; 95% CI = 22.98, 54.81). Being illiterate (3.63; 95% CI = 2.35, 4.91), having a comorbid medical illness (4.7; 95% CI = 2.75, 6.66), having a low monthly income (3.62; 95% CI = 1.96, 5.27), having positive symptoms (0.32; 95% CI = 0.19, 0.55), and having negative symptoms (0.26; 95% CI = 0.16, 0.43) were predictors of QoL. Thus, some factors are significantly associated with pooled effect estimates of QoL. Conclusions: The current systematic review and meta-analysis showed that almost half of patients with mental illness had poor QoL. Being illiterate, having a comorbid medical condition, having a low monthly income, having positive symptoms, and having negative symptoms of mental illness were independent predictors of poor QoL. This systematic review and meta-analysis emphasize that poor QoL of people with mental illness in Africa needs attention to reduce its negative consequences. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyse the ethical issues relating to privacy that arise in smart homes designed for people with dementia and for people with intellectual disabilities. We outline five different conceptual perspectives on privacy and detail the ways in which smart home technologies may violate residents' privacy. We specify these privacy threats in a number of areas and under a variety of conceptions of privacy. Furthermore, we illustrate that informed consent may not provide a solution to this problem. We offer a number of recommendations that designers of smart homes for people with dementia and people with intellectual disabilities might follow to ensure the privacy of potential residents. [ABSTRACT FROM AUTHOR]

This study extended the research on technology-aided programs for promoting the independent performance (practice) of functional motor responses (e.g., arm or leg-foot movements) in people with intellectual disabilities and extensive motor impairments. Specifically, the study assessed (a) the suitability of simple commercial technology (i.e., a smartphone) to monitor the responses targeted and provide stimulation contingent on them, and (b) the impact of response performance on the participants' level of physical exertion (heart rates) and mood. The results showed that the simple commercial technology was effective in helping the participants independently practice the two target responses selected for them. All participants had a significant increase in their heart rates during the intervention sessions, thus suggesting that the performance of the target responses represented a mild form of physical activity. Moreover, all participants displayed mood improvement (i.e., an increase in indices of happiness) during the intervention sessions. The implications of these results are discussed in terms of (a) new technology solutions for intervention programs with people with intellectual disabilities and extensive motor impairments, and (b) potential benefits of those programs. [ABSTRACT FROM AUTHOR]

There is a synergistic relationship between epilepsy and intellectual disability (ID), and the approach to managing people with these conditions needs to be holistic. Epilepsy is the main co-morbidity associated with ID, and clinical presentation tends to be complex, associated with higher rates of treatment resistance, multi-morbidity and premature mortality. Despite this relationship, there is limited level 1 evidence to inform treatment choice for this vulnerable population. This review updates the current evidence base for anti-seizure medication (ASM) prescribing for people with ID. Recommendations are made on the basis of evidence and expert clinical opinion and summarised into a Traffic Light System for accessibility. This review builds on work developed through UK’s Royal College of Psychiatrists, Faculty of Intellectual Disability Psychiatry and includes newer pragmatic data from the Cornwall UK Ep-ID Research Register, a national research register for England and Wales that has been in existence for the last 10 years. The Register acts as a source for an in-depth exploration of the evidence base for prescribing ‘newer’ (third generation, specifically post-2004) ASMs. Its findings are discussed and compared. A practical approach to prescribing and choosing ASMs is recommended on the based evidence. This approach considers the drug profile, including adverse effects and clinical characteristics. The review also details newer specialist ASMs restricted to certain epilepsy syndromes, and potential future ASMs that may be available soon. For completeness, we also explore non-pharmacological interventions, including surgeries, to support epilepsy management. [ABSTRACT FROM AUTHOR]

Purpose This systematic review analyzed the effectiveness of rehabilitation interventions on the employment and functioning of people with intellectual disabilities (ID), as well as barriers and facilitators of employment. Methods This was a systematic review of quantitative, qualitative, and mixed methods studies. The outcomes were employment, transition to the open labor market and functioning. The review included qualitative studies of employment barriers and facilitators. The population comprised people with ID aged 16–68 years. Peer-reviewed articles published in English between January 1990 and February 2019 were obtained from the databases Cinahl, the Cochrane Library, Embase, Eric, Medic, Medline, OTseeker, Pedro, PsycInfo, PubMed, Socindex, and the Web of Science. We also searched Google Scholar and Base. The modified selection instrument (PIOS: participants, intervention, outcome, and study design) used in the selection of the articles depended on the selection criteria. Results Ten quantitative (one randomized controlled, one concurrently controlled, and eight cohort studies), six qualitative studies, one multimethod study, and 21 case studies met the inclusion criteria. The quantitative studies showed that secondary education increases employment among people with ID when it includes work experience and personal support services. Supported employment also increased employment in the open labor market, which sheltered work did not. The barriers to employment were the use of sheltered work, discrimination in vocational experience, the use of class teaching, and deficient work experience while still at school. The facilitators of employment were one's own activity, the support of one's family, job coaching, a well-designed work environment, appreciation of one's work, support form one's employer and work organization, knowledge and experience of employment during secondary education, and for entrepreneurs, the use of a support person. Conclusions The employment of people with ID can be improved through secondary education including proper teaching methods and personal support services, the use of supported work, workplace accommodations and support from one's family and employer. These results can be utilized in the development of rehabilitation, education, and the employment of people with ID, to allow them the opportunity to work in the open labor market and participate in society. [ABSTRACT FROM AUTHOR]

The aims of this review were to systematically identify, critically appraise and synthesize the results of existing qualitative literature exploring the views and experiences of intimate relationships amongst people with intellectual disabilities. Fourteen peer-reviewed articles were identified through a systematic search of eight databases, reference lists, citations, and relevant journals. The identified articles were appraised for quality, then synthesized using a metaethnography approach. No study met all quality criteria and references to ethical approval were often lacking. Interpretation of the findings suggested three key themes: the meaning of intimate relationships, external constraints and facilitators, and managing external constraints. Though many people with intellectual disabilities desire and benefit from intimate relationships, they experience restrictions that others do not, which can lead to isolation and loneliness. Intimate relationships are not always necessarily linked with sexual behavior; therefore, intimate relationships warrant their own focus in future research, as well as in education and training for people with intellectual disabilities and their caregivers. Within this, a commitment to transparency over research processes is needed, in particular with reference to how ethical approval was obtained, since this has been a shortcoming of research with this focus to date. [ABSTRACT FROM AUTHOR]

Background: People with epilepsy (PWE) and people with intellectual disabilities (ID) both live shorter lives than the general population and both conditions increase the risk of death further. We aimed to measure associations between certain risk factors for death in PWE and ID. Methods: A retrospective case–control study was conducted in ten regions in England and Wales. Data were collected on PWE registered with secondary care ID and neurology services between 2017 and 2021. Prevalence rates of neurodevelopmental, psychiatric and medical diagnoses, seizure frequency, psychotropic and antiseizure medications (ASM) prescribed, and health activity (epilepsy reviews/risk assessments/care plans/compliance etc.) recorded were compared between the two groups. Results: 190 PWE and ID who died were compared with 910 living controls. People who died were less likely to have had an epilepsy risk assessment but had a greater prevalence of genetic conditions, older age, poor physical health, generalized tonic–clonic seizures, polypharmacy (not ASMs) and antipsychotic use. The multivariable logistic regression for risk of epilepsy-related death identified that age over 50, medical condition prevalence, antipsychotic medication use and the lack of an epilepsy review in the last 12 months as associated with increased risk of death. Reviews by psychiatrists in ID services was associated with a 72% reduction in the odds of death compared neurology services. Conclusions: Polypharmacy and use of antipsychotics may be associated with death but not ASMs. Greater and closer monitoring by creating capable health communities may reduce the risk of death. ID services maybe more likely to provide this holistic approach. [ABSTRACT FROM AUTHOR]

