Nick J. Gore

Assessing the implicit beliefs of sexual offenders using the implicit relational assessment procedure: a first study.

Researchers have proposed that the cognitive distortions of sexual offenders are underpinned by a number of implicit cognitive processes termed implicit theories. Until recently, however, the implicit theory hypothesis has received little empirical support due to broader limitations with standard forensic assessment procedures. The current research aimed to determine whether a new assessment methodology, the Implicit Relational Assessment Procedure (IRAP), could provide further evidence for Ward and Keenans (1999) children as sexual beings implicit theory. The results indicated that the IRAP was significantly more effective at identifying core implicit differences between sexual offenders against children and nonoffenders than a cognitive distortion questionnaire. Furthermore, although both groups demonstrated an overall response bias towards adults as sexual and children as nonsexual, this bias was significantly impaired in the sexual offender group. The findings are discussed in relation to previous implicit theory research and recommendations for the development of implicit methodologies are made.Researchers have proposed that the cognitive distortions of sexual offenders are underpinned by a number of implicit cognitive processes termed implicit theories. Until recently, however, the implicit theory hypothesis has received little empirical support due to broader limitations with standard forensic assessment procedures. The current research aimed to determine whether a new assessment methodology, the Implicit Relational Assessment Procedure (IRAP), could provide further evidence for Ward and Keenans (1999) children as sexual beings implicit theory. The results indicated that the IRAP was significantly more effective at identifying core implicit differences between sexual offenders against children and nonoffenders than a cognitive distortion questionnaire. Furthermore, although both groups demonstrated an overall response bias towards adults as sexual and children as nonsexual, this bias was significantly impaired in the sexual offender group. The findings are discussed in relation to previous implicit theory research and recommendations for the development of implicit methodologies are made.

Staff attitudes towards sexuality in relation to gender of people with intellectual disability: A qualitative study

Abstract Background Research has found staff attitudes regarding the sexuality of people with intellectual disability (ID) to be negative but influenced by several factors. The current study aimed to examine whether gender of people with ID affects such attitudes. Method Semistructured interviews were completed with 10 staff members and analysed using thematic analysis. Results Results indicated 3 themes: Women are perceived as sexually innocent, men as more sexually motivated, and motivations for sexual relationships are perceived to differ between men and women with ID. Conclusion The study indicates unfavourable attitudes towards sexuality in individuals with ID that correlate with traditional, restricted gender stereotypes. The identification of these themes highlights the importance of considering gender when supporting the sexuality of people with ID.

Assessing the implicit beliefs of sexual offenders using the implicit relational assessment procedure.

Researchers have proposed that the cognitive distortions of sexual offenders are underpinned by a number of implicit cognitive processes termed implicit theories. Until recently, however, the implicit theory hypothesis has received little empirical support due to broader limitations with standard forensic assessment procedures. The current research aimed to determine whether a new assessment methodology, the Implicit Relational Assessment Procedure (IRAP), could provide further evidence for Ward and Keenans (1999) children as sexual beings implicit theory. The results indicated that the IRAP was significantly more effective at identifying core implicit differences between sexual offenders against children and nonoffenders than a cognitive distortion questionnaire. Furthermore, although both groups demonstrated an overall response bias towards adults as sexual and children as nonsexual, this bias was significantly impaired in the sexual offender group. The findings are discussed in relation to previous implicit theory research and recommendations for the development of implicit methodologies are made.Researchers have proposed that the cognitive distortions of sexual offenders are underpinned by a number of implicit cognitive processes termed implicit theories. Until recently, however, the implicit theory hypothesis has received little empirical support due to broader limitations with standard forensic assessment procedures. The current research aimed to determine whether a new assessment methodology, the Implicit Relational Assessment Procedure (IRAP), could provide further evidence for Ward and Keenans (1999) children as sexual beings implicit theory. The results indicated that the IRAP was significantly more effective at identifying core implicit differences between sexual offenders against children and nonoffenders than a cognitive distortion questionnaire. Furthermore, although both groups demonstrated an overall response bias towards adults as sexual and children as nonsexual, this bias was significantly impaired in the sexual offender group. The findings are discussed in relation to previous implicit theory research and recommendations for the development of implicit methodologies are made.

Rates of breastfeeding and exposure to socio-economic adversity amongst children with intellectual disability

Children with intellectual disability are at increased risk of experiencing poor health relative to their typically developing peers. Previous research indicates that exposure to socio-economic disadvantage contributes towards this disparity but that additional factors (including parenting practices) may be involved in mediating/moderating pathways. This study examined duration of breastfeeding amongst children with and without intellectual disability by a secondary analysis of data from the UK Millennium Cohort Study. Children with intellectual disability were significantly less likely to have been ever breastfed; breastfed exclusively or at all at 3 months or breastfed at all at 6 months relative to children without intellectual disability. None of these differences remained significant when other psycho-social risk factors for reduced breastfeeding were controlled for. The study adds to both the sparse literature on breastfeeding practices amongst families of children with intellectual disability and research demonstrating relationships between socio-economic disadvantage and wellbeing for children with intellectual disability.

New ways of seeing and being: Evaluating an acceptance and mindfulness group for parents of young people with intellectual disabilities who display challenging behaviour

The current study presents findings from an acceptance and commitment therapy-based intervention for family carers of children who have an intellectual/developmental disability and display high levels of challenging behaviour. The parent well-being workshops consist of two workshops incorporating acceptance and mindfulness-based exercises and discussions. Semi-structured interviews were conducted with five family carers following attendance of the workshops. Participants found the workshops useful and reported that they were better able to cope with stress. They also described how they had incorporated mindfulness into their daily lives and how their practice had had positive effects on their own well-being and on those around them (e.g. their child). Implications of the findings are discussed with emphasis on how the workshops can be included within a positive behaviour support framework. Future directions include a more robust quantitative evaluation, inclusion of follow-up sessions and the application of the workshops with other client groups and in other delivery formats.

