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People with intellectual disability (ID) are likely to experience mental health concerns and poor physical health. However, there is a lack of understanding regarding what factors, specifically psychosocial factors, influence physical and mental health in this population. In people without disabilities, three factors have consistently been tied to mental and physical well-being, stress, social support, and physical activity. Though there is a plethora of research into how these three factors impact health in people without disabilities, research in people with ID is lacking. The present study used a combination of established and novel self-report scales to collect data on the well-being, conceptualized as both physical and mental health, of 150 adults with ID. Measures of social support, physical activity and stress were also obtained. For a sub sample of participants (n=90), proxy report was obtained on identical factors. The primary goal of the study was to use structural equation modeling (SEM) to test a theoretical model of health informed solely by self-report. Secondary aims were to expand the research base on self-report in people with ID by examining use of several scales in this population and to compare self and proxy report.People with ID were found to be capable of reporting on various aspects of life such as health, mental health symptoms, social support, stress, and physical activity. The majority of the scales used had acceptable psychometric properties, though some scales were found to need additional research in this population. Specifically, it was found that the scale used as a measure of mental health may perform differently in this population than in people without disabilities and that the measure of social support used may need an alternate scoring method. Agreement between raters on various scales ranged from poor to substantial with significant variation between and with-in scales. These results indicate that efforts should be made to obtain self-report whenever possible and proxy reports should be used with caution. The theoretical model testing the impact of social support, physical activity, and stress on physical and mental health was determined to have acceptable to good fit. The model indicated that higher stress was associated with poorer mental and physical health while higher reports of friendships were also associated with poorer mental health. The model showed that important variables related to well-being can be modeled using self-report in this population and provide valuable information regarding the impact of stress on the health of people with ID.

Previous research has demonstrated a relationship between stress and mental health in both the general population and individuals with intellectual disability (ID). In the general population social support and physical activity have both been shown to have an ameliorating effect upon this relationship, but little research has addressed this topic in adults with ID or examined the gender differences that may be present in social support. This study examines the effects of social support, gender, and physical activity on the stress-mental health relationship in adults with ID. A nationally representative sample from a preexisting dataset, the National Core Indicators was used to examine these factors. Mental health was conceptualized as both mental illness and behavior problems, as both play an important role in the overall health and wellness of individuals with ID. Hierarchical regression was used to examine the predictive power of social support, gender and physical activity on both mental illness and severity of behavior problems. Stress was a significant predictor of both mental illness and severity of behavior problems, with each additional stressor increasing the odds of poor mental health by 20%. This relationship held, even after controlling for level of ID, gender and place of residence. Though a lack of social support was a strong predictor of having a mental illness, individuals who lacked social support were twice as likely to have a mental illness, it was not a predictor of behavior problems nor did gender affect social support. Physical activity was a predictor of behavior problems but not a predictor of mental illness. The results of this study suggest that stress is an important variable that should be considered a part of the assessment of both mental illness and behavior problems. This study also suggests that while both mental illness and behavior problems are similarly impacted by stress, social support may play a different role in each of these factors. Implications for treatment and assessment of mental health concerns are discussed and directions for future research suggested.