Commentary on "The use of cognitive behaviour therapy to treat depression in people with learning disabilities: a systematic review"

Purpose – The purpose of this paper is to provide a commentary on “The use of cognitive-behaviour therapy to treat depression in people with learning disabilities: a systematic review”. Design/methodology/approach – Drawing on the literature, as well as both clinical and research experience, some reasons are outlined for the lack of attention given to psychological therapies to treat depression amongst people with intellectual disabilities (IDs). Findings – More research is needed, but existing evidence is promising regarding the effectiveness of adapted cognitive-behaviour therapy for depression amongst people with IDs. Originality/value – The commentary draws attention to the scope for developing a range of effective cognitive, behavioural and cognitive-behavioural treatments

Can a computerised training paradigm assist people with intellectual disabilities to learn cognitive mediation skills? A randomised experiment

Aims: The aim was to examine whether specific skills required for cognitive behavioural therapy (CBT) could be taught using a computerised training paradigm with people who have intellectual disabilities (IDs). Training aimed to improve: a) ability to link pairs of situations and mediating beliefs to emotions, and b) ability to link pairs of situations and emotions to mediating beliefs. Method: Using a single-blind mixed experimental design, sixty-five participants with IDs were randomised to receive either computerised training or an attention-control condition. Cognitive mediation skills were assessed before and after training. Results: Participants who received training were significantly better at selecting appropriate emotions within situation-beliefs pairs, controlling for baseline scores and IQ. Despite significant improvements in the ability of those who received training to correctly select intermediating beliefs for situation-feelings pairings, no between-group differences were observed at post-test. Conclusions: The findings indicated that computerised training led to a significant improvement in some aspects of cognitive mediation for people with IDs, but whether this has a positive effect upon outcome from therapy is yet to be established

The Relationship Between Problem-Solving Ability and Self-Harm Amongst People with Mild Intellectual Disabilities

The purpose of this study was to investigate the relationship between depression, hopelessness, problem-solving ability and self-harming behaviours amongst people with mild intellectual disabilities (IDs). Methods Thirty-six people with mild IDs (77.9% women, Mage = 31.77, SD = 10.73, MIQ = 62.65, SD = 5.74) who had a history of self-harm were recruited. Participants were asked to complete measures of depression, hopelessness and problem-solving ability. Results Cutting was most frequently observed, and depression was prevalent amongst the sample. There was a significant positive relationship between depression and hopelessness, while there was no significant relationship between self-harm and depression or hopelessness. Problem-solving ability explained 15% of the variance in self-harm scores. Conclusions Problem-solving ability appears to be associated with self-harming behaviours in people with mild IDs

Effectiveness of cognitive behavioural therapy for people who have autistic spectrum disorders: A systematic review and meta-analysis

The aims of this study were to undertake a meta-analytic and systematic appraisal of the literature investigating the effectiveness of cognitive behavioural therapy (CBT) when used with individuals who have autistic spectrum disorders (ASDs) for either a) affective disorders, or b) the symptoms of ASDs. Following a systematic search, 48 studies were included. CBT, used for affective disorders, was associated with a non-significant small to medium effect size, g = .24, for self-report measures, a significant medium effect size, g = .66, for informant-report measures, and a significant medium effect size, g = .73, for clinician-report measures. CBT, used as a treatment for symptoms of ASDs, was associated with a small to medium non-significant effect size, g = .25, for self-report measures, a significant small to medium effect size, g = .48, for informant-report measures, a significant medium effect size, g = .65, for clinician-report measures, and a significant small to medium effect size, g = .35, for task-based measures. Sensitivity analyses reduced effect size magnitude, with the exception of that based on informant-report measures for the symptoms of ASDs, which increased, g = .52. Definitive trials are needed to demonstrate that CBT is an empirically validated treatment for use with people who have ASDs

Attentional bias toward negative and positive pictorial stimuli and its relationship with distorted cognitions, empathy, and moral reasoning among men with intellectual disabilities who have committed crimes

