Abuse of persons with mental retardation: A literature review

The literature reports a number of reasons why abuse of people with mental retardation occurs. These causes of abusive behavior can be divided into three categories: organizational variables, staff characteristics, and client characteristics. The author examines each of the variables and presents recommendations for reducing their contributions to abusive behavior.     

Involuntary sterilization of persons with mental retardation: an ethical analysis

Legitimate concerns on the part of parents and guardians may lead to requests for sterilization of a mentally retarded person in their care. At the same time, mentally retarded persons must be protected from actions that do not serve their best interests. This paper will review the history of involuntary sterilization in the United States and evaluate the ethical arguments that are relevant to decisions about involuntary sterilization. While other, less permanent forms of contraception might be acceptable, involuntary sterilization ought not be performed on mentally retarded persons who retain the capacity for reproductive decision-making, the ability to raise a child, or the capacity to provide valid consent to marriage. Mentally retarded persons who lack capacity in those three areas should be considered for involuntary sterilization only when the procedure is necessary, sterilization would serve the best interests of the mentally retarded person, less intrusive and temporary methods of contraception or control of menstruation are not acceptable alternatives, and procedural safeguards have been implemented to assure a fair decision-making process.     

Personality and mental health: an investigation of South African police trainees

The relationship between personality and mental health was investigated in one cohort of police trainees at a South African police academy (1145 police recruits; 648 men, 497 women). Male trainees reported less somatisation, depression, anxiety, and phobic anxiety symptoms and lower harm avoidance as well as higher persistence than female trainees. A cluster analysis based on the personality scores was used to identify three clusters with personality profiles characterized as Vulnerable, Healthy, and Intermediate profiles. Sociodemographic variables and temperament and character domain scores contributed separately and differentially to the explanation of variance in mental health symptom scores. Selection tools should be developed to identify vulnerable individuals in terms of personality characteristics during selection and prior to training, to prevent later problems with stress reactions. Additional training modules focusing on coping skills could possibly reduce vulnerability to stress in some trainees.     

Effects of Responding or Not Responding to Hecklers on Audience Agreement with a Speaker

The hypothesis that responding to hecklers would produce more agreement with a speaker than not responding, stemmed from commodity theory (Brock, 1968). One hundred twenty-one introductory speech students participated in what they were told was a "speech workshop" (not a psychology experiment). Two types of responding to live hecklers were used: In one, the speaker responded in a calm, relevant manner; in the other, she responded in an upset, irrelevant manner. In a third condition, the speaker did not respond to the heckles. There were two additional conditions: One in which the speaker responded to interruptions, and a further control in which there were neither heckles nor interruptions. In these five conditions, the speaker either argued for or against the audience's position. Regardless of whether or not the speaker's position agreed with the audience's, upset-irrelevant responding decreased the speaker's persuasiveness over making no response, while calm-relevant responding tended to enhance persuasiveness. Finally, in agreement with all other empirical studies, it was clearly shown that heckling, whether responded to or not, did not improve the speaker's effectiveness.     

Review of refugee mental health and wellbeing: Australian perspectives

This review covers refugee mental health and wellbeing within the Australian context to assist psychologists who provide services for, or who conduct research with, refugees. It provides a brief overview of the refugee movement, prior to examining evidence relating to the impacts of pre‐displacement, displacement and resettlement factors on psychological adjustment in the resettlement phase, and the systemic and sociopolitical factors that influence the process of adaptation during resettlement. Australian findings suggest that mental health and wellbeing outcomes are influenced by a complexity of pre‐displacement, displacement, resettlement and systemic factors; the detention or award of temporary residence to refugees who are already experiencing psychological distress on arrival are cases in point. Limitations of the findings are considered. More research into the combined, pathwise relations between the psychosocial pre‐determinants and psychological sequelae of the refugee experience is required. Finally, suggestions for the development of practice, training and ethical guidelines are offered.     

