Mental health assessment and monitoring tools for people with intellectual disabilities

doi:10.1017/CBO9780511543616.003

2 - Mental health assessment and monitoring tools for people with intellectual disabilities

from Part I - Assessment and diagnosis

Published online by Cambridge University Press: 15 December 2009

Caroline Mohr and

Helen Costello

Edited by

Nick Bouras and

Geraldine Holt

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Caroline Mohr: Affiliation:
Consultant Clinical Psychologist, Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, Victoria, Australia
Helen Costello: Affiliation:
Senior Researcher, King's College London
Nick Bouras: Affiliation:
King's College London
Geraldine Holt: Affiliation:
King's College London

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Summary

Introduction

Assessing the presence of mental health problems in individuals with intellectual disabilities (ID) is a complex process. Increased clinical and research attention in recent years has resulted in the development of a range of assessment instruments aimed at improving the identification and diagnosis of psychiatric and behavioural disorders in this population. The routine use of valid and reliable assessment and monitoring tools may make a significant contribution to improving the quality of care. Yet, currently there is no consensus about which assessment instruments should be used.

The aim of this chapter is to provide an overview of the characteristics and psychometric properties of what the authors consider to be the best available assessment and monitoring tools. The chapter describes the approaches employed for the development of assessment instruments, describes the key features of six checklists and rating scales and summarizes evidence about their validity and reliability. In doing so, the strengths and limitations of available assessment instruments are highlighted, and recommendations for using assessment and monitoring tools are made.

Developing assessment and monitoring tools

While the precise function of instruments may vary, the central aim of assessment and monitoring tools is to increase the validity and reliability with which the presence and severity of the signs, or symptoms, of mental health problems are measured over a given period. Standardized instruments help to ensure that individuals referred to mental health services receive a comprehensive and objective assessment, less subject to factors such as ‘diagnostic overshadowing’ (Reiss et al., 1982) and variations in the opinions of individual carers and clinicians (Einfeld & Tonge, 1992).

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Type: Chapter
Information: Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities , pp. 24 - 41

DOI: https://doi.org/10.1017/CBO9780511543616.003 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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References

Achenbach, T. M. (1998). Diagnosis, assessment, taxonomy, and case formulations. In Handbook of child psychopathology, ed. Ollendick, T. H. and Hersen, M.. New York, Plenum Press: pp. 63–87.

Achenbach, T. M., Mc Conaughy, S. H., & Howell, C. T. (1987). Child/adolescent behavioural and emotional problems: Implications of cross-informant correlations for situational specificity. Psychological Bulletin, 101, 213–32.Google Scholar

Aman, M. G. (1991). Assessing psychopathology and behaviour problems in persons with mental retardation. Rockville, MD: U.S. Department of Health and Human Services.

Aman, M. G., Burrow, W. H. & Wolford, P. L. (1995). The Aberrant Behavior Checklist – Community: Factor validity and effect of subject variables for adults in group homes. American Journal on Mental Retardation, 100(3), 283–92.Google Scholar

Aman, M. G., Richmond, G., Bell, J. C. & Kissel, R. C. (1987). The Aberrant Behavior Checklist: Factor structure and the effect of subject variables in American and New Zealand facilities. American Journal of Mental Deficiency, 91(6), 570–8.Google Scholar

Aman, M. G. & Singh, N. N. (1985). Psychometric characteristics of the Aberrant Behavior Checklist. American Journal of Mental Deficiency, 89(5): 492–502.Google Scholar

Aman, M. G., Watson, J. E., Singh, N. N., Turbott, S. H. & Wilsher, C. P. (1986). Psychometric and demographic characteristics of the Psychopathology Instrument for Mentally Retarded Adults. Psychopharmacology Bulletin, 22(4), 1072–6.Google Scholar

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.

Bamburg, J. W., Cherry, K. E., Matson, J. L. & Penn, D. (2001). Assessment of schizophrenia in persons with severe and profound mental retardation using the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). Journal of Developmental and Physical Disabilities, 13(4), 319–31.Google Scholar

Davidson, M. (1988). Psychometric Characteristics of the Checklist of Emotional Problems with Mentally Retarded Adults (CHEMRA). Unpublished doctoral dissertation, University of Illinois, Chicago.

Deb, S., Matthews, T., Holt, G. & Bouras, N. (2001b). Practice Guidelines for Assessment and Diagnosis of Mental Health Problems in Adults with Intellectual Disability. Brighton: Pavilion.

Deb, S., Thomas, M. & Bright, C. (2001a). Mental disorder in adults with intellectual disability. 1: Prevalence of functional psychiatric illness among a community-based population aged between 16 and 64 years. Journal of Intellectual Disability Research, 45, 495–505.Google Scholar

Einfeld, S. L. & Tonge, B. J. (1992). Manual for the Developmental Behaviour Checklist (DBC)(Primary Carer version). Melbourne: School of Psychiatry, University of New South Wales, and Centre for Developmental Psychiatry, Monash University, Clayton, Victoria.

