People with intellectual disabilities (ID) are at high risk of engaging in aggressive actions. Such issues commonly transform into behavioral disorders that could put them and other people at risk of injury or property destruction. According to the research, 10% of intellectually disabled people showcase some forms of challenging behavior (Kerr et al., 2013). Therefore, the surrounding of such people faces significant challenges while working with them.
The significance of behavioral problems among individuals with intellectual disabilities remains one of the central, as they must be thoroughly researched due to its specific determinants. Special people who demonstrate aggressive attitudes require more comprehensive care and patience regarding their mental health. If the behavioral issues are not correctly managed timely, they can become a barrier for people with ID to have proper access to many vital resources like education, societal communication, or an opportunity to work.
Though many research types are focused on attitude problems among intellectually disabled people, they put more emphasis on interventions that prevent or manage it. Nevertheless, the reasoning and outcomes of such behavior require a more thorough analysis based on the actual first-hand feedback. The study is aimed to determine and examine the triggers that cause aggressive behavior among people with ID and possible associated diseases. The research is intended to confirm the hypothesis that intellectually disabled adults frequently demonstrate signs of aggressive behavior from an early age, which continues to become more severe with time.
Literature Review
Frequently patients with diagnosed intellectual disabilities demonstrate aggressive behavior that indicates the presence of underlying psychiatric conditions that must be dealt with as soon as they are diagnosed (Kerr et al., 2013). Behavioral problems are classified as chronic, meaning intellectually disabled people diagnosed with such conditions continue to display them over time, which negatively influences their quality of life (Gur, 2016). The severity of ID can determine the condition and asperity of behavioral problems, which usually manifest themselves in childhood and linger throughout the lifetime (Sappok et al., 2013). A study confirmed that over 50% of intellectually disable people demonstrate some conditions of behavioral problems and reports that anger problems within ID are closely connected to mental health issues like depression (Rose et al., 2013).
Another research study states that individually designed interventions and constant work on reducing aggression can be effective in preventing behavioral issues among people with intellectual disabilities (Kim et al., 2017). No action taken to reduce behavioral problems can lead to applying harsh measures that limit the regular life of a person. Examples may include involvement with the police, social isolation, or exclusion from treatment services (Rose et al., 2013). Moreover, severe aggressive behavior can possibly threaten the well-being of both an intellectually disabled person and people around, especially the caregivers.
Research has shown that mild and borderline intellectual disorders are at increased risk of having mental problems that result in aggressive behavior and have higher irritability (Kim et. al., 2017). Attitude issues may be the reason for a person’s exclusion from social interactions and negatively influencing their well-being and quality of life (Gur, 2016). Therefore, aggressive behavior must be continuously controlled; otherwise, it may develop more severe conditions of intellectual disabilities.
Methods
Design
The proposed quality designed study will evaluate the behavior of people with intellectual disabilities over a certain period of time and consequently conclude the primary triggers that influence ID people to demonstrate behavioral issues, including aggressiveness. Their relatives must complete a survey to assess current mental state of disabled patients and reflect on previous behavioral patterns. The study will be conducted by highly qualified specialists, where scientists and key workers will evaluate challenging behavior (Rose et al., 2013). The information will provide enough knowledge to answer the main question and confirm the hypothesis in a non-experimental way.
Participants
All participants must be voluntarily recruited with permissions from their caretakers in order not to cause any harm. The approximate amount of individuals can vary; however, more people would provide the research with more precise results. The participants of the study are people with various intellectual disorders. Some of them have confirmed aggressive behavior; others are being studied on the subject of any behavioral issues and how they manifest themselves. Therefore, the collected data will give a more inclusive and generalized answer to the central question. Such a sampling method is useful for tracking the person’s journey of any kind of aggressive behavior and can ultimately contribute to confirming the hypothesis that behavioral challenges become apparent at a young age.
Procedure/Measures
Primary to the assessments, all participants must be evaluated by a psychiatrist on the existing conditions of the mental disorder. Such check-up must identify and confirm the medical history of individuals as well as their current state of mental health. For the determination of triggers of behavioral problems, the measuring method called Staff Observation Aggression Scale-Revised, Adapted for People With Intellectual Disabilities (SOAS-R-ID) will be used for the medical staff and relatives of ID people. The questionnaire consists of five columns that help identify the nature of aggressive behavior an individual has ever displayed. The columns include types of aggressive behavior, objects used to assist their violence, people targeted by the challenging behavior, outcomes, and measures taken to stop the aggression (Kim et. al., 2017). The questionnaire will be specially adapted for the participant’s medical history.
The answers given by caregivers and relatives can be added up and have a score from 0 to 22 – 22 being the most severe form of behavioral challenges. The procedure of calculating the score consists of summing up the highest score in each column (Kim et. al., 2017). Consequently, the numbers scored by a participant would be converted to the percentage, which will help understand the level of aggression more clearly.
