Assessment & Research

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

Deb et al. (2001) · Journal of intellectual disability research : JIDR 2001
★ The Verdict

Behavior disorders hit 60% of community adults with ID, and the risk profile has stayed stable for decades.

✓ Read this if BCBAs working with adults with ID in community or residential settings.
✗ Skip if Clinicians who serve only children or mild learning delays.

01Research in Context

01

What this study did

Roane et al. (2001) counted behavior disorders in UK adults with intellectual disability.

They looked at people aged 16-64 who lived in the community, not hospitals.

The team asked carers and checked medical notes to spot problem behaviors.

02

What they found

Six out of every ten adults had at least one behavior disorder.

Severe problems were more common in women, people with worse ID, epilepsy, or day-center use.

Most of these adults also took psychotropic medicine.

03

How this fits with other research

O'Dwyer et al. (2018) found nearly the same rate (53%) in older Irish adults, showing the problem lasts into old age.

Agiovlasitis et al. (2025) shows little has changed: antipsychotic use is still 45% two decades later, and brief staff training only trims doses a bit.

Gaynor et al. (2008) dug deeper into epilepsy and found no extra behavior problems once adaptive skills were matched, hinting that ID severity, not seizures, drives the link.

04

Why it matters

High rates of behavior disorders and psychotropic use have stayed flat for 20 years. When you see an adult with ID, check for female gender, severe ID, epilepsy, and day-service placement—these flags still predict trouble. Start behavior plans before reflex prescribing; the drugs are not fixing the root.

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Pull your next adult-ID case file—note gender, ID level, epilepsy, and day-service use; if three or more are present, bump functional assessment to the top of the list.

02At a glance

Intervention
not applicable
Design
other
Sample size
101
Population
intellectual disability
Finding
not reported

03Original 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.

Journal of intellectual disability research : JIDR, 2001 · doi:10.1046/j.1365-2788.2001.00373.x