Page 134 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Chapter 6
the participants’ (professional) support systems was observed, with only
incidental support from caregivers rather than structured integration in the
treatment.
Key findings
This section presents two key findings derived from the four studies
presented in this dissertation. These findings bring together the results
across studies and conclude by reflecting on their implications for clinical
assessment, treatment, and future research.
Key finding 1: PTSD can be recognised in adults with MID-BIF through the
Trauma Screener – Intellectual Disability (TS-ID)
In Study 1 (Chapter 2), adults with MID-BIF, living in supported housing and
receiving 24-hour care from ID care services, were studied. Among the 97
participants, 58% could be classified as having PTSD according to the DITS-
ID, whereas only 7% had received a PTSD diagnosis prior to participation.
This discrepancy aligns with findings from other studies and illustrates
how PTSD often remains undetected in these individuals. Mevissen et al.
(2020a) examined 106 adults with MID-BIF who were receiving care from
ID care services and found a PTSD prevalence of 38% based on the DITS-
ID-adults, while only 6% had a PTSD diagnosis recorded in their client
file. Nieuwenhuis et al. (2019) conducted a study in 570 individuals with
severe mental illness in a tertiary mental health care setting and reported
a suspected PTSD rate of 48% among those with suspected MID-BIF,
based on an older screening instrument for PTSD. Nevertheless, PTSD was
recorded in only 2% of the client files. Together with our own findings, we
may conclude that although PTSD is relatively common in adults with MID-
BIF in clinical settings, it is not frequently recognised in clinical practice.
These findings highlighted the urgent need to improve PTSD recognition in
individuals with MID-BIF, because it is likely that if PTSD is not recognised,
effective trauma treatment will not be provided.
As described in the General Introduction (Chapter 1), professional caregivers
and clinicians face several challenges in recognising PTSD in individuals
with MID-BIF, and several explanations have been proposed for this. One
explanation is that professional caregivers are frequently unaware of the
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