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Combining psychiatric and psychological approaches in the inpatient assessment of aggression in a client with moderate intellectual disability

Published online by Cambridge University Press:  13 June 2014

Ian M Grey ,
Brian McClean ,
Leena Kulkarni  and
John Hillery
Ian M Grey
Affiliation:
Assessment Team, Stewart's Hospital Services and Lecturer in Developmental Disability, Trinity College Dublin, Dublin 2, Ireland
Brian McClean
Affiliation:
Brothers of Charity, Roscommon, Ireland
Leena Kulkarni
Affiliation:
Assessment Team, Stewart's Hospital Services, Palmerstown, Dublin 20, Ireland
John Hillery
Affiliation:
Assessment Team, Stewart's Hospital Services and Honorary Lecturer, Centre for Disability Studies, University College Dublin, Belfield, Dublin 4, Ireland
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Abstract

The literature on challenging behaviour is large, with heavy emphasis on behavioural approaches. In recent years more attention has been given to the effect of psychiatric illness on the behaviour of people with intellectual disability. However, theoretical differences between disciplines can lead to one or other approach dominating the assessment process. Increasingly, functional assessment is receiving attention as an assessment approach by both psychiatrists and psychologists. When used properly it can give a holistic overview of the individual and their behaviour, allowing a team approach to assessment and treatment that ensures the consideration of all possible psychiatric/medical/behavioural/environmental possibilities (a bio-behavioural model) in the aetiology and maintenance of challenging behaviour. This case study illustrates the effectiveness of teamwork in this area using functional assessment as a tool. The case also illustrates the possible futility of such comprehensive assessments of challenging behaviour in the absence of appropriate resources to implement the recommendations of such an assessment.

Keywords

Intellectual disabilityChallenging behaviourPsychiatric assessmentFunctional analysisMulti-Disciplinary interventionResidential assessment
Type
Case reports
Information
Irish Journal of Psychological Medicine , Volume 20 , Issue 3 , September 2003 , pp. 91 - 95
Copyright
Copyright © Cambridge University Press 2003

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References

1.Emerson, E, Hatton, C, Bromley, J, Caine, A. Clinical psychology and people with intellectual disabilities. Chichester, England: Wiley. 1998.Google Scholar
2.Mace, FC, Mauk, JE. Bio-behavioural diagnosis and treatment of self-injury. Men Retard Dev Dis 1995; 1: 104–10.CrossRefGoogle Scholar
3.Mace, FC, Blum, NJ, Sierp, BJ, Delaney, BA, Mauk, JE. Differential response of operant self-injury to pharmacologic versus behavioral treatment. J Dev Behav Ped 2001; 22(2): 85–91.CrossRefGoogle ScholarPubMed
4.Deb, S, Mattews, T, Holt, G. Bouras N. Practice guidelines for the assessment and diagnosis of mental health problems in adults with intellectual disability. Brighton: Pavillion, 2001.Google Scholar
5.Dunlap, G, Kincaid, D. The widening world of functional assessment: Comments on four manuals and beyond. J App. Behav 2001; 34: 365–77.CrossRefGoogle Scholar
6.Zuckerman, M. Vulnerability to psychopathology: A biosocial model. Washington DC: American Psychological Association. 1999.CrossRefGoogle Scholar
7.LaVigna, GW, Donnellan, AM. Alternatives to punishment: Solving behavior problems with non-aversive strategies. New York: Irvington. 1986.Google Scholar
8.Bisset, RT, Hayes, SC. The likely success of functional analysis tied to the DSM. Behav Res Ther 1999; 37: 379–83.CrossRefGoogle Scholar
9.Sovner, R. Limiting factors in the use of DSM-III criteria with mentally ill/mentally retarded persons. Psychopharmacology Bull 1986; 24: 4, 1055–64.Google Scholar
10.Moss, S, Emerson, E, Bouras, N, Holland, A. Review. Mental disorders and problematic behaviours in people with intellectual disability: future directions for research. J Intell Dis Res 41 (6): 440–7.CrossRefGoogle Scholar
11Carr, EG, Levin, L, McConnachie, G, Carlson, Kemp, Smith, C. Communication-based intervention for intervention for problem behaviour. Baltimore: Paul H. Brookes, 1994.Google Scholar
12Janardhanan Santosh, P, Baird, G. Psychopharmacotherapy in children and adults with intellectual disability. Lancet 1999; 354: 231–40.Google Scholar
13Quigley, A, Murray, GC, McKenzie, K, Elliot, G. Staff knowledge about symptoms of mental health problems in people with learning disabilities. J Learn Dis 5(3): 235–44.CrossRefGoogle Scholar
14Hillery, J. Integrating models of challenging behaviour: conference brief and musings on a multi-disciplinary workshop. J Intell Dis Res 1998; 42(4): 325–7.Google Scholar