There is clear evidence that people with mental disability suffer from discrimination at school, at work, and in society. Less is known about the psychological processes and perceptions that guide such behaviors and even less if these perceptions vary according to the type of disability. Our objective was to build on well-established social psychological models and investigate the perceptions (i.e., stereotypes, perceived threats, and emotions) of people towards different types of mental disability. Participants from two francophone countries completed a questionnaire measuring their perceptions towards 18 mental disabilities and their familiarity with disability (N = 560). As expected, results revealed heterogeneous perceptions across groups. Moreover, perceived threats mediated the link between the stereotype of warmth and emotions. Surprisingly, greater familiarity with mental disability went along with greater derogation. This research nuances the overly generalized perceptions often associated with mental disability. We discuss implications for the reduction of discrimination against people with mental disability. [ABSTRACT FROM AUTHOR]

The article focuses on the view of intellectually disabled people towards sexuality and its effects on the advancement of sex education. Topics discussed include the study being done on 20 people with intellectual topics through semi-structured interviews on topics like sex education, relationships and support, and results of the study recommended topics for enhancing a sex education programme like online relationships, social media and parenthood through Intervention Mapping.

Scarce clinical trials involving autistic people with intellectual disability (ID) and minimally speaking (MS) status have been a substantial unmet research need in the field. Although earlier studies have demonstrated the feasibility and beneficial potentials of repetitive transcranial magnetic stimulation (rTMS) over the dorsolateral prefrontal cortex (DLPFC) in intellectually able autistic people, the feasibility and tolerability of applying rTMS in autistic people with ID/MS has never been studied. We conducted the world-first 4-week randomized, double-blind, sham-controlled pilot trial to investigate the feasibility, tolerability, and safety of intermittent theta burst stimulation (iTBS, a variant of excitatory rTMS) over the left DLPFC in autistic youth with ID/MS. 25 autistic youth with ID/MS (aged 8–30 years) were randomized to a 20-session 4-week daily iTBS (n = 13) vs. sham stimulation (n = 12) with follow-up 4 and 8 weeks, respectively, after the last stimulation. A retention rate was 100% in our study. Adverse events of local pain (38%) and dizziness (8%) were only noted in the active group. All adverse events were mild and transient. There were no seizures, new behavioral problems, or other severe/serious adverse events noted. No participants dropped out due to adverse events. With a small sample size, we did not find any beneficial signal of DLPFC iTBS. Our pilot data suggest regular daily TBS treatment for four weeks is feasible, well tolerated and safe in autistic youth with ID/MS. Future randomized controlled trials with sufficiently powered samples are needed to investigate the beneficial potential of rTMS/TBS for autistic people with ID/MS. [ABSTRACT FROM AUTHOR]

This study proposes a multi-informant (youth, teachers, and parents) measure of relationship quality with adults for youth with intellectual disabilities (ID). A sample of 395 youth with mild (49.15%) and moderate (50.85%) ID, aged 11–22 (M = 15.82) was recruited in Canada (French-speaking, N = 142), and Australia (English-speaking, N = 253). Results support the reliability, factor validity, discriminant validity (in relation to sex, ID level, country, and comorbidity), convergent validity (depression, anxiety, aggressiveness, and prosocial behaviors), and one-year longitudinal stability of the measure. Youth self-reports provide a complementary perspective on relationship quality with adults relative to teachers' or parents' reports, whereas teachers and parents seem unable to differentiate their own perspective from that of the target youth. [ABSTRACT FROM AUTHOR]

