Page 57 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Development and evaluation of TS-ID
Introduction
Post-traumatic stress disorder prevalence in individuals with mild
intellectual disability or borderline intellectual functioning
People with mild intellectual disability or borderline intellectual functioning
(MID-BIF) (IQ 50–85) experience many negative life events (McDonnell et
al., 2019) and may develop post-traumatic stress disorder (PTSD) more
often than the general population (de Vogel & Didden, 2022; Mason-
Roberts et al., 2018; Mevissen et al., 2016; Nieuwenhuis et al., 2019). The
DSM-5-TR criteria for PTSD include exposure to actual or imminent death,
serious injury and/or sexual violence, followed by symptoms of intrusions,
avoidance, negative alterations in cognitions and mood and alterations
in arousal and reactivity. PTSD symptoms last for at least 1 month and
cause distress in social or occupational functioning or functioning in other
important areas (American Psychiatric Association, 2022). PTSD has
been found to be associated with several other mental health problems
(Goldstein et al., 2016; Pietrzak et al., 2012), which may be especially the
case in individuals with MID-BIF (McNally et al., 2021). In recent years, a
growing body of research has indicated that trauma treatment such as
eye movement desensitisation and reprocessing EMDR therapy is suitable,
safe and potentially effective for adults with MID-BIF diagnosed with PTSD
and/or comorbid behavioural and mental health problems (Penninx et al.,
2021; Verhagen et al., 2023).
Post-traumatic stress disorder unnoticed
Although PTSD is common among individuals with MID-BIF, it often
remains unnoticed in this target group (Kildahl et al., 2020a; Kildahl et al.,
2020b; Mevissen et al., 2020; Nieuwenhuis et al., 2019). For instance, in
Mevissen et al. (2020) study, among 106 adults with MID-BIF, the prevalence
of PTSD-diagnoses reported in the patients’ file was much lower (2%) than
the rate (38%) of PTSD that was found based on a standardised clinical
interview for PTSD. These and other studies suggest that PTSD is frequently
underdiagnosed in individuals with MID-BIF. It is likely that if PTSD is not
recognised, potentially effective trauma treatment will not be provided.
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