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Background: Little is known about the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for post-traumatic stress disorder (PTSD) symptoms in people with mild intellectual disability or borderline intellectual functioning (MID-BIF). Aims: To explore the safety, feasibility, and efficacy of EMDR therapy in adults with MID-BIF, PTSD, and comorbid mental health and psycho-social problems. Methods and procedures: Data were collected from nine participants using a non-concurrent multiple baseline design. PTSD symptoms, level of daily life impairment, and possible adverse effect were measured weekly during baseline, treatment, post-treatment, and at three-month follow-up. Depressive symptoms, general psychopathology, and mental health problems were assessed once in every phase. Outcomes and results: Participants displayed a significant reduction of PTSD symptoms, and the majority of participants no longer met criteria for DSM-5 PTSD diagnosis after therapy. EMDR therapy appeared to be safe, as no adverse events were reported during the study time frame. Further, participants showed a decrease in depressive symptoms as well as less severe general psychopathology and mental health problems following therapy. Conclusion: EMDR therapy was found to be safe, feasible, and (potentially) efficacious in decreasing PTSD symptoms, loss of PTSD diagnoses, reduction of level of daily life impairment, and general psychopathology for adults with MID-BIF, suffering from both severe mental health and psycho-social problems.

Introduction: Persons with mild intellectual disability or borderline intellectual functioning (MID-BIF, IQ 50-85) are at high risk for the development of posttraumatic stress disorder (PTSD). A diagnostic instrument to establish a valid and reliable DSM-5 PTSD diagnosis in adults with MID-BIF was lacking. Aim of the current study was to determine the reliability and validity of the Adapted ADIS-C PTSD-adults for the assessment of PTSD according to DSM-IV-TR and DSM-5 in adults with MID-BIF. Method: 106 adults (18-72 years old) with MID-BIF were interviewed using the Adapted ADIS-C PTSD-adults. Results: Agreement between raters appeared to be good (mean Cohen's kappa for traumatic event scores 0.84, fulfillment of PTSD A-criterion 0.50, and PTSD symptom scores 0.90). Content validity was supported by a significant positive association with scores on the IES-IDs, a DSM-IV PTSD screening instrument (DSM-IV: r = 0.58; DSM-5: r = 0.43; ps <0.001). Convergent validity appeared to be good considering positive correlations between rates of PTSD symptoms and scores on the ADESS, measuring symptoms of anxiety and stress, depression, and social avoidance (DSM-IV: r = 0.47; DSM-5: r = 0.49; ps <0.001). Conclusion: The Adapted ADIS-C PTSD-adults is suitable for assessing DSM-5 PTSD in adults with MID-BIF, an important step to gain access to trauma-focused interventions that have shown to be applicable and potentially effective for this high-risk target group.

ObjectiveMethodResultsConclusionTo assess the reliability and construct validity of the Diagnostic Interview Trauma and Stressors- Intellectual Disability – Adult version (DITS-ID-adults) in adults with mild intellectual disabilities or borderline intellectual functioning (MID-BIF).The DITS-ID-adults, Brief Symptom Inventory–18 (BSI–18), and Impact of Event Scale-Intellectual Disability (IES – ID) were administered to 97 participants with MID-BIF who lived in supported housing. The Anxiety, Depression, and Mood Scale (ADESS) and Behavior Problems Inventory (BPI) were administered to their relatives.The interrater reliability of the DITS-ID-adults was good to excellent. The construct validity of the DITS-ID-adults was good, based on positive correlations between the BSI–18, IES-ID, ADESS and DITS-ID-adults, and mainly positive correlations between the BPI and DITS-ID-adults (r = .21 to r = .75). Reporting potentially traumatic events listed under the A criterium for PTSD was associated with fulfilling PTSD symptom criteria. In this sample, 58% were classified with post-traumatic stress disorder (PTSD) according to the DITS-ID-adults, while PTSD diagnosis on file was low (7%).The present findings support the DITS-ID-adults as a reliable and valid basis for classifying PTSD in individuals with MID-BIF. [ABSTRACT FROM AUTHOR]

Introduction: In persons with severe to moderate intellectual disability (SID), no valid and reliable diagnostic instrument is available to determine PTSD. In this study, a new instrument was evaluated: the Diagnostic Interview Trauma and Stressors – Severe Intellectual Disability (DITS-SID). Methods: DITS-SID, Aberrant Behavior Checklist and Child and Adolescent Trauma Screener were administered to relatives and caregivers of 26 adults with SID. Results: Inter-rater reliability and convergent validity of the DITS-SID are good. There is a moderate to strong correlation between PTSD symptoms and challenging behaviors. PTSD prevalence is high at 13%−19%. Differences in results between relatives and caregivers were found. Conclusion: PTSD may be overlooked in individuals with SID, preventing them from receiving appropriate treatment. This study endorses the importance of using information from both relatives and caregivers when determining PTSD and provides a first step for a PTSD assessment. Follow-up research in a larger sample is needed to further validate the DITS-SID. [ABSTRACT FROM AUTHOR]

The study investigated whether EMDR is a feasible therapy for adults with ASD and a history of adverse events, and whether it is associated with reductions in symptoms of PTSD, psychological distress and autism. Participants received 6 to 8 weeks treatment as usual (TAU), followed by a maximum of 8 sessions EMDR added to TAU, and a follow-up of 6-8 weeks with TAU only. Results showed a significant reduction of symptoms of post-traumatic stress (IES-R: d = 1.16), psychological distress (BSI: d = 0.93) and autistic features (SRS-A: d = 0.39). Positive results were maintained at follow-up. The results suggest EMDR therapy to be a feasible and potentially effective treatment for individuals with ASD who suffer from the consequences of exposure to distressing events.

