Change in self-stigma among persons with schizophrenia enrolled in rehabilitation: associations with self-esteem and positive and emotional discomfort symptoms

Self-stigma is a barrier to the recovery of persons with schizophrenia. Little is known about whether participation in rehabilitation is naturalistically linked to declines in self-stigma, and if so, what is correlated with changes in self-stigma. The current study examined in a quasi-experimental design the rate of change of self-stigma and whether changes were correlated with self-esteem, positive symptoms, and emotional distress for persons enrolled in rehabilitation. Symptoms were measured using the Positive and Negative Syndrome Scale (Kay, Fizsbein, & Opler, 1987), self-esteem was measured with the Multidimensional Self-Esteem Inventory (Lysaker, Ringer, & Davis, 2008), and self-stigma was assessed using the Internalized Stigma of Mental Illness Scale (Ritsher, Otilingam, & Grajales, 2003). Seventy persons with schizophrenia who worked at least one month in a vocational rehabilitation program were assessed on all measures at baseline and five months later. Results indicated a 25% decrease in self-stigma for 38% of the sample; these individuals tended to have less emotional distress both at baseline and follow-up, and had higher levels of self-esteem at follow-up. No differences in positive symptoms were found for groups whose stigma did or did not decrease. Results suggest that decreases in self-stigma may be correlated with increased self-esteem, while higher levels of emotional distress may be a barrier to stigma reduction.     

Obesity and intellectual disability

While much of the industrialized world struggles for clues to the growing rise in obesity in their respective countries, researchers and service providers involved in understanding the health characteristics and health behaviors of persons with intellectual disability (ID) struggle with their own issues regarding the increased prevalence of obesity in this segment of the population. What is particularly alarming is that adults with ID residing in the United States in smaller, less supervised settings (e.g., group homes and family households) have a significantly higher rate of obesity compared to other countries and those living in larger and more supervised settings (e.g., institutions). These differences support the theory that the environment appears to exert a powerful influence on obesity in this population. Obesity presents a substantial threat to the livelihood of persons with ID and may have an effect on community participation, independent living, and healthy years of life. The lack of research on successful weight reduction strategies for obese persons with ID makes this an important and greatly needed area of research.     

Disgust and psychopathological symptoms in a nonclinical sample

There is little doubt that disgust sensitivity plays a role in the development of small animal phobias. However, it has been suggested that the basic emotion of disgust is implied in a broad range of psychopathological conditions. The present study examined the relationship between disgust sensitivity and symptoms of phobias (other than animal phobias), obsessive–compulsive disorder, depression, and eating disorder in a nonclinical sample. Undergraduate psychology students were asked to complete the Disgust Sensitivity Questionnaire, as well as measures of phobic (Fear Questionnaire), obsessive–compulsive (Maudsley Obsessive–Compulsive Inventory), depressive (Beck Depression Inventory), and eating disorder (Restraint Scale) symptomatology. Results showed that disgust sensitivity was only related to symptoms of agoraphobia and obsessive–compulsive disorder. The present findings cast doubts on the idea that disgust sensitivity is a central factor underlying a broad range of psychopathological conditions.     

Career adaptability,hope and life satisfaction in workers with intellectual disability

The unpredictable and unstable current work market is impacting in particular at-risk workers, such as individuals with disability. Based on Life Design approach, the present study focused on two variables, career adaptability and hope, relevant to coping with the current work context and their role in affecting life satisfaction. A partial mediational model between career adaptability and life satisfaction, through agency and pathway (hope), was tested. 120 (60 women and 60 men) adult workers with mild intellectual disability were involved. Results provided support for the model. Specifically, career adaptability indirectly, through agency and pathway, predicted life satisfaction. These results have important implications for practice and underscore the need to support workers with disability in their life design process.     

Adjustment, social skills, and self-esteem in college students with symptoms of ADHD

Many studies of ADHD have shown that the problems associated with the disorder continue into adolescence and beyond for 10% to 60% of patients. The present study assesses several aspects of college adjustment, social skills, and self-esteem in a nonreferred sample of college students meeting criteria for a Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis of ADHD. Twenty-one undergraduate students with symptoms of ADHD are compared to 20 students without significant ADHD symptoms, who match the ADHD students on age, gender, and grade point average. Students with ADHD symptoms show decreased functioning in several areas of college adjustment as well as lower levels of self-reported social skills and self-esteem. The results also suggest that the relation between ADHD and college adjustment is partially mediated by self-reported levels of self-esteem.     

