Post-traumatic stress disorder and substance use disorder in individuals with mild intellectual disability or borderline intellectual functioning: A review of treatment studies.
No one has tested a combined PTSD/SUD therapy for adults with mild-borderline ID, so adapt evidence-based CBT or EMDR with visuals and caregiver support.
01Research in Context
What this study did
Luteijn et al. (2020) hunted for studies that treat both PTSD and substance use in adults with mild or borderline intellectual disability.
They screened every database they could find and asked: did anyone test a combined therapy?
Answer: not a single paper. They also noted that even single-disorder studies rarely check for the other problem.
What they found
Zero trials exist. No one has tested an integrated PTSD/SUD package for this population.
The authors say we must borrow tools made for the general population and adapt them with pictures, plain words, and caregiver help.
How this fits with other research
van Duijvenbode et al. (2015) already showed we lack SUD screening tools for the same group; Ilse extends that gap to the PTSD/SUD combo.
Didden et al. (2009) describe clients with mild-borderline ID in addiction care who also show serious emotional problems, but they never measured PTSD.
Storch et al. (2012) proved brief writing therapy cuts PTSD symptoms in addicted inpatients, yet they excluded people with ID.
These papers form a staircase: each shows a piece of the puzzle, but none connect the full PTSD-plus-SUD picture for clients with ID.
Why it matters
You will meet clients who use substances and carry trauma, but you have no manual. Start simple: use visual feeling cards, shorten sessions, and bring a trusted caregiver into the room. Track both trauma cues and craving triggers; share the data so the field can build the first real evidence base.
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02At a glance
03Original abstract
Individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF; IQ 50-85) are at high risk for developing post-traumatic stress disorder (PTSD) and substance use disorders (SUD). In individuals without MID-BIF, Seeking Safety (SeSa) is found to be effective in treating PTSD and SUD simultaneously. However, little is known about integrated treatment of PTSD and SUD in individuals with MID-BIF. This review aims to provide an overview of studies about this type of triple psychopathology, as well as PTSD or SUD in individuals with MID-BIF (i.e. dual diagnosis). No studies were found on integrated treatment of PTSD and SUD in individuals with MID-BIF. Thirty-two studies were found on treatment of either PTSD (mostly Eye Movement Desensitization and Reprocessing and cognitive behavior therapy) or SUD (mostly cognitive behavior therapy and mindfulness) in individuals with MID-BIF. Only 9.4 % of these studies mentioned the co-morbidity of PTSD and SUD. Suggestions for adapting treatment to individuals with MID-BIF were provided on communication, structure, non-verbal elements, network, coping skills, therapeutic relationship and use of suitable and reliable instruments to measure treatment progress. More research is needed on the effectivity of EMDR or Imaginary Exposure (IE) combined with SUD treatment (CBT and mindfulness), and on the adaption of SeSa tot individuals with MID-BIF, as well as on this type of triple psychopathology in general.
Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103753