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Psychometric assessment of psychiatric disorders in people with learning difficulties (mental handicap): a review of measures

Published online by Cambridge University Press:  09 July 2009

P. Sturmey*
Affiliation:
Learning Difficulties Research Group, School of Psychology; and School of Psychiatry, University of Birmingham
J. Reed
Affiliation:
Learning Difficulties Research Group, School of Psychology; and School of Psychiatry, University of Birmingham
J. Corbett
Affiliation:
Learning Difficulties Research Group, School of Psychology; and School of Psychiatry, University of Birmingham
*
1Address for correspondence: Dr P. Sturmey, School of Psychology, University of Birmingham, PO Box 363, Birmingham B15 2TT.

Synopsis

Instruments designed to assess psychiatric disorders in people with learning difficulties (mental handicap) were critically reviewed from a psychometric perspective. Major trends were found in the assessment of psychopathology related to DSM-III and depressive disorders although research in other areas was patchy. Although some psychometrically sophisticated measures were identified the area was characterized by an absence of important psychometric data for many measures. Future research should attend to developing assessments of schizophrenia, psycho-sexual disorders, adjustment disorders and the validation of screening procedures and instrument formats. Future studies should include more people with severe and profound learning difficulties.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1991

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References

Aman, M. G., Watson, J. E., Singh, N. N., Turbott, S. H. & Wilsher, C. P. (1986). Psychometric and demographic characteristics of the Psychopathology Instrument for Mentally Retarded Adults. Pharmacology Bulletin 22, 19721976.Google ScholarPubMed
Ballinger, B. R. & Reid, A. H. (1987). A standardized assessment of personality disorder in mental handicap. British Journal of Psychiatry 105, 108109.CrossRefGoogle Scholar
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.CrossRefGoogle ScholarPubMed
Blackburn, R. (1979). Psychopathy and personality: the dimensionality of self-report and behaviour rating data in abnormal offenders. British Journal of Clinical Psychology 18, 111119.Google ScholarPubMed
Blackburn, R. (1982). On the relevance of the concept of the psychopath. In Issues in Criminological and Legal Psychology (ed. Black, D. A.), pp. 1225. British Psychological Society: Leicester.Google Scholar
Blackburn, R. (1986). Patterns of personality deviation among offenders. British Journal of Criminology 26, 254269.CrossRefGoogle Scholar
Blackburn, R. (1987). Two scales for the assessment of personality disorder in mentally abnormal offenders. Personality and Individual Differences 8, 8194.CrossRefGoogle Scholar
Blackburn, R. (1988 a). On moral judgements and personality disorders: the myth of personality disorders revisited. British Journal of Psychiatry 153, 505512.CrossRefGoogle ScholarPubMed
Blackburn, R. (1988 b). Psychopathology and personality disorder. In Adult Abnormal Psychology (ed. Miller, E. and Cooper, P. J.), pp. 218244. Churchill Livingstone: Edinburgh.Google Scholar
Blackburn, R. & Lee-Evans, J. M. (1985). Reactions of primary and secondary psychopaths to anger-evoking situations. British Journal of Clinical Psychology 24, 93100.CrossRefGoogle ScholarPubMed
Blackburn, R. & Maybury, C. (1985). Identifying the psychopath: the relation of Cleckley's criteria to the inter-personal domain. Personality and Individual Differences 6, 375386.CrossRefGoogle Scholar
Bouras, N. & Drummond, K. (1989). Community Psychiatric Service in Mental Handicap: Six Years of Experience. National Unit for Psychiatric Research and Development: London.Google Scholar
Bouras, N., Drummond, K., Brooks, D. & Laws, M. (1988). Mental Handicap and Mental Health: a Community Service. National Unit for Psychiatric Research and Development: London.Google Scholar