Self-concept clarity and religious orientations: prediction of purpose in life and self-esteem

The present study concerns the relationship between self-concept clarity, religiosity, and well-being, as well as the mediating influence of religiosity on the relationship between self-concept clarity and sense of meaning in life and self-esteem. Self-concept clarity was found to be a significant predictor of sense of meaning in life and self-esteem; intrinsic religious orientation was found to be a predictor of sense of meaning in life, while the quest religious orientation was a predictor for self-esteem. The cross-products of self-concept clarity and intrinsic religious orientation were found to be related to the sense of purpose in life, which would point to religiosity being a mediator of the relationship between self-concept clarity and sense of purpose in life. The cross-products of self-concept clarity and quest religious orientation were found to be a predictor of self-esteem, which indicates a mediating effect of this religious orientation in the relationship of self-concept clarity and self-esteem.     

Threat perception distortions and psychopathological symptoms in typically developing children

This study examined relationships between symptoms of anxiety, aggression, and depression, on the one hand, and threat perception distortions, on the other hand. A large sample of typically developing children aged 8–12 years (N=157) were interviewed with an instrument for assessing the main types of childhood psychopathology, and were then exposed to a series of ambiguous vignettes in order to measure threat perception. As all measures were obtained twice, some 8 weeks apart, it was also possible to study prospective relationships between threat perception distortions and psychopathological symptoms. Results showed that threat perception was associated with a broad range of psychopathological symptoms, although the connection with anxiety was the most robust. No support was found for the notion that threat perception scores were predictive for the persistence of psychopathological symptoms during the 8‐weeks period. Copyright © 2005 John Wiley & Sons, Ltd.     

Task instructions for persons with severe intellectual disability: reducing the number of instruction occasions after the acquisition phase

During the first part of the study, eight tasks were taught to four participants with severe intellectual disability. A portable computer‐aided system was used that presented one pictorial instruction per task step, individually. During the second part of the study, the same computer‐aided system was used but the number of instruction occasions available for the tasks was reduced. In one condition, the system presented all the step instructions but mostly in small clusters rather than individually. In another condition, the system presented only some of the instructions. Data for the first part of the study showed that the participants managed to perform 83–97% of the task steps correctly. Data for the second part of the study showed that the condition in which instructions were clustered was more effective in maintaining high percentages of correct performance. Implications of the findings are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

Impulsivity in non-clinical persons with obsessive-compulsive symptoms

This study explored the relations between obsessive-compulsive symptoms and four facets of impulsivity (Urgency, Lack of Premeditation, Lack of Perseverance, Sensation seeking) in 220 non-clinical individuals. The results revealed a strong link between Urgency and obsessive-compulsive symptoms. In addition, Lack of Premeditation negatively predicted the Checking and Ordering subscales, while Lack of Perseverance was positively linked with Obsessions and negatively with Ordering. Finally, no relation was found between obsessive-compulsive symptoms and Sensation seeking. These results suggest that it is necessary to differentiate between different facets of impulsivity and different obsessive-compulsive symptoms to study the relationship between these two constructs.     

Vision and oral health needs of individuals with intellectual disability

Over the past 20 years, there has been an increased emphasis on health promotion, including prevention activities related to vision and oral health, for the general population, but not for individuals with intellectual disability (ID). This review explores what is known about the prevalence of vision problems and oral health conditions among individuals with ID, presents a rationale for the increased prevalence of these conditions in the context of service utilization, and examines the limitations of the available research. Available data reveal a wide range of prevalence estimates for vision problems and oral health conditions, but all suggest that these conditions are more prevalent among individuals with ID compared with the general population, and disparities exist in the receipt of preventive and early treatment for these conditions for individuals with ID. Recommendations for health improvement in these areas include better health planning and monitoring through standardized population-based data collection and reporting and increased emphasis on health promotion activities and early treatment in the healthcare system.     

Contextual control in teaching numbers to a child with intellectual disability

The aim of this work was to teach the discrimination of "equal" and "different" in numbers. The experiment was carried out a seven-year-old child with intellectual disability. The problem was analysed from the contextual control perspective. The learning procedure consisted of explicitly teaching a second-order conditional discrimination, and transfer to a novel second-order conditional discrimination was tested. In this study, the boy learned that, in presence of X1 (equal), he had to select the comparison B1 (the number one), given the sample A1 (the word one) and B2 (the number two), given A2 (the word two). He also he learned that, in the presence of X2 (different), he had to select the comparison B2 (the number two), given the sample A1 (the word one) and B1 (the number one), given A2 (the word two). We subsequently presented the contextual stimuli with two new numbers: three and four. The results showed the occurrence of learning transfer without explicit training in the new numbers.     

Restraint safety in a residential setting for persons with intellectual disabilities

The primary purpose of this study was to estimate the risks associated with the use of emergency personal restraints at a residential facility for persons with intellectual and developmental disabilities. A secondary purpose was to determine if correlates of restraint‐related injury could be determined. One in three restraints resulted in an injury, but all of the injuries were minor. In terms of prediction, frequency of aggressive behavior use was the best single predictor of restraint‐related injury. Copyright © 2009 John Wiley & Sons, Ltd.     

