Page 20 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Chapter 1
events that individuals with ID have been exposed to, which significantly
hinders the identification of PTSD in this group (Hoogstad et al., 2023).
These explanations illustrate the complexity of recognising PTSD in people
with MID-BIF, emphasising the need for suitable screening and diagnostic
tools to support accurate identification and assessment of PTSD.
Screening for PTSD in adults with MID-BIF
At the start of this research project, no screening instrument was available
that had been developed for adults with MID-BIF and aligned with the DSM-
5-TR criteria. The lack of a screener likely contributed to not recognising
PTSD in this group. Available PTSD screeners fall roughly into three
categories: those based on the DSM-5-TR but not validated for individuals
with MID-BIF, such as the PTSD Checklist for DSM-5 (PCL-5; Blevins et
al., 2015); those validated for individuals with MID-BIF but based on the
DSM-IV criteria, such as the Impact of Event Scale – Intellectual Disabilities
(IES-ID; Hall et al., 2014); and screeners that are both based on the DSM-IV
and not validated for people with MID-BIF, such as the Trauma Screening
Questionnaire (TSQ; Brewin et al., 2002), used in the study by Nieuwenhuis et
al. (2019). It is essential that a PTSD screener for individuals with MID-BIF is
both aligned with the current DSM-5-TR criteria and adapted and validated
for adults with MID-BIF. The DSM-5-TR introduced substantial revisions
in the conceptualisation and diagnostic criteria of PTSD, rendering earlier
instruments based on the DSM-IV no longer fully appropriate. Moreover,
individuals with MID-BIF have specific cognitive and communicative needs
that require feasible screening tools. Adaptations, such as simplified
language and visual support, are necessary to improve the comprehension
and reliability of self-reporting (Douma et al., 2025). The development and
validation of a DSM-5-TR based trauma screener tailored to the cognitive
and communicative capacities of adults with MID-BIF is therefore important
and is addressed in Chapter 3 of this dissertation. Without such a screener,
clinical practice risks delays in the recognition and diagnosis of PTSD,
ultimately impacting timely access to effective treatment.
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