Cardiovascular disease prevalence and risk factors of persons with mental retardation

This paper reviews the recent literature on cardiovascular disease (CVD) prevalence, CVD-related mortality, physiological CVD risk factors, and behavioral CVD risk factors in adults with mental retardation (MR). The literature on the potential influences of modifiable behavioral CVD risk factors and the physiological CVD risk factors are also reviewed. Adults with mild to moderate MR residing in community settings appear to have an elevated disease prevalence, elevated CVD-related mortality, more adverse physiological CVD risk factors, and elevated behavioral risk compared to others with and without MR. Preliminary evidence supports the benefits of participating in the recommended physical activity levels and consuming the recommended diets to reduce the risk for CVD. The lack of large-scale longitudinal or experimental research indicates a gap in the research. The development of research-based, appropriate, primary prevention programs and intervention strategies aimed at lowering the risk for CVD is highly recommended. Programs should focus on educating individuals with MR along with direct care providers and family members on the importance of appropriate dietary concepts, physical activity habits, and regular health screenings by physicians. Programs should be individualized to regional and cultural issues.     

Relation between self-paced and synchronized movement in persons with mental retardation

The relation between self-paced and synchronized tapping in 64 persons with mental retardation whose mental ages ranged from 2 to 11 years and chronological ages from 13 to 23 years was investigated. In a self-paced tapping task no stimulus was presented, and subjects' easy and spontaneous tapping was measured. In a synchronized tapping task their synchronous tapping with an auditory stimulus present at a quick or slow tempo was measured. Under both tempo conditions, the lower the subjects' mental age, the larger the errors in the intertap interval they made. The subjects of low mental age showed significantly larger errors in the intertap interval in the Slow than in the Quick Tempo condition and tended to tap at a rate near the self-paced tapping. These results may suggest that ability to adjust one's self pace is one of the key factors in the development of motor synchronization in persons with mental retardation.     

Families of persons with Down syndrome: new perspectives, findings, and research and service needs

To understand the families of offspring with Down syndrome, this article begins by describing the change in orientation--from "negative" to "stress-and-coping" perspectives--in studies of families of offspring with disabilities. In reviewing the existing studies, mothers, fathers, and siblings cope slightly better than family members of persons with other disabilities, a phenomenon called the "Down syndrome advantage." Beyond this more general finding, however, much remains unknown. Most studies examine only parental or sibling levels of stress or coping, leaving unknown the marital, occupational, health, educational, and other "real-world" outcomes for these family members. Increased research attention is needed to understand the life-span needs of families of persons with Down syndrome and the impact of cultural and sociocultural diversity on family outcomes. It will also be important to relate family outcomes to differences in the offspring's behaviors, development, relationships, medical conditions, psychopathology, and the presence (and effectiveness) of needed support services. Although these families have received some research attention over the past several decades, we now need to make family research in Down syndrome more concrete, more life-span, and more tied to characteristics of the individual with the syndrome and the family's surrounding support system.     

Brief report: Non-intrusive operant analysis of aggressive behavior in persons with mental retardation

A procedure for operant analysis of aggressive behavior was derived from multi-element assessment methods that have been previously applied to both self-injurious and stereotypic responding. Analog sessions included No Interaction Baseline, Social Disapproval, Demand, Social Reinforcement, and Discriminated Extinction conditions, repeatedly presented within a multi-element design. Three men with differing severity of mental retardation, communicative deficits and aggressive behavior were exposed to multiple brief analog sessions embedded within their normal meal-time routines in group home settings. Mean frequencies of aggressive behavior and concurrent eating indicate that, while aggressive behavior was negatively reinforced in all three participants, both social and non-social contingencies were also prominent. The same contingencies which have been demonstrated to maintain self-injury and stereotypic behavior can therefore also maintain aggression. Results suggest the feasibility of conducting relatively non-intrusive analog assessments in community residences, and support the-extension of functional analysis across differing classes of aberrant behavior.     

