Ishita Khemka

Evaluation of a decision-making curriculum designed to empower women with mental retardation to resist abuse.

The effectiveness of an abuse-prevention curriculum, designed to empower women with mental retardation to become effective decision-makers able to protect themselves against abuse was examined. Thirty-six women with mental retardation were randomly assigned to either an intervention or a control group. Results indicate that the performance of the women in the intervention group was superior to that of the women in the control group on measures of knowledge, decision-making, and empowerment but not on a measure of stress management. The findings suggest that women with mental retardation can acquire effective decision-making strategies and apply them to situations of abuse in their lives.

Increasing Independent Decision-Making Skills of Women with Mental Retardation in Simulated Interpersonal Situations of Abuse.

The effectiveness of two decision-making training approaches in increasing independent decision-making skills of 36 women with mild mental retardation in response to hypothetical social interpersonal situations involving abuse was evaluated. Participants were randomly assigned to a control or one of two training conditions (a decision-making training approach that either addressed both cognitive and motivational aspects of decision-making or included only instruction on the cognitive aspect of decision-making). Although both approaches were effective relative to a control condition, the combined cognitive and motivational training approach was superior to the cognitive only training approach. The superiority of this approach was also reflected on a verbally presented generalization task requiring participants to respond to a decision-making situation involving abuse from their own perspective and on a locus of control scale that measured perceptions of control.

Decision-making by adults with mental retardation in simulated situations of abuse.

The ability of women and men with mental retardation to suggest prevention-focused decisions in response to simulated social interpersonal situations of abuse was investigated. Decision-making performance across three types of abusive situations (physical, sexual, psychological/verbal) was examined. Participants were able to suggest direct prevention-focused decisions aimed at resisting or stopping abuse 45% of the time and other-dependent prevention-focused decisions in the form of reporting 20% of the time. Prevention-focused decision-making was higher in situations of physical abuse (59%) than in situations of sexual (51%) or psychological/verbal abuse (26%). Women and men did not differ significantly in their decision-making responses.

Profiles of women who have mental retardation with and without a documented history of abuse.

Thirty-six women with mental retardation were divided into two groups on the basis of whether they had a documented history of abuse during the preceding 5 years. The women with this history were more likely than the women with no documented history of abuse to be employing passive/avoidant decision-making strategies, reporting higher levels of stress, having dual diagnoses, be receiving counseling, and relying on others to go out into the community. We recommend that special attention be paid to designing interventions that are tailored to the specific needs of these women.

A closer look at interpersonal decision-making in adults with and without mental retardation.

Two experiments were conducted to examine the interpersonal decision-making performance of women and men with and without mental retardation. In Experiment 1, adults with mental retardation listened to either short or long vignettes depicting situations in which a female or male protagonist was faced with a decision involving either a peer or authority figure. In Experiment 2, adults without mental retardation were presented with long versions of the vignettes. As expected, the task was considerably more difficult for the participants with mental retardation, possibly because of differences in their ability to fully comprehend the social situations. Women in both studies outperformed men. Results suggest that emotional and motivational factors may have contributed to these differences.

The Role of Motivation in the Decision Making of Adolescents with Mental Retardation

Publisher Summary This chapter provides a brief overview of some key issues of adolescent development, as identified in the general literature. To the extent possible, these issues are linked to what is known about adolescents with mental retardation. The chapter covers important theoretical and developmental perspectives on decision-making and motivation in individuals without disabilities. The chapter focuses upon research and theory pertaining to the role of motivation in the personal and interpersonal decision making of individuals with mental retardation with a focus on adolescents. The chapter concludes with a discussion of new directions and implications for the design of motivation‐based interventions to enable adolescents with mental retardation to make effective decisions in important areas of their lives.

Randomized Controlled Trial to Evaluate an Abuse Prevention Curriculum for Women and Men With Intellectual and Developmental Disabilities

This study was designed (a) to assess the impact of the ESCAPE-DD curriculum on the decision-making skills of adults with intellectual and developmental disabilities (IDD) in hypothetical situations of abuse, (b) to examine the role of problem awareness, and (c) to identify factors associated with posttest decision-making performance. Fifty-eight women and men with IDD were randomly assigned to an intervention group or a wait-list control group. Participants who experienced ESCAPE-DD made significantly greater gains on measures of overall effective decision making and safe-now effective decision-making relative to participants in the control group. Problem awareness was related to decision making, but it did not improve as a result of the intervention. Implications of the findings for future curriculum-development efforts are discussed.

Empowering Women with Intellectual and Developmental Disabilities to Resist Abuse in Interpersonal Relationships: Promising Interventions and Practices

Women with intellectual and developmental disabilities (IDD) experience heightened rates of domestic violence and all forms of abuse in their interpersonal relationships (e.g., Barger et al. Intellect Dev Disabil 47(4):249–262, 2009; Ward et al. Intellect Dev Disabil 48(2):89–98, 2010). After reviewing studies conducted between 2000 and 2010, Hughes et al. (Rehabil Psychol 56(4):302–319, 2011) reported that up to 90% of women with IDD experience some form of abuse during their lifetime. Almost all of the abuse is perpetrated by someone who is known to the victim, including intimate partners, family members, and paid caregivers (e.g., Stevens. J Ment Health Res Intellect Disabil 5:168–186, 2012). In the present chapter, the terms abuse and maltreatment are used interchangeably to refer to the full range of intentional harm experienced by individuals with IDD. This encompasses the various terms appearing in the literature to describe sexual abuse, physical abuse, and verbal/emotional abuse.

Chapter Six - The Psychology of Decision Making

Abstract This chapter overviews general theoretical advances including developmental perspectives in the study of decision-making behavior and their applicability in understanding how individuals with intellectual and developmental disabilities (IDD) approach interpersonal decisions in their lives. Of particular importance are the theoretical explications of the roles of cognitive and noncognitive processes (e.g., motivation and emotion), and the contextual demands of different decision tasks, as possible loci of the decision-making difficulties observed in individuals with IDD. Extant decision-making research with individuals with IDD is summarized and a Pathways of Decision Processing model is outlined for the systematic study of their decision-making processes and building adaptive decision-making strategies. The chapter examines distinct disability-specific patterns of decision-making difficulties associated with underlying etiologies and phenomenological characteristics of the subtypes of IDD, with implications for the need for differentiated interventions to improve the decision making of individuals with different forms of IDD, including those with intellectual disabilities, Williams syndrome, and autism spectrum disorders.

The Role of Positive Psychology in Interpersonal Decision Making

There is no doubt that decision making plays a pivotal role in people’s lives and that increasing decision-making competence can have a profound positive impact. The focus of this chapter is primarily upon interpersonal decision making, which is central to maintaining a positive quality of life but which poses particular challenges to people with intellectual and developmental disabilities. Interpersonal decisions are at the crux of the social vulnerability of people with intellectual and developmental disabilities. Research to better understand and strengthen interpersonal decision making offers a potential avenue to reducing social vulnerability and increasing positive quality of life. In accord with the tenets of positive psychology, the premise of the chapter is that enabling people with intellectual and developmental disabilities to acquire a repertoire of effective interpersonal decision-making skills can provide them with a powerful tool for building positive, satisfying friendships and intimate relationships as well as for ensuring their own personal safety and preventing harm. This chapter includes a brief description of a working model of four pathways to effective decision making as well as a review of some key decision-making research and intervention studies as well as evidence-based curricula aimed at providing adults and adolescents with intellectual and developmental disabilities with a useful repertoire of decision-making skills. This chapter concludes with suggestions for future directions for research and practice in decision making.