The Relationship of Functional Variables and Psychopathology to Aggressive Behavior in Persons With Severe and Profound Mental Retardation

A number of hypotheses have emerged regarding the etiology of physical aggression in persons with mental retardation. Although a multicomponent model is appropriate, results of functional analysis-based studies have yielded promising results in identifying instigating and maintaining factors of aggression. However, the relationship between functional variables and conditions such as psychiatric diagnosis to aggressive behavior has yet to be investigated in persons with mental retardation. We conducted a study examining the prevalence of environmental or physical factors in aggressive behavior in mentally retarded persons with and without psychiatric disturbance. One hundred and thirty-five individuals with mental retardation who exhibited physical aggression were assessed with the Questions About Behavior Function Scale (QABF) to identify environmental or physical contribution to aggressive behavior. One or more behavioral functions were identified for 75% of the participants. Additionally, of 66 of the participants scoring above the clinical cutoff on an assessment for dual diagnosis, 75% met criteria for an environmental or physical function for aggression. No significant differences in number of participants with an identifiable function of aggression were found between the no dual diagnosis and dual diagnosis groups. Our findings underscore the importance of identifying functions underlying aggressive behavior in persons with mental retardation, and the need to consider functional variables regardless of psychiatric condition in treatment planning efforts for such individuals.     

Validation of Two Hand Test Indices of Aggressive Behavior an Institutional Setting

The purpose of this investigation was to determine the effectiveness of the Hand Test (Wagner, 1962/1983) in differentiating among mentally retarded adults placed in community housing versus those discharged from an institution due to violent and destructive behavior. Hand Test protocols of 24 mentally retarded adults who were discharged from an institution for violent and destructive behavior were compared with those of 12 mentally retarded adults who were placed in community housing, with regard to the presence of two indices of aggressive behavior (the acting-out score, AOS, and the movement response, ACT-MOV). Results indicated that 20 of the 24 residents discharged for aggressive behavior manifested one or more of the signs, whereas only 3 of the 12 residents discharged to a less restrictive environment exhibited one or more of the signs. The findings further demonstrate the usefulness of the Hand Test in predicting violent and destructive behavior in an institutional setting.     

Validation of two Hand Test indices of aggressive behavior in an institutional setting

The purpose of this investigation was to determine the effectiveness of the Hand Test (Wagner, 1962/1983) in differentiating among mentally retarded adults placed in community housing versus those discharged from an institution due to violent and destructive behavior. Hand Test protocols of 24 mentally retarded adults who were discharged from an institution for violent and destructive behavior were compared with those of 12 mentally retarded adults who were placed in community housing, with regard to the presence of two indices of aggressive behavior (the acting-out score, AOS, and the movement response, ACT-MOV). Results indicated that 20 of the 24 residents discharged for aggressive behavior manifested one or more of the signs, whereas only 3 of the 12 residents discharged to a less restrictive environment exhibited one or more of the signs. The findings further demonstrate the usefulness of the Hand Test in predicting violent and destructive behavior in an institutional setting.     

Measurement of range of motion in individuals with mental retardation and with or without Down syndrome

The purpose of this study was to assess differences in variability of three joints' range of motion in the lower extremity among individuals with Down syndrome, mentally retarded individuals without Down syndrome, and sedentary subjects without mental retardation (ns = 13, 25, and 30, respectively). Range of motion for hip and knee flexion was obtained using a Myrin goniometer. For hip abduction the range of motion was obtained using a double protractor goniometer (Brodin type). Three test repetitions were carried out, and the greatest value was recorded. As no significant differences were found between left and right sides for each motion, the average was used to represent the range of motion. The Down syndrome group had significantly higher mean range of motion in hip flexion than the mentally retarded group. No significant differences in mean range of motion were found between Down syndrome and sedentary groups, but a significant difference was observed between the control and mentally retarded groups. In hip abduction, the Down syndrome group showed significantly higher mean range of motion than the control and mentally retarded groups. The control group had significantly a higher mean range of motion than the mentally retarded group. No significant differences were found in knee flexion between the two mentally disabled groups, but significant differences in mean range of motion were found between each of the two groups of mentally retarded individuals and the control group. Because differences exist in mean range of motion between the two mentally disabled groups, individualized and differentiated training programs to improve flexibility must be designed based on the type of handicap.     