Background: This study explored the effectiveness of eye movement desensitisation and reprocessing (EMDR) therapy for post-traumatic stress disorder (PTSD) in persons with mild to borderline intellectual disability (MBID) using a multiple baseline across subjects design. Methods: One child and one adolescent with MBID, who met diagnostic criteria for PTSD according to a PTSD clinical interview (i.e., ADIS-C PTSD section), adapted and validated for this target group, were offered four sessions of EMDR. PTSD symptoms were measured before, during and after EMDR, and at six weeks follow-up. Results: For both participants, number of PTSD symptoms decreased in response to treatment and both no longer met PTSD criteria at post-treatment. This result was maintained at 6-week follow-up. Conclusions: The results of this study add further support to the notion that EMDR can be an effective treatment for PTSD in children and adolescents with MBID. Replication of this study in larger samples and using a randomized controlled design is warranted.

Introduction: People with intellectual disabilities (ID) are at increased risk for developing Post Traumatic Stress Disorder (PTSD). Emerging evidence indicates that Eye Movement Desensitization and Reprocessing (EMDR) therapy is feasible and potentially effective for this group. However, communication, cognition, stress regulation, and attachment difficulties may interfere with the EMDR process. Adaptation of the EMDR protocol seems therefore required for this population. Aim: This review aims to systematically identify and categorize the difficulties in applying EMDR to people with ID and the adaptations made by therapists to overcome these challenges. Methods: A literature search was performed in May 2023. Article selection was based on inclusion and exclusion criteria and quality appraisal. Results: After screening, 13 articles remained for further review. The identified difficulties and adaptations were categorized into the three domains of adaptive functioning (i.e., conceptual, social, and practical functioning). Considerable difficulties in applying the EMDR protocol for this group were reported. The adaptations made by therapists to overcome these difficulties were highly variable. They could be divided into three main categories: adaptions in EMDR delivery (e.g., tuning to the developmental level of the client, simplifying language, decreasing pace), involvement of others (e.g., involving family or support staff during or in between sessions), and the therapeutic relationship (e.g., taking more time, supportive attitude). Discussion: The variability of the number of mentioned difficulties and adaptations per study seems to be partly related to the specific EMDR protocol that was used. In particular, when the Shapiro adult protocol was administered, relatively more detailed difficulties and adaptations were described than in publications based on derived existing versions of an EMDR protocol for children and adolescents. A probable explanation is that already embedded modifications in these protocols facilitate the needed attunement to the client's level of functioning. Practical implications: The authors of this review suggest that EMDR protocols for children and adolescents could be adapted for people with an intellectual disability. Further research should focus on the involvement of trusted others in EMDR therapy for people with ID and the therapeutic relationship from an attachment and relational-based perspective. [ABSTRACT FROM AUTHOR]

Research on trauma treatment in people with severe intellectual disability (SID; IQ 20–35) is scarce, and controlled studies are lacking. This study examined the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy using the storytelling method in three adults with SID and posttraumatic stress disorder (PTSD). A multiple-baseline design was used to examine the effects of the EMDR storytelling method on PTSD classification, PTSD symptoms, challenging behaviors, and dysfunctional behaviors in three adults with SID and PTSD, EMDR resulted in a significant decrease in PTSD symptoms, challenging behaviors, and most dysfunctional behaviors. None of the participants had a PTSD classification after EMDR. Findings suggest EMDR to be effective in the treatment of PTSD in adults with SID. Follow-up research with a larger sample size is required. [ABSTRACT FROM AUTHOR]

Background: There is not one case report of successful trauma treatment with the use of an evidence-based treatment method in people with substantially limited verbal capacities. This paper assessed the applicability of eye movement desensitisation and reprocessing (EMDR) in two clients with moderate ID, serious behavioural problems, and histories of negative life events. Method: The 8-phase protocol of EMDR, a first-line treatment for psychological trauma, was applied. Results: In both cases, posttraumatic stress disorder (PTSD)-like symptoms decreased in a total of only 6 and 5 sessions, respectively. Gains were maintained at 32 and 10 months' follow-up. Conclusions: EMDR seems to be an applicable psychological trauma treatment for persons with limited verbal capacities. Considering the importance of these findings, further and more rigorous research is required. (Contains 2 notes and 1 table.)