The relationship between challenging behaviours, mood and interest/pleasure in adults with severe and profound intellectual disabilities.
Falling interest in activities predicts rising self-injury months later in adults with profound ID.
01Research in Context
What this study did
Researchers watched the adults with severe or profound ID for six months.
They rated each person's mood, interest in toys or music, and any hitting, biting, or head-banging.
Then they waited three more months and checked again to see what got worse or better.
What they found
Adults who showed little interest in activities at the start later showed more self-injury.
The same adults who hurt themselves more later showed even less interest.
Surprisingly, adults who were aggressive toward others later showed more interest in activities, not less.
Mood scores did not predict any problem behavior.
How this fits with other research
Hsieh et al. (2014) found that staff often see self-injury as a way to escape demands.
Perez et al. (2015) now shows that low enjoyment itself can be an early warning sign, even before escape happens.
Willner (2015) reviewed drug studies and found no pill reliably lowers aggression.
Perez et al. (2015) adds that aggression may actually link to higher future interest, so drugs might miss the real signal.
Buhrow et al. (2003) gave us quick tools to test what each person enjoys.
Use those tools monthly; dropping scores may flag rising self-injury risk months ahead.
Why it matters
Stop guessing about mood. Instead, track how much the person reaches for toys, music, or faces each week. A sudden drop is your cue to add fun activities and watch for new self-harm before it escalates.
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02At a glance
03Original abstract
BACKGROUND: We investigated whether current mood and interest/pleasure ratings in adults with moderate to profound intellectual disabilities were predictive of challenging behaviour [self-injurious behaviour (SIB), aggressive/destructive behaviour and stereotypic behaviour] and vice versa. METHOD: In this combined cross-sectional and longitudinal study, staff members of a Hungarian residential facility completed translated versions of the Behaviour Problems Inventory-Short Form (BPI-S), the Challenging Behaviour Interview (CBI) and the Mood, Interest and Pleasure Questionnaire-Short Form (MIPQ-S) for 50 participants at two time points, approximately 4 to 5 months apart. RESULTS: Bivariate correlations from data concurrently assessed at Time-1 showed significant linear relationships between the SIB (both frequency and severity scores) and Interest/Pleasure sub-scales, and the Aggressive/Destructive Behaviour (severity scores) and the MIPQ-S Mood sub-scales (unadjusted for multiple correlations). All of these effects were found with the BPI-S data, but not with the CBI. Multiple regression analyses revealed that (1) low interest/pleasure assessed at Time-1 predicted high SIB (frequency and severity) at Time-2. (2) Interest/pleasure was not predictive of aggressive or stereotypic behaviour. (3) Mood at Time-1 did not predict any of the three types of behaviour problems at Time-2. (4) In reverse, high SIB (frequency and severity) at Time-1 predicted low interest/pleasure ratings at Time-2. (5) Surprisingly, frequent aggressive/destructive behaviour predicted high interest/pleasure. (6) Stereotypic behaviour scores at Time-1 did not predict interest/pleasure ratings at Time-2. Again, all of these effects were only found with the BPI-S data, but not with the CBI. Internal consistency, test-retest reliability and concurrent validity of the Hungarian versions of all three questionnaires had generally satisfactory outcomes. DISCUSSION: The fact that increasingly frequent and severe SIB was predicted by declining measures of interest/pleasure is consistent with previous studies. Contrary to those earlier studies, however, we found that SIB was not predicted by mood and that aggressive/destructive behaviour actually predicted future elevated mood. Implications for future research regarding the directional relationship between affective states such as mood and interest and pleasure, on the one hand, and challenging behaviour, on the other, were discussed.
Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12202