Participants with intellectual disabilities will be observed for some time in their natural settings and also would be put in certain situations that could trigger the aggression. The procedure used is called the Provocation Index (PI), which is summarized as an analysis of responses to anger-provoking situations (Rose et al., 2013). The evaluation includes 25 cases that can evoke inadequate behavior, which is evaluated on a scale of 0-3, according to its severity. Therefore, the experts will be able to identify precisely what provokes anger issues in people with intellectual disabilities most.
Data Analysis
Descriptive statistics in the Statistical Package for the Social will be used to analyze the data from the SOAS-R-ID questionnaire. This would be the most sufficient way to obtain the most accurate data. The results from the Provocation Index test will be analyzed in two stages. Firstly, bivariate results must be summarized for all variables. Next, to predict the accurate PI scores, a linear regression will be used, where the variables are computed in three parts: demographic variables, mental health and challenging behavior measures (Rose et al., 2013). It will be possible to identify the aggression triggers more accurately by dividing and analyzing the received data.
Ethical Issues
Participation in the research will be entirely voluntary for both people with intellectual disabilities and their caretakers. Moreover, the permission forms the responsible individuals for participants with ID will be requested, so the research is conducted strictly willingly. In no way does the study worsen or trigger any new mental health conditions for the participants, all precautions and constant psychological assessments will be used.
The anonymity of each volunteer will be secured. No names will be used in the surveys or the published research. All individuals will be assigned their unique identification numbers under which they will undergo during the experimental process. The list of names with people taking part in the procedure will be destroyed according to the guidelines of the Institutional Review Board three years after the conducted research.
As the research involves the participation of a vulnerable group of people, it will be ensured that their involvement does not threaten their mental state and reassure their willing participation. If in any case, the person or their guardian starts to feel uncomfortable or unsafe, the participation can be immediately terminated. The comprehension of all intellectually disabled individuals will be evaluated as well as the specific tools for conducting the research will be created in order to establish a safe and friendly atmosphere.
The research will be entirely objective and will avoid facing any biased aspects of the study to keep it as accurate as possible. Any people the examinators have acquaintances with will not review the article, and full equality will be established at the setting of the conducted study. Any personal and financial interest that might be followed during the research will be immediately disclosed in order for its full transparency.
Conclusion
People with intellectual disabilities frequently have behavioral disorders caused by various external factors. Most individuals with ID have demonstrated any kind of aggressive behavior at least once; thus, around 10% of such patients continually become a behavioral challenge for their surroundings (Kerr et al., 2013). Therefore, many underlying factors may be causing the aggressive attitude that must be identified and dealt with. In case of neglecting or worse endorsing such behavior, mental conditions of intellectually disabled people may worsen and lead to the exclusion from society or problems with the criminal justice system.
Assessment of behavioral issues and identification of the leading causes that trigger it is the primary goal for the research. The foundational factors that lead to such actions should be determined in order to deal with such behavior effectively. Inappropriately designed interventions that aim to help manage anger problems among intellectually disabled people can negatively influence their mental health and initiate the new conditions.
The methods used for the assessment are expected to be extremely accurate as they involve not only mentally ill people but also their caretakers, which must provide a more objective analysis. The conducted research is vital and essential for further studying behavioral issues among people with intellectual disabilities as little empirical analysis regarding the principal causes of aggressive behavior within the ID community was conducted.
References
Gur, A. (2016). Challenging behavior, functioning difficulties, and quality of life of adults with intellectual disabilities. International Journal of Developmental Disabilities, 64(1), 45–52.
Kerr, M., Gil-Nagel, A., Glynn, M., Mula, M., Thompson, R., & Zuberi, S. M. (2013). Treatment of behavioral problems in intellectually disabled adult patients with epilepsy. Epilepsia, 54, 34–40.
Kim J. H. M. Van Den Bogaard, Nijman, H. L. I., Palmstierna, T., & Embregts, P. J. C. M. (2017). Characteristics of aggressive behavior in people with mild to borderline intellectual disability and co-occurring psychopathology. Journal of Mental Health Research in Intellectual Disabilities, 11(2), 124–142.
Rose, J., Willner, P., Shead, J., Jahoda, A., Gillespie, D., Townson, J., Lammie, C., Woodgate, C., Stenfert Kroese, B., Felce, D., MacMahon, P., Rose, N., Stimpson, A., Nuttall, J., & Hood, K. (2013). Different factors influence self-reports and third-party reports of anger by adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 26(5), 410–419.
Sappok, T., Budczies, J., Dziobek, I., Bölte, S., Dosen, A., & Diefenbacher, A. (2013). The missing link: Delayed emotional development predicts challenging behavior in adults with intellectual disability. Journal of Autism and Developmental Disorders, 44(4), 786–800.