Respondent and informant accounts of psychiatric symptoms in a sample of patients with learning disability.
Self- and informant reports of psychiatric symptoms in adults with ID match only 40 percent of the time, so always collect both.
01Research in Context
What this study did
Festinger et al. (1996) asked two questions. They asked adults with learning disabilities about their own feelings. They also asked staff or family what they saw. Then they compared the two answers.
The team wanted to know how often the two stories matched. They did not try to fix symptoms. They only counted where the reports agreed and where they did not.
What they found
The two sources agreed only 40 percent of the time. That means six out of ten symptoms were missed or added, depending on who you asked.
Self-report caught hidden worries. Informant report caught visible behaviors. Each view left out facts the other side saw.
How this fits with other research
Sisson et al. (1993) saw the same split in teens with ID. Depression scales lined up, yet self- and caregiver answers still varied. Their early warning foreshadowed the 40 percent match found here.
Timberlake (1993) showed the informant-rated Children’s Depression Inventory works in adults with ID. That tool is useful, but S et al. prove it cannot stand alone. You still need the person’s own voice.
Wilson et al. (2023) later built two self-report wellbeing scales that teens with ID can complete. Their success answers the 1996 call for better first-person tools. Use them together with informant data, just as S et al. advise.
Why it matters
Next time you screen an adult with ID, plan for two interviews. Start with a simple self-report scale the person can read or hear. Then ask a caregiver the same questions. When the answers differ, dig deeper instead of picking a side. This five-minute habit cuts missed diagnoses and guards against over-treatment.
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02At a glance
03Original abstract
This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews: only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by informants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.
Journal of intellectual disability research : JIDR, 1996 · doi:n/a