Developmental psychology and mental retardation. Integrating scientific principles with treatment practices

The current debates about "best practices" within mental retardation reflect key unresolved issues about the nature of mental retardation and the goals of treatment programs. The central axiom proposed is that better integration of basic principles about human development with treatment practices for children will yield substantial benefits to individuals and society. To illustrate the format for this proposed integration, three principles have been abstracted from scientific inquiry in human development: (a) targeted environmental prevention, (b) metacognitive conveyance, and (c) ecological dominion. A contextual analysis, using special education as an example of a major treatment setting, indicates that application of these developmental principles is likely to reduce the prevalence of mild retardation (as currently defined), to minimize social and behavioral problems, and to foster improved levels of environmental mastery (adaptive success) for many children with low IQs and cognitive deficiencies. Consistent with these developmental principles, the current construct of mental retardation is judged inadequate, and an alternative diagnostic strategy is proposed. This strategy is based on repeated developmental profiling of a child and his or her biosocial environmental history.     

Brief report: Teaching persons with moderate mental retardation to use printed instructions and time cues in a work context

Printed instructions and programable watches were used for helping two adults with moderate mental retardation perform variable tasks and follow a time schedule for task execution. The subjects, who could not read, were to match the words appearing in instruction notes to identical words superimposed on illustrative pictures (and collected in a vocabulary form). The pictures identified through this matching explained the meaning of the words being matched (i.e., indicated to the subjects which responses/tasks to perform). Self-recording was also used. The results showed that both subjects learned to use the printed instructions and the watches successfully. The subjects' performance remained positive over time. Procedural aspects and practical implications of the study are discussed.     

Human participants challenges in youth-focused research: perspectives and practices of IRB administrators

The purpose of this research was to understand institutional review board (IRB) challenges regarding youth-focused research submissions and to present advice from administrators. Semistructured self-report questionnaires were sent via e-mail to administrators identified using published lists of universities and hospitals an Internet searches. Of 183 eligible institutions, 49 responded. One half indicated they never granted parental waivers. Among those considering waivers, decision factors included research risks, survey content, and feasibility. Smoking and substance abuse research among children was generally considered more than minimal risk. These findings are consistent with those from a study conducted by Mammel and Kaplan (1995), which investigated IRB practices concerning protocols involving adolescent participants. IRBs and investigators need to become aware of regulations' flexibility to ensure adequate participant protection. Investigators need to limit jargon and assumptions about participants' understanding of research objectives.     

Responding to deviance: target exclusion and differential devaluation

Two studies explored responses to ingroup deviance. Group-defining opinions of prowar Republicans (Study 1) and prolife Christians (Study 2) were challenged by either an ingroup or outgroup deviate. Participants evaluated the deviate and structured the boundaries of their ingroup in counterbalanced order. Of importance, boundary structuring allowed participants to exclude deviates from the ingroup. Consistent with previous research, ingroup deviates were devalued relative to out-group deviates, but only when target evaluation was participants' first response option. Participants excluded deviates from the boundaries of their ingroup irrespective of measure order, and doing so eliminated differential devaluation when exclusion was participants' first response option. Exclusion decreased liking for outgroup deviates in Study 1 and increased liking for ingroup deviates in Study 2. The findings suggest that devaluation is an attempt to exclude deviates from the ingroup and that doing so reduces the threat otherwise experienced.     

An evaluation of in vivo desensitization and video modeling to increase compliance with dental procedures in persons with mental retardation

Fear of dental procedures deters many individuals with mental retardation from accepting dental treatment. This study was conducted to assess the effectiveness of two procedures, in vivo desensitization and video modeling, for increasing compliance with dental procedures in participants with severe or profound mental retardation. Desensitization increased compliance for all 5 participants, whereas video modeling increased compliance for only 1 of 3 participants.     

Personality and police selection: Trait differences in successful and non-successful applicants to the metropolitan police

Three hundred and nineteen applicants to the Metropolitan Police Force (270 men and 49 women) were asked to complete the EPQ. Successful candidates were more extraverted and less neurotic than unsuccessful ones. No differences were found for P or L scores. All candidates ‘faked good’ displaying unusually high E and L scores and low N and P scores. The 64 applicants who declined to complete the questionnaire were less likely to be accepted into the force than the rest. It is hypothesized that this is because they are less outgoing types than their more willing counterparts. There was no difference in acceptance rates for men and women.     