Bouras, N., Laws, M., Brooks, D., Drummond, K. & Turk, V. (1987). Multi-axial Information Rating Profile of Grove Park Residents. National Unit for Psychiatric Research and Development: London.Google Scholar
Brugha, T. S., Collacot, R., Warrington, J., Debh, S. & Bruce, J. (1988). Eliciting and reliably rating delusions and hallucinations in the mildly mentally retarded.Paper read at 8th IASSMD Congress,Dublin,August 1988.Google Scholar
Castaneda, A., McCandless, B. R. & Palerno, D. S. (1956). The children's form of the Manifest Anxiety Scale. Child Development 27, 317326.CrossRefGoogle ScholarPubMed
Cleckley, H. (1976). The Mask of Sanity. Mosby: St Louis.Google Scholar
Cochran, I. L. & Cleland, C. C. (1963). Manifest anxiety of retardates and normals matched as to academic achievement. American Journal of Mental Deficiency 67, 539542.Google ScholarPubMed
Coffman, T. L. & Harris, M. C. (1980). Transition shock and adjustment of mentally retarded persons. Mental Retardation 18, 370.Google ScholarPubMed
Corbett, J. A. (1977). Population studies of mental retardation. In Child Psychiatry (ed. Graham, P.), pp. 305322. Academic Press: New York.Google Scholar
Corbett, J. A. (1979). Psychiatric morbidity and mental retardation. In Mental Illness and Mental Retardation (ed. Snaith, P. and Jones, F. E.), pp. 1125. Gaskell: London.Google Scholar
Corbett, J. A. (1984). Psychiatry and mental handicap. In Scientific Studies in Mental Retardation (ed. Dobbin, J., Clarke, A. D. B., Corbett, J. A., Hogg, J. and Robinson, R. O.), pp. 479490. Macmillan/Royal Society of Medicine: London.CrossRefGoogle Scholar
Corbett, J. A. (1985). Mental retardation: psychiatric aspects. In Child Psychiatry – Modern Approaches (ed. Rutter, M. and Hersov, L.), pp. 661668. Blackwell: Oxford.Google Scholar
Cronbach, L. J. (1946). Response sets and test validity. Educational and Psychological Measurement 6, 475494.CrossRefGoogle Scholar
Cuvo, A. J. (1976). Decreasing repetitive behavior in an institutionalised mentally retarded resident. Mental Retardation 14, 2225.Google Scholar
Day, K. (1988). Services for psychiatrically disordered mentally handicapped adults. A UK perspective. Australia and New Zealand Journal of Developmental Disabilities 14, 1925.CrossRefGoogle Scholar
Duff, R., La Rocca, J., Lizzet, A., Martin, P., Pearce, L., Williams, M. & Peck, C. (1981). A comparison of the fears of mildly retarded adults with children of their mental age and chronological age matched controls. Journal of Behavior Therapy and Experimental Psychiatry 12, 121124.CrossRefGoogle ScholarPubMed
Edelbrook, C. & Costell, A. J. (1988). Convergence between statistically derived behavior problem syndromes and child psychiatric diagnoses. Journal of Abnormal Child Psychology 16, 219231.CrossRefGoogle Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 5763.CrossRefGoogle ScholarPubMed
Feinstein, C., Kaminer, Y., Barrett, R. P. & Tylenda, B. (1988). The assessment of mood and affect in developmentally disabled children and adolescents: the Emotional Disorders Rating Scale. Research in Developmental Disabilities 9, 109121.CrossRefGoogle ScholarPubMed
Fieldhausen, J. F. & Klausmeier, H. J. (1962). Anxiety, intelligence, and achievement in children of low, average, and high intelligence. Child Development 33, 403409.CrossRefGoogle Scholar
Flynn, M. C. (1989). Independent Living for Adults with Mental Handicap. A Place of Their Own. Cassell: London.Google Scholar
Folstein, M., Folstein, S. & McHugh, P. (1975). ‘Mini-mental State’: a practical method for grading cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189198.CrossRefGoogle Scholar
Glue, P. (1989). Rapid cycling affective disorder in the mentally retarded. Biological Psychiatry 26, 250256.CrossRefGoogle ScholarPubMed