The effect of social skills training procedures on the acquisition of appropriate interpersonal skills for mentally retarded adults

A pretest/posttest control group design was utilized to examine the effect of social skills training on social interactions with peers, conversational interactions with a novel partner, and ratings of overall social functioning. The results failed to support the hypothesis that social skills training could increase the generalization of overall conversational responding of mentally retarded adults. The results showed that social skills training augmented with self-monitored videotape feedback could not optimize the effects of social skills training alone. The subjects did demonstrate acquisition of the targeted behaviors during training by meeting preestablished criteria for all of the training sessions. However, the subjects failed to generalize those behaviors across settings to in vivosocial situations.     

Daily suppression of discrete emotions during the work of police service workers and criminal investigation officers

Abstract

This study provided an initial test of a theoretical model which emphasizes patterns of actual and perceived control. The model suggests that profiles of actual and perceived control are differentially related to emotional and behavioral problems. We examined whether anxiety and depression symptoms and aggressive behavior would differ among diverse patterns of actual (caregiver reported competencies) and perceived control (anxiety-related control beliefs) in youth (n=203). Results were consistent with the theoretical predictions in that reported levels of anxiety and depression symptoms and aggressive behavior varied depending upon youth's control profiles. For example, youth with high actual and low perceived control exhibited relatively more anxiety/depression symptoms than aggressive behavior, while those youth with low actual and high perceived control exhibited relatively more aggressive behavior. Furthermore, youth with both high actual and perceived control reported and were reported by caregivers as having the least anxiety/depression symptoms and aggressive behavior, respectively. The findings provide empirical support for the model and suggest the importance of considering the role of actual and perceived control in emotional and behavioral problems. Implications for future tests of the model are also discussed.     

The collateral decrease of self-injurious behavior with teaching communicative gestures to individuals who are mentally retarded

The present study assessed the effect of teaching communicative gestures on the occurrence of self-injurious behavior and other behavior disorders with 14 individuals who are severely/ profoundly mentally retarded. Results show a statistically significant decrease of about 40% in self-injurious behavior as a collateral effect of an increased use of communicative gestures. Apart from a decrease in the occurrence of destructive behaviors, no other effects on other behavior disorders were found. Results are discussed in terms of the possible use of communicative gestures as a therapeutic supplement to standard procedures for decreasing self-injurious behavior with individuals who are nonverbal and mentally retarded.     

Automatic and conscious processing in retarded and nonretarded adolescents

Educable mentally retarded and nonretarded adolescents participated in incidental learning tasks that emphasized the utilization of processes that were consciously controlled but not deliberately aimed at memory (Experiment 1). Retarded individuals' performance on a standard recognition test was equivalent to that of nonretarded subjects following phonetic encoding and nonstrategic encoding, but was deficient following semantic encoding. Retarded subjects also demonstrated a lower level of performance on a rhyme recognition task. In Experiment 2, retarded subjects provided a pattern of responding identical to that of nonretarded subjects on a picture-word interference task designed to assess automatic processing. The two groups produced equivalent levels of semantic activation. It was argued that the results of the two experiments indicate deficient semantic processing on the part of retarded individuals relative to that of nonretarded individuals that cannot be accommodated by a structural-deficiency model, a developmental-lag model, or a hypothesis that predicts intelligence-related differences only when the task involves the use of deliberate mnemonic strategies.     

STIMULUS OVERSELECTIVITY IN LEARNING DISABLED CHILDREN

Stimulus overselectivity, a phenomenon exhibited by autistic and institutionalized retarded individuals, was examined in mildly handicapped and nonhandicapped public school children. Subjects were 16 young, educable mentally retarded, 16 learning disabled, 15 nonhandicapped first- and second-graders, and 16 older, educable retarded students. The children were trained on a 3-component visual discrimination task and then tested on individual elements to determine which element or elements were controlling subject responses. Nine of the young educable mentally retarded children and eight of the learning disabled students showed some overselectivity. The majority of overselective retarded children were controlled by only one of the three components of the training cue, whereas the majority of the overselective learning disabled children responded to the discrimination task on the basis of two of the three components. No overselectivity was exhibited by the nonhandicapped students. All three cue components were also functional in controlling the responding of 14 of the 16 older retarded students, but two children were under the control of only one cue. The research indicated that in terms of overselectivity, learning disabled children respond more like young, mildly retarded children than they do like nonhandicapped ones. The demonstration of stimulus overselectivity in a sizable portion of a learning disabled sample may have implications for a more empirically based approach to this handicapped population.     

