摘要:

AbstractDiagnosis of mental health needs in people with mental retardation using the DSM‐III‐R manual was critically reviewed. Conceptual issues included the interaction of different diagnosis categories; the cognitive and linguistic competencies often required for diagnosis; the potential mismatch between psychopathology in people with mental retardation and the DSM‐III‐R nosology; and issues relating to multi‐axial classification. Strategies identified to explore and resolve these issues include better documentation of the frequency and nature of these problems when using unmodified DSM‐III‐R criteria, better empirical piloting of modified diagnostic criteria with people with severe and profound mental retardation, and the use of social validity data to identify potential mismatches between psychopathology in people with mental retardation and DSM‐

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00539.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractSevere mental handicap in phenytketonuHa (PKU) can be prevented if dietary treatment is implemented at birth. Controversy remains about the optimum age for terminating treatment, A group of adolescents and young adults with PKU from the West of Scotland Register was identified which had received early treatment, been well‐controlled on diet, ceased treatment at 10 years old and subsequently were hyperphenyialaninaemic for 3 years or more. They were given a battery of neuropsychologcal tests and their results were compared with those of onndiet subjects with PKU and normal controls. The findings generally supported the view that dietary cessation at age 10 is sufficient to prevent a substantial reduction of cognitive and motor ability, and that the central nervous system is probably mature enough to withstand the toxic effects of high blood phenylaianine by then. However, there were minor indications, in keeping with Welshet al.'shypothesis [M.C. Welsh. B.F. Pennington. S. Ozonoff. B. Rouse E.R.B. McCabe (1990) Neuropsychology of early‐treated phenylketonuria: specific executive function deficits.Child Development61, 1697–713], that subtle intelleaual deficiencies might arise both during and after treatment, possibly in the realm of frontal‐executive fu

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00540.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractOver‐eating and resultant obesity is well recognized as a central feature of the Prader–Willi Syndrome (PWS). The eating behaviour of 13 subjects with PWS was been studied retrospectively over a 28‐day period and also by direct observation when given free access to food. Changing cognitions normally associated with food intake (e.g. changes in hunger) were assessed using visual analogue scales (VAS) and by asking subjects to rate photographs of particular foods. Eight out of 13 subjects (61 %) with PWS had to have their access to food severely restricted. Ten (77%) ate excessive amounts when given free access to food, and although feelings of ‘hunger',‘desire to eat’ and ‘fullness’ changed in the expected direaion. these changes were delayed, compared to a control group, and only occurred after eating a significantly greater amount of food. Ratings of ‘hunger’ and ‘fullness’ started to return to pre‐meal levels sooner than in the controls. The present authors consider that PWS is an example of genetic obesity secondary to an impaired satiety response. These observations have important i

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00541.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThis paper reports a clinical study of reported or disclosed sexual abuse of adults with learning disabilities. The findings support the results of a recent survey [V. Turk&H. Brown (1993) Sexual abuse of adults with learning disabilities: results of a two‐year incidence survey.Mental Handicap Research6, 193–216] but some differences were found, particularly with regard to sex of the survivors. The study also illustrates more than previous studies a link Isetween sexual abuse and sexualized and Inappropriate sexual behaviour and other challenging behaviours in men with learning disabilit

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00542.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractAspects of the topography and behavioural function underlying the challenging behaviours of all people with learning disabilities and challenging behaviour (n =70) in a defined geographical area were investigated. Results indicated that: (1) more severe challenging behaviours were shown by people with more severe disabilities; (2) a significant minority (44%) of people showed more than one form of challenging behaviour, this rising to 79% among people with more severe challenging behaviours; and (3) cross‐sectional analyses revealed specific clusters of problematic, aggressive and self‐injurious behaviours. Analysis of information derived from the Motivation Assessment Scale (MAS) indicated that (5) the most common funaions of challenging behaviours appeared to be ‘self‐stimulation’(for self‐injury, destructiveness and ‘other’ challenging behaviours) and securing the attention of carers (for aggressive behaviours). However, (6) parametric analyses failed to identify any consistent relationships between the form and function of an individual's challenging behaviour for aggressive, destructiveness and ‘other’ challenging behaviours, but (7) clients with self‐injurious behaviour were significantly more likely to score highly on the ‘self‐stimulation’ sub‐scale than other sub‐scales of the MAS. Finally, (8) significant consistency of behavioural functions across different forms of challenging behaviours shown by the same individual were found for the two combinations of aggressive‐destructive behaviours a