Iceland is considered a gender equal country where diversity and human rights are prioritized. However, people with intellectual disabilities seem to be marginalized within Icelandic society, with limited access to resources and opportunities. They have not been viewed as autonomous agents and their abilities to form sexual and gender identities have been questioned, based on the stereotypical views that they are eternal children. The article addresses the manifestation of masculinity, femininity, and autonomy in the lives of Icelanders with intellectual disabilities by employing the concepts of hegemonic masculinity, emphasized femininity, and relational autonomy. Interviews were taken with 29 individuals with intellectual disabilities and participant observations were carried out in the homes of other 15 individuals who had been identified by health/human service professionals as having severe/profound disabilities. Results show that the participants saw themselves as adults and the men who participated in this research performed their autonomy through the construction of hegemonic masculinity. The women seemed to be at more risk of being surveilled and controlled by staff and family members by, for example, restricting activities, pressuring sterilizations, and abortions. The men and the women interviewed relied equally on traditional gender roles in their narratives, although the women resisted emphasized femininity by focusing on independence and abilities in their narratives. We suggest that the structure and practices of the school and support systems have normalized gender/sexuality in the lives of people with intellectual disabilities, thus contributing to their status as eternal children and consequently diminishing their opportunities to develop their autonomy. [ABSTRACT FROM AUTHOR]

The article aims to investigate the perceptions of parents and professionals about the Internet as a social arena for love and sexuality among young people with intellectual disabilities. It indicates a continuous restrictive net script where young people with intellectual disabilities as a group are looked upon as more vulnerable than other youth and are therefore are in need of more rules and threats than other young people.

Introduction: The lockdown due to COVID-19 affected the sexual health of the people with intellectual disabilities by differentially modifying the frequency and characteristics of people's sexual activity depending on whether or not they lived with a partner during this period. The aim of this study was to analyze the extent to which the sexual behavior of people with intellectual disabilities (with and without a partner) was affected during the lockdown. Methods: The sample consisted of 73 people with intellectual disabilities between 21 and 63 years old (M = 39.63; SD = 10.11). The variables analyzed were the physical, social, and technological environment during the lockdown, sexual appetite, sexual behavior, online sexual activity, and sexual abuse. The data were collected between the months of May and June of 2020. Results: The lockdown increased the sexual appetite of a third of the sample (38%), especially the youngest participants. Sexual activity focused on autoeroticism and online behavior, particularly sending nude images of oneself (88%) and viewing pornography (83.6%). Rates of sexual abuse during this period were relatively high (6.8%). Conclusions: The sexual activity of people with ID was important during the lockdown, and they had to adapt to the circumstances of isolation in a similar way to the general population. Technological improvements in terms of devices and connection quality at home allowed their sexual behavior to be reoriented, opening the door to new risks for the sexual health of people with ID. Policy Implications: Cybersex and the increase in sexual abuse due to confinement are aspects that should be included in programs to improve the sexual health of this group. [ABSTRACT FROM AUTHOR]

People with neurodevelopmental disabilities, including intellectual disabilities and autism, want to have relationships but few are given the tools and opportunity to create those relationships in a safe and meaningful way. This strong desire to have relationships, coupled with reduced access to information, puts people with neurodevelopmental disabilities at high risk for being targets of sexual abuse and exploitation, as well as demonstrating social-sexual behavior that is unexpected or offensive to others. Research has long demonstrated that people with intellectual disabilities are sexually assaulted at much higher rates than the general population. In addition, it is common for people with intellectual disabilities and autism to miss out on employment, housing, and social opportunities due to unexpected social-sexual behaviors. To address this need, the research team developed the social-sexual education (SSE) program to teach people with neurodevelopmental disabilities how to create safe and meaningful relationships while also giving them information about sexual abuse and coercion. We recruited licensed professionals to pilot test the SSE program, and then we evaluated the tool using quantitative and qualitative methods. Our findings provide preliminary support for the SSE program. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

Large discrepancies have sometimes been found between the quality of life (QOL) experienced by clients with intellectual disabilities and their QOL as described by their caregivers. Olsen and Schober (Soc Indi Res 1993; 28: 173-193) may have provided a framework useful to conceptualize such discrepancies. They suggested that lack of concordance between objective circumstances (i.e. poverty) and perceived QOL must not be treated as measurement noise, but as a source of information. They speculated on the psychological processes that underly and explain this lack of concordance; particularly processes that try to deal with the stress induced by cognitive dissonance and learned helplessness. In this study low to moderate agreement was found between caregivers judgement of QOL of individual clients and clients' own perception of QOL. In some areas and for some clients the discrepancies indicated dissonance (caregivers are satisfied, clients are not) and in other areas and for other clients adaptation (clients are satisfied, caregivers are not). There were systematic differences between clients falling in these groups with respect to their personal characteristics and with respect to factual conditions of care. These outcomes are interpreted with respect to Olson and Schober's contentions regarding the psychological processes that underly a person's experience of QOL. The Olson and Schober framework appears to be a fruitful way to combine different sources of information regarding QOL. [ABSTRACT FROM AUTHOR]