The aims of this study were to examine: (a) whether men with intellectual disabilities who have a history of criminal offending attend to affective pictorial stimuli in a biased manner, and (b) whether there is a relationship between an affective attentional bias and offence-supportive cognitions, empathy, and moral development. Forty-six men with intellectual disabilities who had a documented history of criminal offending, and 51 men who also had intellectual disabilities, but no such history, were recruited and asked to complete a computer-based dot-probe task using affective pictorial stimuli with randomisation, along with measures of distorted cognitions, empathy, and moral development. Those with a history of criminal offending endorsed significantly more offence-supportive cognitions, had significantly lower general empathy, and more “mature” moral development, as well as a significant attentional bias toward affective pictorial stimuli. Attentional bias significantly predicted offence-supportive cognitions, and vice versa, having controlled for offence history, and Full-Scale IQ, but this was not the case for empathy or moral development. While the findings require replication, interventions which aim to modify attention bias with this population should be tested

Occupational stress, coping and wellbeing among registered psychologists working with people with intellectual disabilities during the COVID-19 pandemic in the United Kingdom

Objectives: To characterise the changes at work experienced by psychologists working with people with intellectual disabilities during the pandemic and whether these changes, stressors and aspects of working life were associated with mental wellbeing and occupational stress. Methods: Ninety-seven psychologists completed an online survey. Free text comments were analysed using thematic analysis and triangulated with our quantitative findings. Results: Occupational stress, learning new roles, demands at home, and changes due to COVID-19 were associated with poorer mental wellbeing, while uncertainty about the role, a shortage of personal protective equipment, and poorer mental wellbeing were associated with occupational stress. Two main themes emerged during the thematic analysis: being human and being an employee, and triangulation revealed agreement. Conclusions: The wellbeing and occupational stress of psychologists working with people with intellectual disabilities have been affected during the pandemic. It is of note that almost a quarter of our sample reported having been redeployed

Contingent electric shock as a treatment for challenging behavior for people with intellectual and developmental disabilities : support for the IASSIDD policy statement opposing its use

Issues: The International Association for the Scientific Study of Intellectual and Developmental Disabilities (IASSIDD) is an international group of researchers, clinicians, students, parents, and self-advocates that promotes worldwide research and exchange of information on intellectual and developmental disabilities. IASSIDD recently developed a policy statement regarding their opposition to the use of contingent electric skin shock (CESS) with individuals with challenging behaviour and intellectual and developmental disabilities. To support the policy, the available literature was reviewed to evaluate the efficacy, side effects, generalization, and long-term effectiveness of the procedure as an intervention for challenging behaviour. Findings: The review provides a history that demonstrates that, although CESS can decrease the frequency of challenging behaviour, it comes at a cost in terms of physical and emotional side effects, and questions remain regarding the long-term effectiveness of the procedure. In addition, we raise several ethical and methodological issues that make the research on the use of CESS even more concerning. Conclusions: Although research continues in some countries, these studies are now rare. In fact, in the United States, the Food and Drug Administration has just banned the use of such devices with individuals with self-injury and aggression (Federal Register, 2020). It is hoped that, because there are many other forms of treatment that have shown to be effective for severe challenging behaviour, we can completely avoid the use of CESS

The Clinical Utility of Social Information Processing Theory in Assessing and Treating Offenders with Autism Spectrum Disorder

Purpose: Social deficits are central within conceptualisations of autism spectrum disorder (ASD), and seperately linked to offending behaviour. Social problem solving interventions are often used with offenders, but little research has examined the social information processing (SIP) skills of individuals with ASD and a history of criminal offending behaviours. Design/methodology/approach: This conceptual paper will introduce the SIP model, review SIP research as applied to those with ASD and in forensic populations, and further consider the relevance to the assessment and treatment of offenders with ASD. Findings: Difficulties in all areas of the SIP model are noted in ASD and research suggests these difficulties may be directly linked to behaviour. Practical implications: It is possible that identifying SIP abilities and deficits could improve the effectiveness of rehabilitation programmes for this group. Originality/value: This paper reviews the utility of social information models in the offending behaviour of people with ASD

A Precision Teaching Framework for Improving Mathematical Skills of Students with Intellectual and Developmental Disabilities

The aim of this study was to investigate the effect of a precision teaching (PT) framework on the mathematical ability of students with intellectual and developmental disabilities. We also examined if students of moderate mathematical ability could perform as well as their peers with fewer difficulties with their math skills. Sixteen students participated and were divided into three groups. One group engaged in PT, and the other two groups functioned as comparisons. The PT group practiced six skills introduced linearly. An A-B design was used for the five component skills, and a multiple baseline across participants design was used for the composite skill (addition). The intervention led to a significant improvement in all skills, including addition, and this was associated with a large effect size; student performance met or exceeded that of their peers. Overall, the findings suggest that PT is an efficient and effective approach for teaching students with IDDs