Assessment & Research

Family burden related to clinical and functional variables of people with intellectual disability with and without a mental disorder.

Irazábal et al. (2012) · Research in developmental disabilities 2012
★ The Verdict

Behavior problems and comorbid psychiatric diagnoses drive the majority of caregiver burden in adults with intellectual disability.

✓ Read this if BCBAs serving adults with ID and dual diagnoses in day or residential programs.
✗ Skip if Clinicians working only with typically developing clients or brief outpatient consults.

01Research in Context

01

What this study did

The team gave one survey to families of adults with intellectual disability. They asked about behavior problems, mental health diagnoses, daily living skills, and how heavy the caregiving load felt.

No one was put into treatments. The researchers just looked at which problems went hand-in-hand with higher family burden.

02

What they found

Behavior issues, mood disorders, and psychotic symptoms together explained most of the caregiver stress. Daily living skill deficits added more weight.

In plain numbers, these factors accounted for more than sixty-one percent of why some families felt crushed while others did not.

03

How this fits with other research

Manor-Binyamini (2011) saw the same crush in Bedouin mothers of younger children, showing the pattern starts early and lasts.

Galuska et al. (2006) found parent personality shapes coping; the new study adds that the adult’s own behavior and diagnoses are even stronger drivers.

Fianco et al. (2015) looked at Italian caregivers and saw low life satisfaction where burden was high. The two surveys line up: once burden climbs, parent well-being drops, no matter the country.

Singh et al. (2017) showed family support can buffer depression in Indian mothers of autistic kids. That points to a practical bridge: lowering behavioral crises (the main driver here) while boosting family backup may give a double benefit.

04

Why it matters

You can’t change personality, but you can target the behaviors and comorbid disorders that eat families alive. When you write behavior plans, add goals that ease daily routines and reduce aggression or mood outbursts. A calmer adult means a calmer home, and that drops caregiver stress faster than any pep talk.

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Pick the top two challenging behaviors in the adult’s plan, track them for a week, and add a replacement skill that makes daily routines easier for the family.

02At a glance

Intervention
not applicable
Design
pre post no control
Sample size
203
Population
intellectual disability, mixed clinical
Finding
not reported

03Original abstract

Few studies have been found that to assess the factors that explain higher levels of family burden in adults with intellectual disability (ID) and intellectual disability and mental disorders (ID-MD). The aims of this study were to assess family burden in people with ID and ID-MD and to determine which sociodemographic, clinical and functional disability variables account for family burden. The sample is composed of pairs of 203 participants with disability and their caregivers, of which 33.5% are caregivers of people with ID and 66.5% of ID-MD. Assessments were performed using scales of clinical and functional disability as the following instruments: Weschler Adult Intelligence Scale-III (WAIS-III), Inventory for Client and Agency Planning (ICAP), Psychiatric Assessment Schedule for Adults with Development Disability (PAS-ADD checklist), Disability Assessment Schedule of the World Health Organization (WHO-DAS-II) and family burden (Subjective and Objective Family Burden Inventory - SOFBI/ECFOS-II). People with ID-MD presented higher levels of functional disability than those with ID only. Higher levels of family burden were related to higher functional disability in all the areas (p<0.006-0.001), lower intelligence quotient (p<0.001), diagnosis of ID-MD (p<0.001) and presence of organic, affective, psychotic and behavioral disorders (p<0.001). Stepwise multiple regression showed that behavioral problems, affective and psychotic disorder, disability in participation in society, disability in personal care and presence of ID-MD explained more than 61% of the variance in family burden. An integrated approach using effective multidimensional interventions is essential for both people with ID and ID-MD and their caregivers in order to reduce family burden.

Research in developmental disabilities, 2012 · doi:10.1016/j.ridd.2011.12.002