The article focuses on a study conducted by the authors for understanding frailty in people with intellectual disabilities (ID) by comparing two concepts, the frailty phenotype (FP) and the frailty index (FI) taking into account factors such as feasibility and validity. Topics discussed include FI as a stronger predictor for mortality with higher feasibility, lower sensitivity of the variables of the FI to lifelong disabilities and pre-defined elements as not measurable in individuals with ID.

Background: Relatively little is known about social cognition in people with intellectual disability (ID), and how this may support understanding of co-occurring autism. A limitation of previous research is that traditional social-cognitive tasks place a demand on domain-general cognition and language abilities. These tasks are not suitable for people with ID and lack the sensitivity to detect subtle social-cognitive processes. In autism research, eye-tracking technology has offered an effective method of evaluating social cognition—indicating associations between visual social attention and autism characteristics. The present systematic review synthesised research which has used eye-tracking technology to study social cognition in ID. A meta-analysis was used to explore whether visual attention on socially salient regions (SSRs) of stimuli during these tasks correlated with degree of autism characteristics presented on clinical assessment tools. Method: Searches were conducted using four databases, research mailing lists, and citation tracking. Following in-depth screening and exclusion of studies with low methodological quality, 49 articles were included in the review. A correlational meta-analysis was run on Pearson's r values obtained from twelve studies, reporting the relationship between visual attention on SSRs and autism characteristics. Results and conclusions: Eye-tracking technology was used to measure different social-cognitive abilities across a range of syndromic and non-syndromic ID groups. Restricted scan paths and eye-region avoidance appeared to impact people's ability to make explicit inferences about mental states and social cues. Readiness to attend to social stimuli also varied depending on social content and degree of familiarity. A meta-analysis using a random effects model revealed a significant negative correlation (r = −.28, [95% CI −.47, −.08]) between visual attention on SSRs and autism characteristics across ID groups. Together, these findings highlight how eye-tracking can be used as an accessible tool to measure more subtle social-cognitive processes, which appear to reflect variability in observable behaviour. Further research is needed to be able to explore additional covariates (e.g. ID severity, ADHD, anxiety) which may be related to visual attention on SSRs, to different degrees within syndromic and non-syndromic ID groups, in order to determine the specificity of the association with autism characteristics. [ABSTRACT FROM AUTHOR]

