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Challenging behaviours in adults with an intellectual disability: A total population study and exploration of risk indices

Bowring, DL; Totsika, V; Hastings, RP; Toogood, S; Griffith, GM; (2016) Challenging behaviours in adults with an intellectual disability: A total population study and exploration of risk indices. British Journal of Clinical Psychology , 56 (1) pp. 16-32. 10.1111/bjc.12118. Green open access

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Abstract

Objectives Considerable variation has been reported in the prevalence and correlates of challenging behaviour (CB) in adults with intellectual disabilities (ID). To provide a robust estimate of prevalence, we identified the entire administrative population of adults with ID in a defined geographical area and used a behaviour assessment tool with good psychometric properties. Methods Data from 265 adults who were known to services were collected using a demographic survey tool and the Behavior Problems Inventory – Short Form. The prevalence of self‐injurious, aggressive/destructive, stereotyped, and overall CB was evaluated. We explored the potential of developing cumulative risk indices (CRI) to inform longitudinal research and clinical practice. Results The prevalence of overall CB was 18.1% (95% CI: 13.94–23.19%). The prevalence of self‐injurious behaviour was 7.5% (95% CI: 4.94–11.37%), aggressive–destructive behaviour 8.3% (95% CI: 5.54–12.25%), and stereotyped behaviour 10.9% (95% CI: 7.73–15.27%). Communication problems and severity of ID were consistently associated with higher risk of CBs. CRIs were significantly associated with CBs, and the five methods of CRI development produced similar results. Conclusions Findings suggest a multi‐element response to CB is likely to be required that includes interventions for communication and daytime activity. Exploratory analyses of CRIs suggested these show promise as simple ways to capture cumulative risk in this population. Subject to longitudinal replication, such a tool may be especially useful in clinical practice to identify adults who are priority for interventions and predict future demand on services.

Type: Article
Title: Challenging behaviours in adults with an intellectual disability: A total population study and exploration of risk indices
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjc.12118
Publisher version: https://doi.org/10.1111/bjc.12118
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Social Sciences, Psychology, Clinical, Psychology, intellectual disability, challenging behaviour, cumulative risk, relative risk, population sample, INVENTORY-SHORT FORM, SELF-INJURIOUS-BEHAVIOR, PREVALENCE, INDIVIDUALS, RELIABILITY, REGRESSION, DISORDERS, REMISSION, VALIDITY, MARKERS
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10062237
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