The differential validity of hyperactivity/attention deficits and conduct problems among mentally retarded children

The independence of hyperactivity, attention deficits, and conduct problems among mentally retarded children was addressed using factors of the Conners' Teacher Rating Scale-39 (CTRS-39) and the more recently developed IOWA Conners' inattention/overactivity (IO) and aggression (A) subscales. CTRS-39 ratings were obtained for children of normal intelligence and for mentally retarded children. Differences between the groups were examined as were intercorrelations of the Conners' factors and IOWA subscales. Conduct problems proved to be less strongly associated with hyperactivity and attention deficits among mentally retarded children compared to children of normal intelligence. However, attention problems and conduct problems may be associated with mental retardation in general. Implications of these data and CTRS scoring system recommendations for mentally retarded children are discussed.     

The lack of effects of enriched and automated environments on the adaptive and maladaptive behavior of mentally retarded persons

This study addressed the relative effects of repeated exposures to an austere institutional dayroom, a toy enriched dayroom, a PUSH (Play Units for the Severely Handicapped) room that contained automated stimulation devices within a physical terrain, and a modular room that contained wall mounted automated stimulation devices, on the adaptive and maladaptive freeplay behavior of six groups of institutionalized mentally retarded individuals (N = 6 per group). Group One was observed in all four settings, whereas the other five were observed in two or more of the active settings. The results indicated that (1) there were only slight differences in object-directed adaptive behavior when the three active settings were compared to the austere setting, and (2) only the higher functioning subjects (Group Five) displayed consistent individual differences on any of the measures when active settings were compared. None of the comparisons, however, revealed statistically significant effects. This study clearly demonstrates the need for active control conditions, raises questions regarding the relevance of much of the previous research, and suggests that further refinements will be necessary before environments such as those in the present study produce meaningful changes in appropriate environmental interaction in the absence of staff mediation.     

Does medics' social identification increase handicap for mentally retarded patients?

Briefs about mentally retarded people are more negative than briefs about other social categories; professionals, such as medical doctors evaluate them most negatively of all. It was hypothesized (a) that medics' beliefs about mentally retarded people are mediated by psychological salience of their clinical social identification, rather than by personal characteristics that medics happen to share and (b) that such beliefs will bias decisions, rather than enhance accuracy. Forty-five doctors and medical students were randomly assigned to conditions designed to enhance salience of their shared clinical social identification or individual self-perceptions. Subjects completed semantic differentials about mentally retarded people and distinguished between slides of ‘mentally retarded’ and ‘normal’ children. Beliefs of subjects in the medical condition were significantly more negative than those in the personal condition. A signal detection analysis revealed no difference between conditions in subjects' ability to distinguish between children but showed that subjects in the medical condition were significantly more likely to judge a child ‘mentally retarded’ when in doubt. Results were discussed within an information processing framework and supported the idea that a salient clinical social identity can mediate beliefs that are likely to handicap patients.     

自闭症幼儿的情感认知特点的实验研究

本实验采用3(组别)×4(基本情绪)×3(实验材料)×2(实验条件)的混合设计的方法对平均心理年龄24个月的6名自闭症幼儿和心理年龄与之相近的6名正常儿童和6名弱智儿童的情感认知特点进行了比较性的研究。实验结果表明:在“语言提示”条件下,自闭症幼儿的正答率远远低于正常儿童和弱智儿童,但在“表情提示”条件下,自闭症幼儿与弱智幼儿几乎没差距,在对“愤怒”和“惊恐”等情绪的认知中,正答率高于弱智幼儿。这意味着自闭症幼儿可能运用了其他的替代策略进行情感认知。     

An Investigation of the Nature of Non-Directive Psychotherapy

An experiment was performed to assess the effects of mental age (MA) and external cues on response inhibition in the mentally retarded. Twelve Ss were presented with an experimental task which required that they withhold responding for five or more seconds before pressing a key to obtain reinforcement. For half the Ss the key was lighted (cued) during the waiting interval, while it was unlighted (uncued) for the other half. The results indicate that (a) response inhibition increased with MA and (b) MA differences might have been due to an inability to mediate the delay interval. The results were interpreted in terms of possible mediating mechanisms and implications for training inhibitory performance in the mentally retarded.     

