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Introduction: The measures implemented to manage the COVID-19 pandemic have been shown to impair mental health. This problem is likely to be exacerbated for carers., Method: Informal carers (mainly parents) of children and adults with intellectual disabilities, and a comparison group of parents of children without disabilities, completed an online questionnaire. Almost all the data were collected while strict lockdown conditions were in place., Results: Relative to carers of children without intellectual disability, carers of both children and adults with intellectual disability had significantly greater levels of a wish fulfilment coping style, defeat/entrapment, anxiety, and depression. Differences were 2-3 times greater than reported in earlier pre-pandemic studies. Positive correlations were found between objective stress scores and all mental health outcomes. Despite their greater mental health needs, carers of those with intellectual disability received less social support from a variety of sources., Conclusions: The greater mental health needs of carers in the context of lesser social support raises serious concerns. We consider the policy implications of these findings., (© 2020 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.)

Objectives: To characterise the changes at work experienced by psychologists working with people with intellectual disabilities during the pandemic and whether these changes, stressors and aspects of working life were associated with mental wellbeing and occupational stress. Methods: Ninety-seven psychologists completed an online survey. Free text comments were analysed using thematic analysis and triangulated with our quantitative findings. Results: Occupational stress, learning new roles, demands at home, and changes due to COVID-19 were associated with poorer mental wellbeing, while uncertainty about the role, a shortage of personal protective equipment, and poorer mental wellbeing were associated with occupational stress. Two main themes emerged during the thematic analysis: being human and being an employee, and triangulation revealed agreement. Conclusions: The wellbeing and occupational stress of psychologists working with people with intellectual disabilities have been affected during the pandemic. It is of note that almost a quarter of our sample reported having been redeployed.

Background: Many people with intellectual disabilities display high levels of anger, and cognitive-behavioural anger management interventions are used routinely. However, for these methods to be used optimally, a better understanding is needed of different forms of anger assessment. The aim of this study was to investigate the relationship of a range of measures to self- and carer reports of anger expression, including instruments used to assess mental health and challenging behaviour. Method: Adults with intellectual disabilities, who had been identified as having problems with anger control, their key-workers and home carers all rated the service users' trait anger, using parallel versions of the same instrument (the Provocation Inventory). In addition, service users completed a battery of mental health assessments (the Glasgow Depression Scale, Glasgow Anxiety Scale and Rosenberg Self-Esteem Scale), and both groups of carers completed a battery of challenging behaviour measures (the Hyperactivity and Irritability domains of the Aberrant Behavior Checklist and the Modified Overt Anger Scale). Results: Participants had high levels of mental health problems (depression: 34%; anxiety: 73%) and severe challenging behaviour (26%). Hierarchical linear regression analysis was used to explore the extent to which anger ratings by the three groups of respondents were predicted by demographic factors, mental health measures and challenging behaviour measures. Older service users rated themselves as less angry and were also rated as less angry by home carers, but not by key-workers. More intellectually able service users were rated as more angry by both sets of carers, but not by the service users themselves. Significantly, mental health status (but not challenging behaviour) predicted service users' self-ratings of anger, whereas challenging behaviour (but not mental health status) predicted carers' ratings of service users' anger. Conclusions: Service users and their carers appear to use different information when rating the service users' anger. Service users' self-ratings reflect their internal emotional state and mental health, as reflected by their ratings of anxiety and depression, whereas staff rate service users' anger on the basis of overt behaviours, as measured by challenging behaviour scales.