Guarnaccia, V. J. & Weiss, R. L. (1974). Factor structure of fears in the mentally retarded. Journal of Clinical Psychology 30, 540544.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.CrossRefGoogle ScholarPubMed
Hathaway, S. R. & McKinley, J. C. (1967). Minnesota Multiphase Personality Inventory: Manual for Administration and Scoring. Psychological Corporation: New York.Google Scholar
Helsel, W. J. & Matson, J. L. (1988). The relationship of depression to social skills and intellectual functioning in mentally retarded adults. Journal of Mental Deficiency Research 32, 411418.Google ScholarPubMed
Hogg, J., Moss, S. & Cooke, D. (1988). Ageing and Mental Handicap. Croom Helm: London.Google Scholar
Hucker, S. J., Day, K. E., George, S. & Roth, M. (1979). Psychosis in mentally handicapped adults. In Psychiatric Illness and Mental Handicap (ed. Snaith, P. and James, P. E.). Headley Brothers: Ashford.Google Scholar
Hurley, A. D. (1989). Individual psychotherapy with mentally retarded individuals: a review and call for research. Research in Developmental Disabilities 10, 261275.CrossRefGoogle ScholarPubMed
Irvine, L. K., Halpern, A. S. & Reynolds, W. M. (1979). Assessing social and provocational awareness in mildly and moderately retarded individuals. American Journal of Mental Deficiency 82, 266272.Google Scholar
Iverson, J. C. & Fox, R. A. (1989). Prevalence of psychopathology among mentally retarded adults. Research in Developmental Disabilities 10, 7783.CrossRefGoogle ScholarPubMed
Jacobson, J. W. & Ackerman, L. J. (1989). Psychological services for persons with mental retardation and psychiatric impairments. Mental Retardation 27, 3336.Google ScholarPubMed
Kay, S. R. (1989). Cognitive battery for differential diagnosis of mental retardation v. psychosis. Research in Developmental Disabilities 10, 251260.CrossRefGoogle Scholar
Kazdin, A. E., Matson, J. L. & Senatore, V. (1983). Assessment of depression in mentally retarded adults. American Journal of Psychiatry 140, 10401043.Google ScholarPubMed
Keys, C. B., Fletcher, R. J., Holmes, P. A. & Schloss, P. J. (1989). Bridging the two cultures of dual diagnosis: research and service. Research in Developmental Disabilities 10, 277284.CrossRefGoogle ScholarPubMed
Kline, R. B. (1988). Methodological considerations in the evaluation of the convergence of psychiatric diagnoses and parent informant checklists. Journal of Abnormal Child Psychology 16, 189198.CrossRefGoogle ScholarPubMed
Kline, R. B., Lachar, D. & Gdowski, C. L. (1988). Convergence and concurrent validity of DSM-III diagnoses and the Personality Inventory for Children (PIC). Canadian Journal of Behavioral Science 20, 251264.CrossRefGoogle Scholar
Lindsay, W. R. & Michie, A. M. (1988). Adaption of the Zung self-rating anxiety scale for people with a mental handicap. Journal of Mental Deficiency Research 32, 485490.Google ScholarPubMed
Lipman, R. S. (1960). Children's Manifest Anxiety in retardates and approximately equal M.A. normals. American Journal of Mental Deficiency 64, 10271028.Google Scholar
Lubin, B. (1967). The Depression Adjective Checklist Manual. Education and Industrial Testing Services: San Diego.Google Scholar
Lund, J. & Munk-Jorgensen, P. (1988). Psychiatric aspects of Down's Syndrome. Acta Psychiatrica Scandinavica 78, 369374.CrossRefGoogle ScholarPubMed
Malpass, L. F., Mark, S. & Palermo, D. S. (1960). Responses of retarded children to the Children's Manifest Anxiety Scale. Journal of Educational Psychology 51, 305308.CrossRefGoogle Scholar
Mann, A. H., Jenkins, R., Cutting, J. C. & Cowen, P. J. (1981). The development of a standardised measure of abnormal personality. Psychological Medicine 11, 839847.CrossRefGoogle Scholar
Marcell, M. M. & Jett, D. E. (1985). Identification of expressed emotions by mentally retarded individuals. American Journal of Mental Deficiency 89, 537545.Google Scholar
Matson, J. L. (1982). Treatment of obsessive compulsive behavior in mentally retarded adults. Behavior Modification 6, 551557.CrossRefGoogle Scholar
Matson, J. L. (1983). Depression in the mentally retarded: toward a conceptual analysis of the diagnosis. Progress in Behavior Modification 15, 5779.CrossRefGoogle Scholar
Matson, J. L. (1988). Behavioural approaches with developmental disabilities: the state of the art.Paper presented to the World Congress on Behaviour Therapy,Edinburgh,September 1988.Google Scholar
Matson, J. L. & Barrett, R. P. (1982). Psychopathology in the Mentally Retarded. Grune & Stratton: New York.Google Scholar
Matson, J. L. & Frame, C. (1983). Psychopathology. In Assessing the Mentally Retarded (ed. Matson, J. L. and Breuning, S. E.), pp. 115141. Grune & Stratton: New York.Google ScholarPubMed
Matson, J. L., Barrett, R. P. & Helsel, W. J. (1988). Depression in mentally retarded children. American Journal of Mental Deficiency 9, 3946.Google ScholarPubMed
Matson, J. L., Kazdin, A. E. & Esveldt-Dawson, K. (1980). Training interpersonal skills among mentally retarded and socially dysfunctional children. Behaviour Research and Therapy 18, 419427.CrossRefGoogle ScholarPubMed
Matson, J. L., Kazdin, A. E. & Senatore, V. (1984). Psychometric properties of the Psychopathology Instrument for mentally retarded adults. Applied Research in Mental Retardation 5, 881889.CrossRefGoogle ScholarPubMed
Miller, L. C., Barrett, C. L., Hampe, E. & Noble, H. (1972). Factor structure of childhood fears. Journal of Consulting and Clinical Psychology 39, 264268.CrossRefGoogle ScholarPubMed
Myers, B. A. (1987). The Mini-Mental State in those with developmental disabilities. Journal of Nervous and Mental Diseases 175, 8589.CrossRefGoogle Scholar
Ollendick, T. H. & Ollendick, D. G. (1982). Anxiety disorders. In Psychopathology in the Mentally Retarded (ed. Matson, J. L. and Barrett, R. P.). Grune & Stratton: New York.Google Scholar
Parks, S. L. (1983). The assessment of autistic children: a selective review of available instruments. Journal of Autism and Developmental Disorders 13, 225268.CrossRefGoogle ScholarPubMed
Pawlarczyk, D. & Beckwith, B. E. (1987). Depressive symptoms displayed by persons with mental retardation: a review. Mental Retardation 25, 325340.Google Scholar
Pirodsky, D. M., Gibbs, J. W., Hesse, R. A., Hsieh, M. C., Krause, R. B. & Rodriguez, R. B. (1985). Use of the dexamethasone suppression test to detect depressive disorders of mentally retarded individuals. American Journal of Mental Deficiency 90, 245252.Google ScholarPubMed
Prout, H. T. & Schaefer, B. M. (1985). Self-reports of depression by community-based mildly mentally retarded adults. American Journal of Mental Deficiency 90, 220222.Google ScholarPubMed
Pryer, M. W. & Cassel, R. H. (1962). The Children's Manifest Anxiety Scale: reliability with assessments. American Journal of Mental Deficiency 66, 860.Google Scholar
Reed, J. & Clements, J. (1989). Assessing the understanding of emotional states in a population of adolescents and young adults with mental handicaps. Journal of Mental Deficiency Research 33, 299333.Google Scholar
Reid, A. H. (1982). The Psychiatry of Mental Handicap. Blackwell: London.Google Scholar
Reid, A. H. (1989). Schizophrenia in mental retardation: clinical features. Research in Developmental Disabilities 10, 241249.CrossRefGoogle ScholarPubMed
Reid, A. H. & Ballinger, B. R. (1987). Personality disorder in mental handicap. Psychological Medicine 17, 983987.CrossRefGoogle ScholarPubMed
Reid, A. H. & Naylor, G. J. (1976). Short-cycle manic depressive psychosis in mental defectives: a clinical and physiological study. Journal of Mental Deficiency 20, 6776.Google ScholarPubMed
Reiss, S. & Benson, B. A. (1984). Awareness of negative social conditions among mentally retarded, emotionally disturbed out-patients. American Journal of Psychiatry 141, 8890.Google Scholar
Reiss, S. & Benson, B. A. (1985). Psychosocial correlates of depression in mentally retarded adults. I. Minimal social support and stigmatization. American Journal of Mental Deficiency 89, 331337.Google ScholarPubMed
Reynolds, W. K. & Baker, J. A. (1988). Assessment of depression in persons with mental retardation. American Journal of Mental Retardation 93, 93103.Google ScholarPubMed
Reynolds, W. M. & Miller, K. L. (1985). Depression and learned helplessness in mentally retarded and non-mentally retarded adolescents: an initial investigation. Applied Research in Mental Retardation 6, 295306.CrossRefGoogle Scholar
Reynolds, W. M., Baker, J. A., Crain, B. A. & Youngerman, D. (1987). Reliability and factor structure of the Hamilton Depression Rating Scale with mentally retarded individuals. Unpublished manuscript, University of Wisconsin, Madison, USA.Google Scholar
Riddle, K. D. & Rappaport, J. L. (1976). A 2-year follow-up of 172 hyperactive boys. Journal of Nervous and Mental Diseases 162, 126134.CrossRefGoogle Scholar
Rivinius, T. M. & Harmatz, J. S. (1979). Diagnosis and lithium treatment of affective disorder in the retarded: five case studies. American Journal of Psychiatry 136, 551554.CrossRefGoogle Scholar
Rutter, M., Tizard, J., Graham, P. & Whitmore, K. (1976). Isle of Wight Studies, 1964–74. Psychological Medicine 6, 313332.CrossRefGoogle Scholar
Senatore, V., Matson, J. L. & Kazdin, A. E. (1985). An inventory to assess psychopathology in mentally retarded adults. American Journal of Mental Retardation 89, 459466.Google ScholarPubMed
Smith, A. H. W., Ballinger, B. R. & Presly, A. S. (1981). The reliability and validity of two assessment scales in the mentally handicapped. British Journal of Psychiatry 136, 1516.CrossRefGoogle Scholar
Snaith, P. & James, F. E. (1979). Mental Illness and Mental Retardation. Gaskell: London.Google Scholar
Sovner, R. & Hurley, A. D. N. (1983). Do the mentally retarded suffer from affective illness? Archives of General Psychiatry 40, 6167.CrossRefGoogle ScholarPubMed
Stark, J. A., Menolascino, F. J., Albarelli, M. H. & Gray, V. C. (1988). Mental Retardation and Mental Health. Classification, Diagnosis, Treatment, Services. Springer-Verlag: New York.CrossRefGoogle Scholar
Sturmey, P. & Ley, T. (1990). The Psychopathology Instrument for Mentally Retarded Adults: internal consistencies and relationship to behaviour problems. British Journal of Psychiatry 156, 428430.CrossRefGoogle ScholarPubMed
Sturt, E. (1981). Hierarchical patterns in the distribution of psychiatric symptoms. Psychological Medicine 11, 783794.CrossRefGoogle ScholarPubMed
Turner, T. H. (1989). Schizophrenia and mental handicap: an historical review, with implications for further research. Psychological Medicine 19, 301314.CrossRefGoogle ScholarPubMed
Vittiello, B., Spreat, S. & Behar, D. (1989). Obsessive compulsive disorder in mental retardation. Journal of Nervous and Mental Disease 177, 232236.CrossRefGoogle Scholar
Watson, J. E., Aman, M. G. & Singh, N. N. (1988). The psychopathology Instrument for Mentally Retarded Adults: psychometric characteristics, factor structure, and relationship to subject characteristics. Research in Developmental Disabilities 9, 277290.CrossRefGoogle ScholarPubMed
Weiseler, N. A., Campbell, G. J. & Sonis, W. (1988). Ongoing use of an affective rating scale in the treatment of a mentally retarded individual with rapid-cycling bipolar affective disorder. Research in Developmental Disabilities 9, 4753.CrossRefGoogle Scholar
Worrall, E. P., Moody, J. P. & Naylor, G. J. (1975). Lithium in non-manic depressives: anti-aggressive effect and red blood cell lithium values. British Journal of Psychiatry 126, 464468.CrossRefGoogle Scholar
Zigler, E. & Burack, J. A. (1989). Personality development in the dually diagnosed person. Research in Developmental Disabilities 19, 225240.CrossRefGoogle Scholar
Zung, W. W. K. (1965). A self-rating depression scale. Archives of General Psychiatry 12, 6370.CrossRefGoogle ScholarPubMed
Zung, W. W. K. (1971). A rating instrument for anxiety disorders. Psychosomatics 12, 371379.CrossRefGoogle ScholarPubMed