Psychosocial correlates of psychiatric diagnoses and maladaptive behaviour in youth with severe developmental disability.
In severe ID, kids who gain adaptive skills under high life stress are the very ones most likely to pick up a psychiatric diagnosis, and their behavior problems drag down parent well-being.
01Research in Context
What this study did
van Timmeren et al. (2016) ran a one-time survey of youth with severe intellectual disability and autism. They asked parents about kids' daily skills, recent stressful events, behavior problems, and family life.
The team wanted to know which factors link to a psychiatric diagnosis and which ones ride with day-to-day problem behavior.
What they found
Kids who had stronger adaptive skills and more negative life events were more likely to carry a psychiatric label. Maladaptive behavior, in turn, went hand-in-hand with poorer parent mental health and lower family quality of life.
In short, more skills plus more stress equaled higher psychiatric risk, while challenging behavior hurt the whole family system.
How this fits with other research
Balboni et al. (2020) looked like they disagreed. In their severe-profound group, better adaptive skills came with more challenging behavior, not less. The gap is method: Giulia sampled adults in institutions; A et al. sampled youth living at home and counted actual psychiatric diagnoses, not just behavior counts.
Donoso et al. (2024) extend the talk to autistic youth across IQ levels. They found higher socialization skills protect against both anxiety and acting-out. A et al. show the twist: once life stress piles up, those same skills can flag higher clinical risk in the severe-ID slice.
Older surveys — Dudley et al. (2008), Koskentausta et al. (2007), Lecavalier et al. (2006) — already fingered family stress and parent mood as key. A et al. keep the beat but add life-events and family-quality scores, tightening the case for whole-family screening.
Why it matters
When you see a child with severe ID gaining new skills, stay alert. Ask about recent moves, bullying, or medical events. Pair skill growth with extra mental-health check-ins and parent support. Track parent stress and family quality of life right alongside behavior data; both predict outcomes and guide where you put resources.
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02At a glance
03Original abstract
BACKGROUND: We know little about the correlates of mental health problems in youth with severe and profound intellectual disability (ID), as most research includes these youth within larger samples that include greater proportions of mild and moderate disability. The purpose of the current study was to identify the child, family and psychosocial characteristics that were associated with the presence of psychiatric diagnoses and maladaptive behaviour in youth with severe ID. METHODS: Participants were 141 parents of youth with severe or profound levels of ID, 4 to 18 years of age. The mean age of children was 11.04 years (SD = 3.38), with 68% male and 39% with autism spectrum disorder (ASD). Parents completed a primarily online survey of child and family characteristics, negative life events, family quality of life and their own mental health. RESULTS: Logistic regression analyses revealed that youth with a psychiatric diagnosis had higher levels of adaptive behaviour and experienced more negative life events than youth without psychiatric diagnosis, while the presence of clinically significant maladaptive behaviour was related to higher levels of adaptive behaviour, parents' mental health problems and lower family quality of life. Child age, gender, ASD status and financial hardship were not related to either outcome variable. CONCLUSIONS: Youth with severe and profound ID who experience psychosocial stressors are more likely reported to have mental health problems than youth without such stressors. It is likely that a combination of child and family based interventions, along with with policies that address larger systemic issues of social adversity, are needed to promote mental health and treat psychopathology when it arises.
Journal of intellectual disability research : JIDR, 2016 · doi:10.1111/jir.12278