Assessment & Research

Psychopathology: differences among adults with intellectually disabled, comorbid autism spectrum disorders and epilepsy.

Smith et al. (2010) · Research in developmental disabilities 2010
★ The Verdict

Adults with ID plus both ASD and epilepsy show the sharpest mood and behavior problems—screen this trio closely.

✓ Read this if BCBAs serving adults with dual or triple diagnoses in day programs or residential homes.
✗ Skip if Clinicians who work only with typically developing children.

01Research in Context

01

What this study did

Busch et al. (2010) compared four groups of adults with intellectual disability.

One group had ID only. One had ID plus autism. One had ID plus epilepsy. The last had all three.

They used the ASD-Comorbidity for Adults scale to measure anxiety, irritability, ADHD, and depression.

02

What they found

The triple-diagnosis group scored highest on every problem area.

More diagnoses meant more mood and behavior symptoms.

03

How this fits with other research

Busch et al. (2010) is a direct twin to Busch et al. (2010) social-skills paper. Same people, same year. One shows more mood problems; the other shows weaker social skills.

Matson et al. (2009) came first. It showed adaptive living skills drop as diagnoses pile on. The new study adds epilepsy to the pile and shows mood drops too.

Jokiranta et al. (2014) moves the lens to kids. It proves epilepsy plus ASD is common. The adult paper shows what happens to mood when that pair meets ID.

04

Why it matters

If your adult client has ID, ASD, and epilepsy, plan for extra anxiety, irritability, ADHD signs, and depression. Screen early, track mood often, and build mental-health goals into the behavior plan.

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Add brief mood-check questions to your intake for any adult with ID and epilepsy.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
100
Population
intellectual disability, autism spectrum disorder
Finding
positive
Magnitude
small

03Original abstract

The goal of this study was to systematically examine group differences among adults with intellectual disabilities (ID), comorbid autism spectrum disorders (ASD), and epilepsy through a detailed exploration of the characteristics that these disorders present in the area of psychopathology. Previous studies indicating that individuals with ID have comorbid ASD and epilepsy tend to stop short of addressing these disorders' impact on the full range of psychosocial issues, particularly in adult samples. Assessment of psychopathology was made with the ASD-comorbidity-adult version (ASD-CA). One hundred participants, with ID held constant, were matched and compared across four equal groups comprising 25 participants with ID, 25 participants with epilepsy, 25 participants with ASD, and 25 participants with combined ASD and epilepsy. When controlling for age, gender, race, level of ID, and hearing and visual impairments, results of the MANOVA revealed significant differences among groups, Wilks's Lambda=.76, F(15, 254)=1.82, p<.05, eta(2)=.09. A one-way ANOVA was conducted for each of the five subscales of the ASD-CA as follow-up tests to the MANOVA. Groups differed significantly Anxiety/Repetitive Behavior subscale, F(3, 96)=2.93, p<.05, eta(2)=.08, Irritability/Behavior excess subscale, F(3, 96)=4.74, p<.01, eta(2)=.13, Attention/Hyperactivity subscale, F(3, 96)=5.18, p<.01, eta(2)=.14, and Depressive Symptoms subscale, F(3, 96)=3.73, p<.01, eta(2)=.10. Trend analysis demonstrated that individuals with ID expressing combined comorbid ASD and epilepsy were significantly more impaired than the control group (ID only) or groups containing only a single comorbid factor with ID (ASD or epilepsy only). Implications of these findings elucidate the nature of these disorders and their influence on patient care and management.

Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2010.01.016