Assessment & Research

Symptoms of psychopathology in adults with intellectual disability and seizures.

Fitzgerald et al. (2011) · Research in developmental disabilities 2011
★ The Verdict

Among adults with ID living in residences, those who also have seizures show more mood symptoms on the DASH-II, but no extra behavior or anxiety problems.

✓ Read this if BCBAs working with adults with ID in residential or day-program settings where epilepsy is common.
✗ Skip if Clinicians who only see children or clients without seizure history.

01Research in Context

01

What this study did

Lancioni et al. (2011) compared adults with intellectual disability who have seizures to adults with ID who do not.

Everyone lived in the same residential center. Staff filled out the DASH-II, a checklist that tracks mood, anxiety, and other psychiatric signs in people who cannot talk about feelings.

02

What they found

Only the mood subscale showed a clear difference. The seizure group scored higher, meaning more signs of depression or irritability.

All other DASH-II areas—anxiety, psychosis, behavior problems—looked the same between the two groups.

03

How this fits with other research

Arshad et al. (2011) seems to say the opposite. In their clinic, adults with ID plus epilepsy carried fewer psychiatric diagnoses, not more. The key difference is setting: E’s people came from everyday residential homes, while Saadia’s were already sent to a mental-health clinic. Seizures may only add mood risk in the broader, non-clinical ID population.

Matson et al. (1999) also studied the same residential type and found lower social and daily-living skills when seizures are present. Together, the picture is: seizures in ID predict flatter day-to-day skills and slightly darker mood, but not extra behavior disorders.

Myrbakk et al. (2008) remind us that when we do see severe behavior problems, look hard for an underlying psychiatric illness. Seizure status alone does not create those behaviors, so keep searching for other causes.

04

Why it matters

If you serve adults with ID who have epilepsy, plan to watch mood, not just seizure logs. A higher DASH-II mood score can be your early warning. Simple steps—more exercise, preferred activities, or a psychiatric consult—can stop a slide into full depression. You do not need to expect extra aggression or self-injury; seizures did not raise those risks in this study.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add the DASH-II mood subscale to your quarterly data cycle for every client with ID plus seizures; flag any item scored 2 or higher for team review.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
321
Population
intellectual disability
Finding
mixed
Magnitude
small

03Original abstract

Seizures are more common in individuals with intellectual disabilities than in the general population. As a result, differences in functioning for individuals with intellectual disability with and without seizures have been evaluated. Research on differences in psychopathology for individuals with intellectual disability with and without seizures has been mixed. The purpose of this study was to examine differences in subscale scores on the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) between individuals with intellectual disability with and without seizures. In this study, 321 individuals from two large developmental centers in the southeastern United States were administered the DASH-II. Researchers found that the seizure group endorsed significantly more symptoms on the mood subscale than the group without seizures. No other group differences were found to be significant. Implications of these results are discussed.

Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.07.044