Planning ability across ranges of intellectual ability: An examination of the Luria-Das information-processing model

According to the Luria-Das information-processing theory, impaired planning ability is the source of more generalized cognitive deficits in mentally retarded populations. Also, the model suggests the possibility of relative independence between unit 2 (planning) and unit 3 (coding) abilities for mentally retarded individuals. Consequently, it was predicted that 26 educable mentally retarded (EMR) children would score significantly less well on relatively pure measures of planning ability than 13 younger average-ability children after the children were matched on cognitive processing ability (Mental Age of the Kaufman Assessment Battery for Children). Moreover, it was predicted that teaching an optimal planning strategy to randomly selected individuals of both groups would improve the EMR group's scores relative to the average-ability group. Neither prediction was supported. The results are not inconsistent with the model, but can be explained parsimoniously by neurodevelopmental stage theories also.     

Caregiver interactions with autistic children

Caregiver interactions with young autistic children were contrasted with those involving caregivers and developmentally matched mentally retarded and normal infants. Caregivers of autistic children were similar to other caregivers in their responsiveness to child nonverbal communication bids and in their engagement in mutually sustained play. Caregivers of autistic children were similar to caregivers of mentally retarded children in their greater use of control strategies. However, these two groups of caregivers differed in the particular strategies they used to shape their children's behavior. Caregivers of mentally retarded children pointed to objects while caregivers of autistic children spent more time physically holding their children on task. Individual differences within the autistic sample indicated that caregivers regulated their children's behavior less and showed more mutual play and positive feedback to more communicatively able autistic children. These findings suggest that caregivers respond differentially to the specific deficiencies shown by their children.     

Androgens and aggression in man: A controlled case study

A controlled case study is reported of the behavioural effects of androgen treatment in an institutionalised hypogonadal mentally retarded male patient. This man was previously treated with intramuscular depot injections of testosterone esters; however, treatment had to be stopped as the androgens allegedly precipitated frequent bouts of violent behaviour. Using ratings of behaviour by hostel staff, replacement therapy was restarted using the new orally effective androgen, testosterone undecanoate (TU). Gradually increasing the replacement dose of TU in a double-blind fashion resulted in no stimulatory effect on aggressive behaviour. Possible reasons for the differential behavioural response to the two androgen preparations are presented.     

Differential effects of the menstrual cycle on reactive and proactive aggression in borderline personality disorder

Borderline personality disorder (BPD) is characterized by rapidly shifting symptoms, including intense anger and aggressive behavior. Understanding how fluctuations in ovarian hormones across the menstrual cycle may contribute to symptom instability is key for accurate assessment of BPD symptoms and effective interventions. Reactive and proactive aggression, as well as anger-in and anger-out, were assessed daily in 15 physically healthy, unmedicated naturally cycling female individuals meeting criteria for BPD across 35 days. Urine luteinizing hormone surge and salivary progesterone were used to confirm ovulation and verify the cycle phase. Multilevel models evaluated cyclical differences of symptoms between cycle phases. Both forms of aggressive behavior demonstrated marked cycle effects, with reactive aggression highest during the midluteal cycle phase, co-occurring with initial increases in anger and irritability and followed by perimenstrual peaks in anger and anger-in. In contrast, highest levels of proactive aggression were observed during the follicular and ovulatory phases, when emotional symptoms and anger were otherwise at lowest levels. These findings highlight the importance of identifying the function of aggression when considering potential psychological and biological influences. Naturally cycling individuals with BPD may be at elevated risk for luteal worsening of a range of interpersonally reactive symptoms, including reactive aggression, whereas proactive aggression may occur more in phases characterized by less emotional and cognitive vulnerability and greater reward sensitivity. Research on aggression in this population should consider cycle effects. Cycling individuals with BPD attempting to reduce aggressive behavior may benefit from cycle-tracking to increase awareness of these effects and to develop appropriate strategies.