Background: Information about mortality patterns in different psychiatric populations is scanty, yet it is vital for designing successful preventive mental health strategies. In this study, we aimed to assess mortality rates and patterns for the patients admitted to Ain Shams University Institute of Psychiatry (ASUIP) with different psychiatric diagnoses from1990 to 2013. All medical records and related registration files were reviewed and investigated for death cases and their possible causes in a retrospective record linkage study. Data were recorded, tabulated, and coded to be used in the Statistical Package for Social Sciences (SPSS) Version 17. Results: The study identified 57 death cases in 23-years duration with a mortality rate of 3/1000. Mortality rates were more in younger patients and females. Medical comorbidity was reported in 34.8% of them. The most common known causes for death in the current sample were cardiac causes 15.2%, followed by cerebrovascular causes that were 10.9%. However, sudden or unknown causes were the most frequent diagnosis in the sample. Conclusions: The institute mortality rates were lower than those of the general population during this period. The most common known death causes were cardiovascular problems, which mandates close monitoring of high-risk psychiatric patients with co-morbid cardiac problems. Unknown morality causes represented an unresolved challenge for the current registration system and the quality of care given to patients with serious mental illness. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate whether socio-demographic variables and physical disability (e.g. sensory impairment and mobility problems) were associated with self-reported stigma in people with intellectual disabilities (ID), and to examine whether age, sex and ethnicity modified the relationship between severity of intellectual disability and self-reported stigma.Methods: 229 participants with mild or moderate intellectual disabilities were recruited from 12 centres/sites in England from community intellectual disability services, day centres, supported housing schemes, voluntary organisations and invitation letters. Information on physical disability and socio-demographic variables were obtained using a structured data collection form. Self-reported stigma was measured using a validated questionnaire.Results: Age was associated with self-reported stigma, with older adults reporting more stigmatising experiences. Participants with moderate intellectual disabilities were more likely to report being treated differently such as being made fun of and being treated like children. Physical disability such as sensory, mobility and speech problems were not associated with self-reported stigma. Gender modified the relationship between severity of ID and self-reported stigma as participants who were male and had moderate ID were more likely to report stigma compared to females with moderate ID. Categorical age also modified the relationship between severity of ID and self-reported stigma as older participants who had moderate ID were more likely to report stigma compared to younger people with moderate ID.Conclusions: Older adults and those with moderate ID are potentially at higher risk of being targets of public stigma or are more likely to report stigma. Interventions to help individuals cope with stigma could be targeted to this group. [ABSTRACT FROM AUTHOR]

Anxiety continues to be one of the most frequent disorders with typically developing children and youth. However, people with intellectual disability (ID) lack validated diagnostic tests backed by sufficient methodological rigor. Analyze the psychometric properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in this clinical population, specifically in children and young Spanish with Nonspecific Intellectual Disability. Descriptive statistics and item analysis (N = 542), exploratory factorial analysis (n = 245) and confirmatory (n = 297) and scale reliability analyses were performed and evaluated the internal consistency with various indices (Cronbach's alpha and omega) and the stability of the measurement (test–retest) of the resulting scale with better goodness-of-adjustment indices. A new scale called SCARED-DI was obtained in this clinical sample with three factors and a smaller number of items (22), offering important goodness-of-fit indices (RMSEA [95% CI] 03[0.01;.04]; CFI = 0.99; TLI = 0.98; GFI = 0.88; AGFI = 0.89) and high internal consistency (α = 0.91; ω = 0.93) and adequate measurement stability (rxx = 0.92). The importance of validating psychopathological anxiety tests for children and youth with ID in order to build good mental health is discussed, emphasizing the need to provide easy, short-duration tests on both cognitive and emotional aspects in this clinical sub-population. In addition, the results are assessed in terms of future research and practical implications. This new version of SCARED-ID represents a valid and reliable tool to evaluate the anxiety in people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

During transition to adulthood, emerging adulthood is characterized by continuous identity negotiations (Deaux and Perkins in Individual self, relational self, collective self. Psychology Press, Philadelphia, pp 299-313, ). However, for young people with intellectual disabilities (ID) the ID identity may overshadow the development of sexual identity (Burns in Clin Psychol Forum 137:137-139, ). This study conducted an in-depth exploration of four young people and four of their carers' experiences of the development of sexual identity alongside the ID identity. Interviews were analysed using interpretative phenomenological analysis. Young people struggled for an ' as normal as possible' adult identity, and to develop sexual identity as a ' normal' identity, in the context of the overshadowing ID identity. Despite believing they should be enabled to develop sexual identity as part of their transition to adulthood, young people faced many obstacles, including stigma related to their ID. Carers described their challenges in proactively supporting sexual identity education and exploration, due to concerns about risk. Equality and protection need not be either/or priorities; however, there remains need for considerable change in UK practice and policy if the principles of rights, independence, choice and inclusion (Department of Health in Valuing people now: a new three-year strategy for people with learning disabilities. The Stationary Office, London, ; Department of Health in Valuing people. The Stationery Office, London, ) are to be met in relation to sexual identity development in people with ID transitioning to adulthood. [ABSTRACT FROM AUTHOR]