Personality disorders in people with learning disabilities: a community survey.
Half of community-dwelling adults with learning disabilities have personality problems—use the SAP to spot heavy service users early.
01Research in Context
What this study did
Coe et al. (1997) visited adults with learning disabilities who lived in the community, not in hospitals.
They gave each person the SAP, a short interview that checks for personality problems.
The team wanted to know how many adults would meet ICD-10 rules for a full personality disorder.
What they found
Half of the adults showed some personality abnormality.
About one in three met full ICD-10 criteria for a personality disorder.
Those who met criteria were already using psychiatric services more often.
How this fits with other research
Costa et al. (2017) later used the SURPS tool and linked personality traits to substance-use risk in younger adults with ID. Their work extends the 1997 finding by showing personality data can predict future problems, not just label current ones.
Heavey et al. (2000) screened adults with ID in a vocational program and also found hidden psychiatric illness. Both studies agree that routine settings miss serious conditions.
Linaker (1991) validated the older PIMRA in institutionalized adults. Coe et al. (1997) moved the same question into the community and switched to ICD-10, showing the field was updating tools rather than contradicting earlier work.
Why it matters
If you support adults with ID in day programs, group homes, or vocational sites, plan on high personality disorder rates. A quick SAP screen during intake can flag people who will need stronger mental-health supports and more staff time. Share the results with the psychiatrist early so care is ready before crises hit.
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02At a glance
03Original abstract
The prevalence of personality disorders has been determined by studies of both the general population and mental handicap hospitals. The present study attempts to determine the prevalence of personality disorders in a community sample and to check the implications for treatment. A community sample of learning disability service users was surveyed by obtaining a rating from a good informant to establish demographic data, level of functioning and the nature of personality disorders, if any, using the ICD-10 version of the Standardized Assessment of Personality (SAP). Fifty per cent of the sample had personality abnormalities, and 31% had sufficient impairment of the social and occupational domains and personal distress to warrant a diagnosis of personality disorder. These findings are compared with previous studies. Paranoid, schizoid, impulsive and dissocial personality abnormalities were seen to be associated with a high referral rate to psychiatric services and needed considerable therapeutic input. The prevalence of personality abnormalities in community populations with a learning disability is high. The SAP is a useful instrument for screening. This subpopulation makes significant demands on community psychiatric services.
Journal of intellectual disability research : JIDR, 1997 · doi:10.1111/j.1365-2788.1997.tb00716.x