Effects of reinforced directed rehearsal on expressive sign language learning by persons with mental retardation

This study used a multielement design to compare standard training (prompting and reinforcement) with and without reinforced directed rehearsal as a correction procedure in teaching expressive sign language to 10 nonverbal students with moderate to severe mental retardation. Standard training consisted of either sequential prompting or graduated guidance and 5 students were randomly assigned to each condition. Directed rehearsal involved 10 practices of the correct sign contingent on an error or no response; praise was given during directed rehearsal for cooperation and attempted signing. A stimulus control analysis revealed that only 6 of the 10 students (3 from each standard training condition) completely discriminated the trained signs within the maximum training period of 160 trials (3 of the 4 students who failed the stimulus control test were hearing impaired; the remaining 6 who showed stimulus control were not). Using only these six students' data, we found that directed rehearsal increased: (a) accuracy (percent correct), (b) speed of learning (required fewer trials to criterion), (c) efficiency (decreased total instruction time), and (d) generalization (across trainers, objects, and settings). There were no obvious interactions between directed rehearsal and the type of prompting strategy employed. Very little agitated behavior occurred in any of the sessions, and a treatment acceptability survey indicated that 10 of 14 direct-care staff and the trainers in this study preferred corrective directed rehearsal (as used in this study) over standard training alone. The results indicate that directed rehearsal may be a valuable adjunct to sign language training with nonverbal students with mental retardation.     

Theoretical perspectives on language and communication problems in mental retardation and developmental disabilities

We argue that researchers interested in language and communication problems in mental retardation or any other developmental disorder should view such problems as emerging within the broader context of the behavioral profile, or phenotype, associated with a particular genetic condition. This will require understanding the direct and indirect effects of genes on the development of language and communication and thereby an understanding of the complex relations that exist between language and other dimensions of psychological and behavioral functioning as well as an understanding of the environments in which the developing person acts and is acted upon. We believe that the dominant model for understanding language and communication problems--the nativist approach, which emphasizes the child's innate capacity for acquiring language and characterizes language as consisting of a set of context-free deterministic rules that operate on abstract representations--is inconsistent with an emphasis on indirect genetic effects. We review recent evidence that undermines the nativist approach--evidence concerning the initial state of the language-learning child, the role of environmental input, the competence-performance distinction, and modularity. In place of nativism, we argue for Emergentism, which is a model in which language is seen to emerge from the interaction between the child's biological abilities to map statistical properties of the language input into a distributed representation and the characteristics of the language learning environment and for the purpose of engaging in real-time, meaningful language use.     

Apathy is associated with lower mental and physical quality of life in persons infected with HIV

HIV infection is associated with lower health-related quality of life (HRQoL), which is influenced by immunovirological factors, negative affect, neurocognitive impairment, and functional dependence. Although apathy is a common neuropsychiatric sequela of HIV infection, emerging findings regarding its unique role in lower HRQoL have been mixed. The present study was guided by Wilson and Cleary's (1995), model in examining the association between apathy and physical and mental HRQoL in 80 HIV+ individuals who completed a neuromedical examination, neuropsychological assessment, structured psychiatric interview, and a series of questionnaires including the SF-36. Apathy was measured using a composite of the apathy subscale of the Frontal Systems Behavioral Scale and the vigor-activation subscale of the Profile of Mood States. Independent of major depressive disorder, neurocognitive impairment, functional status, and current CD4 count, apathy was strongly associated with HRQoL. Specifically, apathy and CD4 count were significant predictors of physical HRQoL, whereas apathy and depression were the only predictors of mental HRQoL. All told, these findings suggest that apathy plays a unique role in HRQoL and support the importance of assessing and managing apathy in an effort to maximize health outcomes among individuals with HIV disease.