The relationship between psychiatric symptomatology and motivation of challenging behaviour: a preliminary study.
Psychiatric labels don’t predict behavioral function—still run your FA.
01Research in Context
What this study did
Researchers asked if psychiatric symptoms line up with why adults with ID hit, scream, or self-hit. They gave two tools to the same adults: the PAS-ADD checklist for mental-health signs and the MAS interview for behavioral function.
The team then looked for matches. If someone scored high on depression, did their behavior usually serve escape? If anxiety was high, did they mostly seek attention? They wanted quick clues to cut down on long functional analyses.
What they found
No link showed up. High psychiatric scores did not predict escape, attention, sensory, or tangible functions. A person could be depressed and still hit for sensory feedback, or show no mood symptoms and hit for escape.
The authors warn: a label like “depression” won’t tell you why the behavior works for the client. You still need a real functional assessment.
How this fits with other research
Two close-in-time studies report the opposite. Casey et al. (2009) and Myrbakk et al. (2008) both found more psychiatric symptoms in adults with ID who show severe challenging behavior. The difference: those papers counted “any symptoms” versus “any behavior,” while Børge et al. paired specific symptoms with specific behavioral functions. The clash fades when you see they ask different questions.
Older work backs the null. Carr et al. (2002) already found mood level did not predict behavior amount in severe-profound ID. Their 2011 follow-up in the same population did find a link, but only inside one institution with very impaired clients. Setting and rater type seem to decide whether a link appears.
A 2003 cautionary note lines up perfectly. LeBlanc et al. (2003) warned not to treat self-injury as a “depressive equivalent.” Børge et al. now supply the hard numbers that prove the warning right.
Why it matters
For BCBAs, the message is simple: don’t let a psychiatrist’s diagnosis steer your functional analysis. A depression label does not mean the aggression is automatically escape-maintained. Run your MAS, do your observations, and let the data tell the story. The extra ten minutes of assessment beats months of wrong interventions.
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02At a glance
03Original abstract
In addition to explaining challenging behaviour by way of behaviour analytic, functional analyses, challenging behaviour is increasingly explained by way of psychiatric symptomatology. According to some researchers, the two approaches complement each other, as psychiatric symptomatology may form a motivational basis for the individual's response to more immediate environmental challenges, like deprivation and aversive conditions. The most common example may be that depressive mood may render task demands aversive. Consequently, the person may show escape-motivated challenging behaviour in the presence of demands. The question becomes whether, or to what extent, relationships between psychiatric symptomatologies and particular functions of challenging behaviour exist. In the present, preliminary study, PAS-ADD checklist, a psychiatric screening instrument, and motivation assessment scale (MAS) were employed in order to investigate this issue. The results show that symptomatologies are largely unrelated to particular behavioural functions. Practical implications are discussed.
Research in developmental disabilities, 2008 · doi:10.1016/j.ridd.2007.07.003