Screening for intellectual disability in Dutch police suspects

The screener for mild intellectual disability (SCIL) was developed to screen for mild intellectual disability (IQ below 85). The aims of this study were (a) to examine the predictive validity of the SCIL in screening for intellectual disability among police suspects and (b) to explore the prevalence of cognitive intellectual disability among suspects in police custody in the Netherlands. An unselected sample of police suspects (N = 178) charged with a variety of offences was assessed with the SCIL, a Wechsler Adult Intelligence Scale (WAIS)‐III‐NL short form, and a malingering measure. The SCIL screened 50.0% of the sample as having mild intellectual disabilities, whereas the short WAIS classified 84.3% of the sample with an IQ below 85. A principal component analysis of the SCIL showed ambiguous results. Furthermore, the short WAIS classified 55.6% of our sample with a borderline IQ (IQ = 70–84), 84.3% with an IQ below 85 and 28.7% with an IQ below 70. The prevalence of intellectual disability in this sample of Dutch (police) suspects appears to be higher than prevalence rates found in previous international studies. More exhaustive research is needed to examine the prevalence of intellectual disabilities in police suspects, and the utility of the SCIL to screen for these disabilities.     

Occupational stress and burnout amongst staff working with people with an intellectual disability

The Occupational Stress Inventory (Osipow & Spokane, 1987) and the Maslach Burnout Inventory (Maslach, 1982) were used to assess the levels of occupational stress and burnout amongst staff providing services to people with an intellectual disability both in an institutional and community settings. Data were analyzed to determine the effects of direct client contact, staff mental health, and working environment (institution vs. community). While levels of burnout and occupational stress were not high overall, staff working in an institutional setting scores more highly.     

A quantitative review of overjustification effects in persons with intellectual and developmental disabilities

The overjustification hypothesis suggests that extrinsic rewards undermine intrinsic motivation. Extrinsic rewards are common in strengthening behavior in persons with intellectual and developmental disabilities; we examined overjustification effects in this context. A literature search yielded 65 data sets permitting comparison of responding during an initial no‐reinforcement phase to a subsequent no‐reinforcement phase, separated by a reinforcement phase. We used effect sizes to compare response levels in these two no‐reinforcement phases. Overall, the mean effect size did not differ from zero; levels in the second no‐reinforcement phase were equally likely to be higher or lower than in the first. However, in contrast to the overjustification hypothesis, levels were higher in the second no‐reinforcement phase when comparing the single no‐reinforcement sessions immediately before and after reinforcement. Outcomes consistent with the overjustification hypothesis were somewhat more likely when the target behavior occurred at relatively higher levels prior to reinforcement.     

Assessing the accuracy of the WISC-IV seven-subtest short form and the child and adolescent intellectual disability screening questionnaire in identifying intellectual disability in children

Little research has been conducted into the accuracy of abbreviated assessments in identifying children and young people with an intellectual disability (ID). The present study compared two such methods in a clinical population of individuals with (n = 106) and without (n = 170) ID: a 7-subtest short form of the Wechsler Adult Intelligence Scales for Children—fourth edition (WISC-IV) proposed by Crawford and colleagues and the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q). Both the CAIDS-Q and the WISC-IV short form had high and comparable levels of predicting group classification (88% and 91% correct classification, respectively). Both methods would appear to offer clinicians and researchers an efficient and accurate means of identifying those who are likely to have ID. The WISC-IV short form was slightly more accurate, but the CAIDS-Q may offer the advantages of being shorter to administer and having no requirement for the user to have a particular qualification or training.     

The behavioural treatment of sleep difficulties in children with an intellectual disability

Reinforcement, instruction giving, partner support strategies, bedtime routine, and standard extinction were taught to the parents of three boys (aged 5–10 years) with an intellectual disability and sleeping difficulties. Sleep was measured using sleep diaries and actigraphy, and daytime behaviour was monitored using diaries and direct observation. At referral, all children needed a parent present to fall asleep, two had co‐sleeping difficulties, and two had night waking difficulties. At post‐intervention, all children were falling asleep independently, co‐sleeping was eliminated for two children, and night waking was reduced in one child. An extinction burst was experienced by two children, with one family putting their child back to bed 259 times on the first night. Though one child still had night waking difficulties following intervention, actigraph recording demonstrated an improvement in his sleep quality. In addition to the children's independence, improvements were seen for sleep length, sleep latency, and morning wake time. However, improvements in daytime behaviour showed inconsistency across behaviours and settings. Improvement in sleep was maintained at a three month follow‐up. It was concluded that using extinction to address sleep problems in children with an intellectual disability is effective and approved of by parents, but any impact on daytime behaviour is equivocal. Copyright © 2002 John Wiley & Sons, Ltd.