成年智障者的精神障碍。2:16至64岁社区人群中的行为障碍发生率。

Mental disorder in adults with intellectual disability. 2: The rate of behaviour disorders among a community-based population aged between 16 and 64 years.

作者信息

Deb S, Thomas M, Bright C

机构信息

Division of Psychological Medicine, University of Wales College of Medicine, Cardiff, UK.

出版信息

J Intellect Disabil Res. 2001 Dec;45(Pt 6):506-14. doi: 10.1046/j.1365-2788.2001.00373.x.

Abstract

Despite the difficulty of defining behaviour disorder, most previous studies have reported a high rate of behaviour disorders in people with intellectual disability (ID). The aim of the present study was to establish the overall rate and types of behaviour disorders in a population-based sample of adults with ID. The other aim was to explore the possible risk factors that are associated with the overall rate as well as different types of behaviour disorders. One hundred and one adults with ID aged between 16 and 64 years were randomly selected from a sample of 246 such adults, i.e. those who were known to the Vale of Glamorgan Social Services Department in South Wales, UK. Thirteen behaviour disorders were rated according to the Disability Assessment Schedule. Background data on subjects were also collected, and were subsequently analysed to assess the relationship between different risk factors and behaviour disorders. Sixty-one subjects (60.4%) had at least one behaviour disorder of any severity or frequency. Twenty-three per cent of subjects showed aggression, 24% self-injurious behaviour, 36% temper tantrum, 26% overactivity, 29% screaming, 38% attention-seeking behaviour, 20% objectionable habits, 18% night-time disturbance and 12% of subjects showed destructiveness. Statistically significant associations were seen between the rate of overall behaviour disorder and the use of psychotropic medication, and between family and group home residence. The rate of aggression was significantly associated with the use of psychotropic medication. The rate of self-injurious behaviour was significantly associated with the severity of ID, female gender and poor communication abilities. The rate of temper tantrum was significantly associated with the use of psychotropic medication. Twenty-four subjects showed severe or frequent aggression, destructiveness, self-injury or temper tantrum, and 11 individuals showed real challenging behaviours. Severe behaviour problems were significantly associated with female gender, severity of ID, the presence of a history of epilepsy and attendance at day activities.

摘要

尽管很难对行为障碍进行定义,但此前大多数研究均报告称,智力残疾者中行为障碍的发生率很高。本研究的目的是确定在一个基于人群的成年智力残疾样本中行为障碍的总体发生率及类型。另一个目的是探究与总体发生率以及不同类型行为障碍相关的可能风险因素。从246名此类成年人(即英国南威尔士格拉摩根谷社会服务部所了解的成年人)样本中随机选取了101名年龄在16至64岁之间的成年智力残疾者。根据《残疾评估量表》对13种行为障碍进行评分。还收集了受试者的背景数据,随后对这些数据进行分析,以评估不同风险因素与行为障碍之间的关系。61名受试者(60.4%)至少有一种任何严重程度或频率的行为障碍。23%的受试者表现出攻击行为,24%表现出自伤行为,36%表现出发脾气,26%表现出多动,29%表现出尖叫,38%表现出寻求关注行为,20%表现出不良习惯,18%表现出夜间干扰,12%的受试者表现出破坏行为。在总体行为障碍发生率与精神药物使用之间,以及在家庭住所和集体家庭住所之间,发现了具有统计学意义的关联。攻击行为的发生率与精神药物的使用显著相关。自伤行为的发生率与智力残疾的严重程度、女性性别及沟通能力差显著相关。发脾气的发生率与精神药物的使用显著相关。24名受试者表现出严重或频繁的攻击、破坏、自伤或发脾气行为,11名个体表现出真正具有挑战性的行为。严重行为问题与女性性别、智力残疾的严重程度、癫痫病史的存在以及日间活动参与情况显著相关。

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