The associations of quality of life and general functioning with trauma, borderline intellectual functioning and mild intellectual disability in outpatients with serious mental illness.
Trauma plus mild or borderline ID spells poorer daily functioning and lower life satisfaction in adults with serious mental illness.
01Research in Context
What this study did
Noorthoorn et al. (2021) asked how trauma and mild or borderline intellectual disability affect adults with serious mental illness.
They tracked quality of life and everyday functioning in outpatients who already carried major psychiatric diagnoses.
What they found
Both trauma history and low IQ were linked to worse daily functioning.
Trauma also dragged down quality-of-life scores.
How this fits with other research
The finding builds on Levin et al. (2014). That team showed that adverse events quickly turn into trauma symptoms in adults with mild-moderate ID. O et al. widen the lens by showing the same events still hurt functioning years later once serious mental illness is in the mix.
Titlestad et al. (2019) and Thomas et al. (2021) tell a similar story in older Irish and Australian samples. Life events predicted poorer mental health in those over 60. O et al. now show the pattern holds for working-age outpatients and adds everyday functioning and quality of life to the damage list.
No clash exists across studies. The earlier work flags short-term mental-health dips; the new paper maps longer-term life-quality fallout.
Why it matters
If you serve adults who carry both SMI and ID, treat trauma history as a red flag. Ask about adverse events at intake, then fold extra skill-building and coping goals into the plan. Small boosts in daily living skills or safety plans may protect the quality of life that this study shows is already at risk.
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02At a glance
03Original abstract
BACKGROUND: Trauma and intellectual disability are highly prevalent in the serious mental ill (SMI). Little is known of their impact on general functioning and quality of life. AIM: This study investigated the association of trauma and intellectual disability (ID) with general functioning and quality of life in SMI. METHODS: Patient characteristics and diagnoses were extracted from electronic patient records. We used the Trauma Screening Questionnaire (TSQ), the Screener for Intelligence and Learning Disabilities (SCIL), the Health of the Nation Outcome Scale (HoNOS) and the Manchester Short Assessment of Quality of Life (MANSA) to asses trauma, intellectual impairment, general functioning and quality of life. Proportions on cut-off scores were analysed with cross-tabulations, questionnaire scores with t-tests. Multivariable associations were determined by logistic regression analysis. RESULTS: 611 patients from an outpatient service were assessed. Trauma and ID were associated with each other (r = -0.207). Trauma was associated with worse general functioning and a lower quality of life. Mild intellectual disability (MID) or borderline intellectual functioning (BIF) were associated with worse general functioning. CONCLUSIONS: For patients with SMI, trauma and ID should be identified early in care to treat the lower general functioning and quality of life it caused.
Research in developmental disabilities, 2021 · doi:10.1016/j.ridd.2021.103988