This paper describes the characteristics of groups of prisoners selected to take part in an anger management programme in prisons in Trinidad. Participants completed demographic measures, an IQ assessment, mental health measures and anger rating scales. Fifty-six inmates were screened with the WASI-2 and characteristics of this group are explored in this paper. The mean IQ for the group was 72.34 and 22 had a recorded IQ below 70 (37.5%). All of the respondents reported high levels of mental health problems with their mean ratings on the SCL-90 being closer to those of inpatient psychiatric group norms than non-clinical groups. A score of less than 70 on the WASI-2 is not sufficient for a diagnosis of an Intellectual Disability. Nevertheless, the results suggest that a significant number of individuals in these prisons may have an Intellectual Disability. More research is needed to help identify these individuals and provide support. [ABSTRACT FROM AUTHOR]

Purpose. Many studies have reported that professionals have a limited understanding of mental capacity issues. Implementation (in England and Wales) of the Mental Capacity Act (MCA) (2005) presents a challenge to services. The aim of this study was to evaluate the extent to which National Health Service (NHS) staff benefited from attending MCA training courses. Methods. Participants were assessed before and after MCA training using a structured interview, which included three scenarios describing mental capacity dilemmas, four vignettes addressing the role of the Independent Mental Capacity Advocate (IMCA), and 16 true-false items. Results. Interview performance improved post-training, but this could be largely ascribed to an increased awareness of mental capacity issues, with minimal improvements in the knowledge that would be needed to undertake the assessments. Nine areas were identified where there remained significant gaps in participants' knowledge post-training. Participants with experience of dealing with mental capacity issues performed better than those without. Conclusions. The results suggest that methods other than formal training events may be needed to prepare health staff to implement new legislation. [ABSTRACT FROM AUTHOR]

Abstract: Cognitive behavioural therapy (CBT) assumes that psychological disorders are characterized by distorted or dysfunctional thinking, and can be treated by working with the patient to modify thinking in the direction of more realistic or adaptive evaluations of events. CBT has been evaluated extensively and is now the first-line treatment of choice for many psychological disorders. It is increasingly being used with people with learning disabilities, although the evidence base with this population is relatively weak, consisting largely of case studies and case series. There are also controlled trials in anger and depression, for which all published studies report significant clinical improvements that are well maintained over 3–6-month follow-up periods. There are many barriers to engagement with CBT for people with learning disabilities, which reflect limitations of ability and motivation. The limitations of ability reflect the fact that people with learning disabilities have to cope with cognitive deficits in addition to the cognitive distortions that are the target of CBT interventions. If barriers to treatment are recognized, significant steps can be taken to increase accessibility by adapting the therapy. Adaptations include involving carers, simplifications of the delivery of therapy (e.g. by using simple language and a slower pace), and simplifications of the model (e.g. by the therapist adopting a more directive, less collaborative, approach). If the current policy of increasing access to psychological therapies is extended to people with learning disabilities, it is likely that evidence will also accrue to support the use of other psychotherapeutic approaches. [Copyright &y& Elsevier]

The chronic mild stress (CMS) model of depression has high validity but has in the past been criticized for being difficult to replicate. However, a large number of recent publications have confirmed that CMS causes behavioural changes in rodents that parallel symptoms of depression. This review summarizes studies from over sixty independent research groups that have reported decreases in reactivity to rewards, and a variety of other depression-like behaviours, in rats or mice, following exposure to CMS. Together, these changes are referred to as a ‘depressive’ behavioural profile. Almost every study that has examined the effects of chronic antidepressant treatment in these procedures has reported that antidepressants were effective in reversing or preventing these ‘depressive’ behavioural changes. (The single exception is a study in which the duration of treatment was too brief to constitute an adequate trial.) There are also a handful of reports of CMS causing significant effects in the opposite direction, termed here an ‘anomalous’ behavioural profile. There are six neurobiological parameters that have been studied in both ‘anhedonic’ and ‘anomalous’ animals: psychostimulant and place-conditioning effects of dopamine agonists; dopamine D2 receptor number and message; inhibition of dopamine turnover by quinpirole, and beta-adrenergic receptor binding. On all six measures, CMS caused opposite effects in animals displaying ‘depressive’ and ‘anomalous’ profiles. Thus, there is overwhelming evidence that under appropriate experimental conditions, CMS can cause antidepressant-reversible depressive-like effects in rodents; however, the ‘anomalous’ profile that is occasionally reported appears to be a genuine phenomenon, and these two sets of behavioural effects appear to be associated with opposite patterns of neurobiological changes. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]