Page 198 - Characterization of genetic neurodevelopmental disorders at adult age, with a focus on 22q11.2 deletion syndrome - Emma Boersma

Chapter 7
Discussion
The results of this first explorative study focusing on trauma in adults with
22q11.2DS support our hypothesis of an elevated risk of developing PTSD
(8.0%) as compared with the general population (3.9%).2, 3
There is growing evidence that intellectual disability and borderline
intellectual functioning, both often seen in 22q11.2DS, increase the risk of
exposure to traumatic events and the development of PTSD symptoms,5-7
with direct negative effects on emotional, behavioural and adaptive
functioning.8 Also, life events are more likely to be experienced as traumatic
in people with intellectual disabilities, even though DSM-5 criteria are not
always met.5 PTSD and traumatic experiences are however often not
recognized in these populations.5,6 One reason may be that symptoms may
be overshadowed by, or attributed to, other psychiatric disorders such as
psychotic illness.6 Another reason may be that patients and/or their relatives
themselves do not recognize trauma-related symptoms,6 or find it hard to
ask for help for trauma-related symptoms. Also, professionals may hesitate
to pay attention to past traumatic experiences, out of fear of aggravating
symptoms and causing a crisis.6 Therefore, we presume under-recognition
and/or under-reporting of PTSD and traumatic experiences in 22q11.2DS.
Here, it should also be noted that adults and patients with intellectual
disability were underrepresented in previous 22q11.2DS research.2
Recognition of trauma and PTSD is important since it allows for treatment
which may also have the potential of reducing psychosis risk in high-risk
populations,9 such as 22q11.2DS. While we are not aware of any study
reporting on the effectiveness of interventions for trauma in 22q11.2DS,
an increasing number of studies have shown positive effects of EMDR and
CBT in individuals with intellectual disability.10
Strengths and limitations
The strengths of this study include the relatively large adult 22q11.2DS
sample and the fact that the focus on trauma was not limited to strict DSM-
5 criteria for PTSD. There were also several limitations, mostly related to
the retrospective nature of the study. For example, data were limited to the
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