Gustafsson, C. & Sonnander, K. (2002). Psychometric evaluation of a Swedish version of the Reiss Screen for Maladaptive Behavior. Journal of Intellectual Disability Research, 46(3), 218–29.Google Scholar

Havercamp, S. M. & Reiss, S. (1997). The Reiss Screen for Maladaptive Behavior: Confirmatory factor analysis. Behavior Research and Therapy, 35(10), 967–71.Google Scholar

Holland, A. J. & Koot, H. M. (1998). Mental health and intellectual disability: An international perspective. Journal of Intellectual Disability Research 42(6): 505–12.Google Scholar

Linaker, O. M. (1991). DSM-III diagnoses compared with factor structure of the Psychopathology Instrument for Mentally Retarded Adults (PIMRA), in an institutionalized, mostly severely retarded population. Research in Developmental Disabilities, 12, 143–53.Google Scholar

Linaker, O. M. & Helle, J. (1994). Validity of the schizophrenia diagnosis of the Psychopathology Instrument for Mentally Retarded Adults (PIMRA): A comparison of schizophrenic patients with and without mental retardation. Research in Developmental Disabilities, 15(6), 473–86.Google Scholar

Marshburn, E. C. & Aman, M. G. (1992). Factor validity and norms for the Aberrant Behavior Checklist in a community sample of children with mental retardation. Journal of Autism and Developmental Disorders, 22(3), 357–73.Google Scholar

Matson, J. L. (1988). The PIMRA Manual. Orland Park, IL: International Diagnostic Systems, Inc.

Matson, J. L., Coe, D. A., Gardner, W. I. & Sovner, R. (1991b). A factor analytic study of the Diagnostic Assessment for the Severely Handicapped Scale. The Journal of Nervous and Mental Disease, 179(9), 553–7.Google Scholar

Matson, J. L., Gardner, W. I., Coe, D. A. & Sovner, R. (1991a). A scale for evaluating emotional disorders in severely and profoundly mentally retarded persons. Development of the Diagnostic Assessment for the Severely Handicapped (DASH) Scale. British Journal of Psychiatry, 159, 404–9.Google Scholar

Matson, J. L., Kazdin, A. E. & Senatore, V. (1984). Psychometric properties of the Psychopathology Instrument for Mentally Retarded Adults. Applied Research in Mental Retardation, 5, 81–9.Google Scholar

Matson, J. L., Kiely, S. L. & Bamburg, J. W. (1997b). The effect of stereotypies on adaptive skills with the DASH-II and Vineland Behavior Scales. Research in Developmental Disabilities, 18(6), 471–6.Google Scholar

Matson, J. L., Rush, K. S., Hamilton, M.et al. (1999). Characteristics of depression as assessed by the Diagnostic Assessment for Severely Handicapped-II (DASH-II). Research in Developmental Disabilities 20(4), 305–13.Google Scholar

Matson, J. L. & Smiroldo, B. B. (1997). Validity of the Mania Subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). Research in Developmental Disabilities, 18(3), 221–5.Google Scholar

Matson, J. L., Smiroldo, B. B., Hamilton, M. & Baglio, C. S. (1997c). Do anxiety disorders exist in persons with severe and profound mental retardation?Research in Developmental Disabilities, 18(1), 39–44.Google Scholar

Matson, J. L., Smiroldo, B. B. & Hastings, T. L. (1998). Validity of the Autism/Pervasive Developmental Disorder Subscale of the Diagnostic Assessment for the Severely Handicapped-II. Journal of Autism and Developmental Disorders, 28(1), 77–81.Google Scholar

McDaniel, W. F., Turner, M. D. & Johns, M. R. (1999). Long-term associations among personality disorder scales of the Reiss Screen for Maladaptive Behaviour and the Psychopathology Inventory for Mentally Retarded Adults. Developmental Disabilities Bulletin, 27(2), 32–41.Google Scholar

Mohr, C., Tonge, B. J. & Einfeld, S. L. (2004). Manual for the Developmental Behaviour Checklist – Adult Version. Melbourne: Monash University, Centre for Developmental Psychiatry & Psychology.

Moss, S. (1999). Assessment: conceptual issues. In Psychiatric and Behavioural Disorders in Mental Retardation, ed. Bouras, N.. Cambridge: Cambridge University Press, pp. 18–37.

Moss, S. C., Patel, P., Goldberg, D., Simpson, N. & Lucchino, R. (1993). Psychiatric morbidity in older people with moderate and severe learning disability. I: Development and reliability of the patient interview (PAS-ADD). British Journal of Psychiatry, 163, 471–80.Google Scholar

Moss, S. C., Prosser, H., Costello, H.et al. (1998). Reliability and validity of the PAS-ADD Checklist for detecting psychiatric disorders in adults with intellectual disabilities. Journal of Intellectual Disability Research, 42(2), 173–83.Google Scholar

Newton, J. T. & Sturmey, P. (1988). The Aberrant Behavior Checklist: A British replication and extension of its psychometric properties. Journal of Mental Deficiency Research, 32, 87–92.Google Scholar

Nihira, K., Foster, R., Shellhaas, M. & Leland, J. (1975). AAMD Adaptive Behavior Scale Manual (Rev.). Washington, DC: American Association on Mental Deficiency.