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00543.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractSeventy‐one subjects with Down's syndrome (DS), between the ages of 29 and 68 years, and 46 matched controls (without DS) were examined for intelligence, memory (short‐ and long‐term memory, and spatial and temporal orientation), communication (receptive, expressive and written language) and daily living skills (personal, domestic and community daily living skills). All subjects were screened on hearing and visual functions, thyroid functions; depression and dementia. DS‐subjects and controls were matched on chronological age, mental age, living conditions and male/female ratio. Comparisons were made between five subgroups (I) non‐demented institutionalized subjects with DS (DSI‐group;n=35); (2) non‐demented institutionalized controls without DS (Ci‐group;n=22); (3) demented institutionalized subjects with DS (n= 10); (4) non‐demented subjects with DS living in group homes (DSg;n=26); and (5) non‐demented controls without DS living in group homes (Cg; n=24). Institutionalized and non‐institutionalized subjects, as well as demented and non‐demented subjects differed significantly on all functions measured. Multiple regression analysis was performed to examine the influence of age and sensory deficits on adaptive and cognitive functioning. In DSg subjects, significant associations were found between age and mental age, and between age and performances on written language. In (non‐demented) DSi subjects, significant relations were found between age and memory functions observed in daily circumstances. Moreover, in the (non‐demented) DSi elderly, visual impairment was significantly related to depressed performance on daily living skills. No age effects were seen in control subjects. Infirmities of old age like dementia and sensory deficits were far more common in people with DS than in controls. Psychiatric and diagnostic aspects of clinical depression and dementia we

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00544.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractAgeing (55 + years) mothers of adults with intellectual disabilities in the Republic of Ireland, Northern Ireland and the United States were compared with respect to three general issues. Firstly, to what extent do the adults in these three countries differ in their level of reliance on their mothers? Secondly, do the mothers differ in the extent to which they have made plans for the future care of their son or daughter with intellectual disabilities? Thirdly, do the mothers differ in physical, social and psychological well‐being? These cross‐national comparisons were undertaken to examine the extent to which lifelong caregiving has either a common influence on mothers across national boundaries, or, alternatively, whether the cultural context exerts a unique influence on mothers In each country. Findings suppxarted the latter explanation, even when background characteristics were statistically control

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00545.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractA cohort of subjects with Down's syndrome born in South Wales, UK, in 1964, 1965 and 1966, and living at home, was studied as infants, teenagers and young adults (the original cohort). Carers were interviewed and the abilities of the subjects assessed, using a variety of measures. Average scores of the cohort improved over the years, although the rate of progress slowed down between the teenage and adult years. Scores were related to social class, stimulation given in the home, and at older ages, maternal age at the birth of the subject. This latter finding was unexpected. A comparative cohort of subjects with Down's syndrome from South Wales born in 1973, 1974 and 1975 was studied as infants and teenagers. They were at the same stage as the original cohort as infants and teenagers, but living 9 years later. In spite of the comparative cohort coming from a favoured background, in terms of social class and having access to improved services, mean scores at the teenage stage were only significantly better on one test of language than those of the original cohort at the same age. Most studies find that females with Down's syndrome have higher abilities than males: this was the case for the original cohort, but not for the comparative cohort.

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00546.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBehavioural disturbance associated with dementia in people with Down's syndrome has not been fully researched. This study investigated such problems in demented Downs’ syndrome subjects and non‐demented Down's syndrome controls. Changes in mood, difficulty with communication, gait deterioration, loss of self‐care skills, sleep disturbance, day‐time wandering and urinary incontinence were found to be associated with dementia. Problems giving the greatest cause for concern to carers were restlessness, loss of communication skills, urinary incontinence and wandering. Care provision specifically focused on management of behavioural disturbance in individuals who develop dementia is reco

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00547.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractTwo hundred and one individuals with Down's syndrome were assessed for evidence of overweight and obesity. Thirty‐one per cent of males and 22% of females were overweight, while 48% males and 47% females were obese. Overweight and obesity was significantly associated with living in the family home compared to supervised community units or in hospital. No association with the degree of learning disability vras foun

ISSN:0964-2633    

DOI:10.1111/j.1365-2788.1995.tb00548.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY