Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factors

Cooper, S.-A. , Smiley, E., Jackson, A., Finlayson, J., Allan, L., Mantry, D. and Morrison, J. (2009) Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factors. Journal of Intellectual Disability Research, 53(3), pp. 217-232. (doi: 10.1111/j.1365-2788.2008.01127.x)

Abstract

<b>Introduction:</b> Aggressive behaviours can be disabling for adults with intellectual disabilities (ID), with negative consequences for the adult, their family and paid carers. It is surprising how little research has been conducted into the epidemiology of these needs, given the impact they can have. This study investigates point prevalence, 2-year incidence and 2-year remission rates for aggressive behaviour (physically aggressive, destructive and verbally aggressive), and it investigates which factors are independently associated with aggressive behaviour. <b>Methods:</b> All adults with ID – within a geographically defined area of Scotland, UK – were recruited to a longitudinal cohort. At baseline, assessments were undertaken of demography, lifestyle, supports, development, problem behaviours, disabilities and physical and mental health. These were repeated for a 2-year period. <b>Results:</b> At baseline, the participation rate was 1023 (65.5%). After 2 years, the cohort retention was 651 adults. The point prevalence of Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) aggressive behaviour was 9.8% (95% confidence interval = 8.0–11.8%), 2-year incidence was 1.8%, and 2-year remission rate from all types of aggressive behaviour meeting DC-LD criteria was 27.7%. The factors independently associated with aggressive behaviours were lower ability, female gender, not living with a family carer, not having Down syndrome, having attention-deficit hyperactivity disorder and having urinary incontinence. Incidence of aggressive behaviour meeting DC-LD criteria in adult life is similar to that for each of psychotic, anxiety and organic disorders. <b>Conclusions:</b> Aggressive behaviour is common among adults with ID, but contrary to previous suggestions, more than a quarter remit within the short to medium term. This is important knowledge for professionals as well as the person and her/his family and paid carers. There is much yet to learn about the mechanisms underpinning aetiology and maintenance of aggressive behaviour in this population, and exploratory epidemiological investigations such as this have a role to play in progressing research towards further hypothesis testing and trials to influence clinical practice, service development and policy.

• Item Type: Articles
• Additional Information: The definitive version is available at www3.interscience.wiley.com
• Keywords: aggressive behaviour, epidemiology, intellectual disabilities, mental ill-health, problem behaviour
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Allan, Miss Lesley and Finlayson, Miss Janet and Smiley, Dr Elita and Cooper, Professor Sally-Ann and Jackson, Dr Alison
• Authors: Cooper, S.-A., Smiley, E., Jackson, A., Finlayson, J., Allan, L., Mantry, D., and Morrison, J.
• Subjects: R Medicine > RC Internal medicine
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Intellectual Disability Research
• Publisher: Wiley-Blackwell
• ISSN: 0964-2633
• ISSN (Online): 1365-2788
• Published Online: 30 October 2008
• Copyright Holders: Copyright © 2008 Blackwell Publishing
• First Published: First published in Journal of Intellectual Disability Research 53(3):217-232
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher.