The relationship between psychopathology symptom clusters and the presence of comorbid psychopathology in individuals with severe to profound intellectual disability.
Impulse, mood, mania, and anxiety symptoms travel together in adults with severe/profound ID—screen them as a set.
01Research in Context
What this study did
The team gave the DASH-II to adults with severe or profound ID. They wanted to see which mental-health symptom clusters show up together.
No one had mapped how impulse, mood, mania, and anxiety scores link in this group.
What they found
Impulse items were the most common red flag. When impulse scores rose, mood, mania, and anxiety scores usually rose too.
Strong positive links appeared among all four clusters. If one area was high, the others were likely high as well.
How this fits with other research
Austin et al. (2015) extends these results. They compared adults with both ASD and ID to adults with ID only. The ASD+ID group had higher scores across eight clinical areas, including the same impulse-anxiety-mood pattern Amore et al. (2011) saw.
Hill et al. (2006) is a predecessor study. They also used the DASH-II on youth with severe ID. Kids with autistic traits had the same spike in anxiety, mania, and stereotypy that Amore et al. (2011) later found in adults.
Horovitz et al. (2014) looks contradictory at first. They studied mild-moderate ID and said each extra Axis I diagnosis hurts quality of life. Amore et al. (2011) did not measure quality of life, but both papers agree: more symptom clusters equal more clinical concern.
Why it matters
When you assess an adult with severe or profound ID, expect overlapping problems. A high impulse score should prompt you to check mood, mania, and anxiety sections of the DASH-II. One red flag rarely travels alone. Use the full profile, not just one scale, to plan supports and referrals.
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02At a glance
03Original abstract
In the typically developing population, comorbid psychopathology refers to the co-occurrence of two different psychopathologies other than cognitive impairments. With respect to individuals with intellectual disability, comorbidity is often described as cognitive deficits and one additional psychopathology manifesting together. However, just as within the typically developing population, individuals with intellectual disability may also present with symptoms of two or more additional disorders. The presentation of these symptom clusters may similarly correlate. Therefore, the current study used the Diagnostic Assessment for the Severely Handicapped-II in order to examine relationships between psychopathological symptom clusters in adults with severe to profound intellectual disability. Additionally, we assessed comorbid presentation of disorders other than cognitive impairments in these same adults. Several symptom clusters were identified as being related with moderate to strong positive correlations. Furthermore, elevations on the Impulse subscale were noted to be the most prevalent in the current sample, with comorbid elevations most commonly occurring along the Mood, Mania, and Anxiety subscales. The significance of these findings is discussed.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.02.004