RESUMEN
The aim of the present study was to identify the age correlates of behavioural crises in adults with intellectual disability (ID) living in the community. The cohort consisted of 185 clients (IQ < 70), ranging in age from 20 to > 70 years, who were referred to a crisis intervention programme specializing in services to individuals with dual diagnosis over a 7-year period. A retrospective cross-sectional analysis of historical and contemporaneous variables was completed. Referrals for crisis intervention were not related to the age of the client Aggression and non-compliant behaviour occurred with similar frequency in all age groups. Other behaviours, including withdrawal, self-injury, stereotypy and symptoms of psychiatric disorders, occurred less often in older clients. Severity of ID affected the pattern of behavioural crises that resulted in referral. The results suggest that people with ID residing in community settings still experience behavioural crises as they grow older. Confirmation of the trends reported in the present study might signal a need for accelerating the development of comprehensive age-span community mental health and behavioural supports.
Asunto(s)
Intervención en la Crisis (Psiquiatría) , Discapacidad Intelectual/psicología , Adulto , Anciano , Envejecimiento/fisiología , Estudios de Cohortes , Servicios Comunitarios de Salud Mental , Humanos , Trastornos Mentales/diagnóstico , Trastornos Mentales/etiología , Trastornos Mentales/psicología , Persona de Mediana Edad , Derivación y Consulta , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
Two interrelated cross-sectional studies were conducted to expand earlier findings about correlates of outwardly directed aggressive behavior in children with mental retardation. In Study 1 we compared children with mental retardation, 27 with and 23 without aggression. Aggression was best predicted by concurrent self-injurious behavior (SIB). In Study 2 we examined the likelihood that aggression was predicted by concurrent SIB and other nondestructive maladaptive behaviors in an archival cohort of 701 children younger than 21 with IQs below 70. Self-injurious behavior significantly predicted outwardly directed aggression for all children regardless of age. Additional predictors besides SIB showed only minimal improvements in model R2 values. Results were discussed in light of recent research proposing a common basis for aggression and SIB.
Asunto(s)
Agresión , Discapacidad Intelectual/complicaciones , Discapacidad Intelectual/psicología , Conducta Autodestructiva/complicaciones , Conducta Estereotipada , Adolescente , Adulto , Agresión/fisiología , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Niño , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Trastornos del Lenguaje/complicaciones , Modelos Logísticos , Masculino , Estudios Retrospectivos , Conducta Autodestructiva/etiología , Índice de Severidad de la Enfermedad , Conducta Estereotipada/fisiologíaRESUMEN
Characteristics of 98 clients re-referred to receive services from a community-based crisis intervention program were compared to those of program clients who were served during the same 5.25-year period who were not referred. The majority of re-referrals occurred because of the same challenging behavior causing initial referral. Eight-eight percent of re-referral clients received the additional referral by 2 years after initial discharge. For persons under 30, nonfamily residence and initial diagnosis of self-injurious behavior were the strongest predictors. For those over 30, the most important factor was aggression. Recidivism following crisis intervention appears to be a complex function of client characteristics and community capabilities.
Asunto(s)
Servicios Comunitarios de Salud Mental , Intervención en la Crisis (Psiquiatría) , Discapacidades para el Aprendizaje/complicaciones , Trastornos Mentales/complicaciones , Derivación y Consulta , Adulto , Agresión , Estudios de Cohortes , Femenino , Humanos , Masculino , Trastornos Mentales/prevención & control , Recurrencia , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
When individuals with a developmental disability experience a behavioral or psychiatric crisis, their community placement may be threatened. A model crisis intervention program for individuals with dual diagnoses was discussed and performance and outcomes of such a service for 267 children and adults reviewed. Analysis indicated that 69% of the individuals required only one crisis intervention. Of the 31% requiring two or more, nearly all were re-referred earlier than 2 years post initial crisis intervention. The central, gulf-bridging role of a crisis intervention service in a comprehensive, coordinated, community-based mental health system for dually diagnosed individuals was discussed.