Ono, Y. (1996). Factor validity and reliability for the Aberrant Behavior Checklist-Community in a Japanese population with mental retardation. Research in Developmental Disabilities, 17(4), 303–9.Google Scholar

Pacalawskyji, T. R., Matson, J. L., Bamburg, J. W. & Baglio, C. S. (1997). A comparison of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) and the Aberrant Behavior Checklist. Research in Developmental Disabilities, 18(4), 289–98.Google Scholar

Reiss, S. (1982). Psychopathology and mental retardation: Survey of a developmental disabilities mental health program. Mental Retardation 20: 128–32.Google Scholar

Reiss, S. (1988). The Reiss Screen for Maladaptive Behavior Test Manual. Worthington, OH: IDS Publishing Corporation.

Reiss, S. (1997). Comments on the Reiss Screen for Maladaptive Behavior and its factor structure. Journal of Intellectual Disability Research, 41(4), 346–54.Google Scholar

Rojahn, J. & Helsel, W. J. (1991). The Aberrant Behavior Checklist with children and adolescents with dual diagnosis. Journal of Autism and Developmental Disorders, 21(1), 17–28.Google Scholar

Royal College of Psychiatrists. (2001). DC-LD. Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation. Occasional Paper 48. London: Gaskell.

Senatore, V., Matson, J. L. & Kazdin, A. E. (1985). An inventory to assess psychopathology of mentally retarded adults. American Journal of Psychiatry, 89, 459–66.Google Scholar

Simpson, N. (1998). Prevalence of Psychiatric Disorders in Adults with Learning Disabilities. Paper presented at the Second International Medical Aspect of Mental Health Meeting, Manchester, England.

Streiner, D. L. and Norman, G. R. (1995). Health Measurement Scales. A Practical Guide to Their Development and Use. Oxford: Oxford University Press.

Sturmey, P. & Bertman, L. J. (1994). Validity of the Reiss screen for maladaptive behavior. American Journal on Mental Retardation, 99(2), 201–6.Google Scholar

Sturmey, P., Burcham, K. J. & Perkins, T. S. (1995). The Reiss Screen for Maladaptive Behavior: Its reliability and internal consistencies. Journal of Intellectual Disability Research, 39(3), 191–5.Google Scholar

Sturmey, P., Jamieson, J., Burcham, J., Shaw, B. & Bertman, L. (1996). The factor structure of the Reiss Screen for Maladaptive Behavior in institutional and community populations. Research in Developmental Disabilities, 17(4), 285–91.Google Scholar

Sturmey, P. & Ley, T. (1990). The Psychopathology Instrument for Mentally Retarded Adults. British Journal of Psychiatry, 156, 428–30.Google Scholar

Sturmey, P., Newton, J. T., Cowley, A., Bouras, N. & Holt, G. (2005). The PAS-ADD Checklist: An independent replication of its psychometric properties in a community sample. British Journal of Psychiatry, 186, 319–23.Google Scholar

Swiezy, N. B., Matson, J. L., Kirkpatrick-Sanchez, S. & Williams, D. E. (1995). A criterion validity study of the schizophrenia subscale of the Psychopathology Instrument for Mentally Retarded Adults (PIMRA). Research in Developmental Disabilities, 16(1), 75–80.Google Scholar

Taylor, J. L., Hatton, C., Dixon, C. & Douglas, C. (2004). Screening for psychiatric symptoms: PAS-ADD checklist norms for adults with intellectual disabilities. Journal of Intellectual Disability Research, 48, 37–41.Google Scholar

Tonge, B. J., Einfeld, S. L., Krupinski, J.et al. (1996). The use of factor analysis for ascertaining patterns of psychopathology in children with intellectual disabilities. Journal of Intellectual Disability Research, 40(3), 198–207.Google Scholar

Minnen, A., Savelsberg, P. M. & Hoogduin, K. A. L. (1994). A Dutch version of the Psychopathology Inventory for Mentally Retarded Adults (PIMRA). Research in Developmental Disabilities, 15(4), 269–78.Google Scholar

Walsh, K. K. & Shenouda, N. (1999). Correlations among the Reiss screen, the Adaptive Behavior Scale Part II, and the Aberrant Behavior Checklist. American Journal on Mental Retardation, 104(3), 236–48.Google Scholar

Watson, J. E., Aman, M. G. & Singh, N. N. (1988). The Psychopathology Instrument for Mentally Retarded Adults: Psychometric characteristics, factor structure, and relationship to subject characteristics. Research in Developmental Disabilities, 9, 277–90.Google Scholar

World Health Organization (1992). ICD-10 International statistical classification of disease and related health problems (10th edn). Geneva: World Health Organization.

World Health Organization (1994). Schedules for Clinical Assessment in Neuropsychiatry Version 2. Geneva: World Health Organization.

Zung, W. K. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12, 371–9.Google Scholar

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