Measurement tools for mental health problems and mental well-being in people with severe or profound intellectual disabilities : a systematic review

Mental health problems affect people with intellectual disabilities (ID) at rates similar to or in excess of the non-ID population. People with severe ID are likely to have persistent mental health problems. In this systematic review (PROSPERO 2015:CRD42015024469), we identify and evaluate the methodological quality of available measures of mental health problems or well-being in individuals with severe or profound ID. Electronic searches of ten databases identified relevant publications. Two reviewers independently reviewed titles and abstracts of retrieved records (n=41,232) and full-text articles (n=573). Data were extracted and the quality of included papers was appraised. Thirty-two papers reporting on 12 measures were included. Nine measures addressed a broad spectrum of mental health problems, and were largely observational. One physiological measure of well-being was included. The Aberrant Behavior Checklist, Diagnostic Assessment for the Severely Handicapped Scale-II and Mood, Interest and Pleasure Questionnaire are reliable measures in this population. However, the psychometric properties of six other measures were only considered within a single study - indicating a lack of research replication. Few mental health measures are available for people with severe or profound ID, particularly lacking are tools measuring well-being. Assessment methods that do not rely on proxy reports should be explored further.

Early intervention for children with learning disabilities: making use of what we know

Purpose – The purpose of this paper is to present a rationale for increasing initiatives for early intervention of emotional and behaviour difficulties. Design/methodology/approach – The authors draw on existing literature regarding rates of emotional and behavioural difficulties together with risk factors and processes related to the development of such difficulties. Findings – Rates of emotional and behavioural difficulties amongst children with learning and developmental difficulties are high. A combination of factors relating to the child, the family system, and wider social contexts is likely to account for this. Research limitations/implications – Increased attempts to provide early intervention to children with learning and developmental disabilities together with their families are warranted. Recommendations are made regarding how the development of such supports might best be taken forward. Originality/value – Whilst drawing on pre-existing literature, the value of this paper is the way in which this has been drawn together to provide an overview of risk and development of behavioural and other difficulties amongst children with learning/developmental disabilities.

Seeking to prevent residential care for young people with intellectual disabilities and challenging behaviour: examples and early outcomes from the Ealing ITSBS

Purpose – The purpose of this paper is to present early outcomes and case examples from the Ealing Intensive Therapeutic and Short Break Service. Design/methodology/approach – The service was piloted over a period of 3.5 years during which clinical data were collected for young people at risk of a move to residential care. Findings – There were positive outcomes for young people with intellectual disabilities and challenging behaviour who were seen through the service with residential placements prevented in the vast majority of cases. Originality/value – These early outcomes highlight the importance of providing intensive therapeutic intervention with short breaks in order to prevent family placement breakdown.

Mental disorder and adverse life events in a forensic intellectual disability service

The study investigated the frequency of adverse life events and prevalence of MD recorded for clients with intellectual disabilities (ID) in a medium secure unit, using data from an electronic patient record (EPR) system. Prevalence of MD was calculated on the basis of ICD‐10 diagnoses and a 38‐item checklist was developed to investigate adverse/traumatic life events for sub‐samples with and without MD. High rates of MD were reported overall, particularly of schizotypal and delusional disorders and disorders of personality. Adverse life events including abuse, bereavement and relationship difficulties had been documented by clinicians. The overall number of recorded events was significantly higher for clients diagnosed with a MD. Associations between MD and life events have been reported previously, but not in a forensic ID population. The study contributes to a growing body of literature highlighting the relationship between life events and mental health in people with ID, offering further information for service development and clinical practice.

Interventions for mental health problems in children and adults with severe intellectual disabilities: a systematic review

Objective Mental health problems are more prevalent in people with than without intellectual disabilities, yet treatment options have received little attention. The aim of this study was to identify and evaluate the effectiveness of pharmacological and psychological interventions in the treatment of mental health problems in children and adults with severe and profound intellectual disabilities, given their difficulties in accessing standard mental health interventions, particularly talking therapies, and difficulties reporting drug side effects. Design A systematic review using electronic searches of PsycINFO, PsycTESTS, EMBASE, MEDLINE, CINAHL, ERIC, ASSIA, Science Citation Index, Social Science Citation Index and CENTRAL was conducted to identify eligible intervention studies. Study selection, data extraction and quality appraisal were performed by two independent reviewers. Participants Study samples included at least 70% children and/or adults with severe or profound intellectual disabilities or reported the outcomes of this subpopulation separate from participants with other levels of intellectual disabilities. Interventions Eligible intervention studies evaluated a psychological or pharmacological intervention using a control condition or pre-post design. Outcomes Symptom severity, frequency or other quantitative dimension (e.g., impact), as assessed with standardised measures of mental health problems. Results We retrieved 41 232 records, reviewed 573 full-text articles and identified five studies eligible for inclusion: three studies evaluating pharmacological interventions, and two studies evaluating psychological interventions. Study designs ranged from double-blind placebo controlled crossover trials to single-case experimental reversal designs. Quality appraisals of this very limited literature base revealed good experimental control, poor reporting standards and a lack of follow-up data. Conclusions Mental ill health requires vigorous treatment, yet the current evidence base is too limited to identify with precision effective treatments specifically for children or adults with severe and profound intellectual disabilities. Clinicians therefore must work on the basis of general population evidence, while researchers work to generate more precise evidence for people with severe and profound intellectual disabilities. PROSPERO registration number CRD 42015024469.