Beliefs About Aggression and Submissiveness: A Comparison of Aggressive and Nonaggressive Individuals with Mild Intellectual Disability

Recent research has examined the relevance of the social information processing model of aggression to individuals with intellectual disability (ID). This study investigated the “response access” and “response decision” steps of this model. Photo stories were used to compare aggressive and nonaggressive individuals' beliefs about the outcomes of responding aggressively and submissively in situations of interpersonal conflict. Coding of participants' open-ended answers indicated that aggressive individuals anticipated that aggressive responses would result in more favorable outcomes than their nonaggressive peers. The aggressive participants also made more negative evaluations of submissive responses. These findings have important implications for the assessment and treatment of aggression with people who have mild ID.     

Social perception in children with intellectual disabilities: the interpretation of benign and hostile intentions

Background A key aspect of social perception is the interpretation of others' intentions. Children with intellectual disabilities (IDs) have difficulty interpreting benign intentions when a negative event occurs. From a cognitive processing perspective, interpreting benign intentions can be challenging because it requires integration of conflicting information, as the social cues accompanying the negative event convey non‐hostile intentions. The present study examined how children with ID process conflicting social information in a more diverse set of situational circumstances than was investigated previously, including situations involving hostile intentions. We hypothesised that when conflicting information in a social situation consists of mixed social cues that convey insincere benign intentions (a type of hostile intentions), children with ID would have difficulty arriving at an accurate interpretation, just as they do when a negative event is accompanied by cues that convey benign intentions. We also hypothesised that when a negative event is accompanied by cues that convey benign intentions, the presence of a highly salient negative event would pose added interpretation difficulty for these children. Methods Participants (58 children with ID and 189 children without ID in grades 2–6) viewed 13 videotaped vignettes. In each vignette, social cues that accompanied a negative event provided information about the intentions of the character that caused the event. After presenting each vignette, we asked the child questions designed to assess aspects of social perception, including his/her interpretation of intentions. Vignettes represented three types of situations that pose conflicting information: (1) a conflict between a negative event and social cues, which conveyed benign intentions (five items); (2) the presence of conflicting social cues that conveyed insincere benign intentions (four items); and (3) additional items designed to examine the effect of the salience of negative event and cues on accurate interpretation of benign intentions (four items). Teachers completed rating scales of social behaviour, enabling us to examine whether the ability to interpret intentions when conflicting information is present is related to children's social behaviour. Results Children with ID had lower interpretation accuracy than children without ID for all three social situations that presented conflicting information. Children with ID appeared to have particular difficulty interpreting benign intentions when a negative event (but not the social cue) was made salient. For children with ID, interpretation accuracy and teacher‐rated social behaviour were related. Conclusions Results demonstrated that the presence of conflicting information poses cognitive processing challenges in a variety of social situations, making it difficult for children with ID to arrive at accurate interpretations. Children with ID were less likely than children without ID to interpret intentions accurately, not just when the social cues conveyed benign intentions, but also when mixed social cues conveyed hostile intentions. In addition, when social cues accompanying a negative event convey benign intentions, the relative salience of the negative event and the cues can affect interpretation accuracy for children with ID. Discussion focuses on implications for understanding the cognitive component of the social domain of adaptive behaviour, for explaining gullibility in children with ID and for instructional practices.     

Profiles and correlates of aggressive behaviour among adults with intellectual disabilities

Background Despite the heterogeneity in aggressive behaviours observed among individuals with intellectual disabilities (ID), little attention has been paid to the identification of typologies of aggression among individuals with mild or moderate ID and their associated factors. Objective The goal of the present study was to identify profiles of aggressive behaviour and their psychosocial correlates. Method In this cross‐sectional study of 296 adults with mild or moderate ID, information was gathered through interviews with the ID participants, their case manager and a significant other. Client files were also reviewed. Results Multiple correspondence analysis followed by hierarchical cluster analysis generated six distinct profiles of aggressive behaviour in this sample. The ‘violent’ group clearly stood out as lacking social and vocational involvement, having more severe mental health problems, high levels of impulsivity and antisocial tendencies compared with all other groups. Discussion The identification of distinct profiles of aggressive behaviour offers new possibilities for studying risk factors and eventually targeting specific risk prevention strategies.     

Social reasoning skills in adults with Down syndrome: the role of language,executive functions and socio‐emotional behaviour

Background Although the prevalence of mental illness and behaviour problems is lower in adults with Down syndrome (DS) than in other populations with intellectual disabilities, they do present emotional and relational problems, as well as social integration difficulties. However, studies reporting on specific competences known to be central in developing appropriate social relationships (e.g. social reasoning, emotion processing, theory of mind) remain rare in the adult DS population and the mechanisms underlying these people's emotional and relational difficulties are unclear. Method The present study investigated the ability to understand the appropriateness of others' social behaviour in 34 adults with DS, using the Social Resolution Task (SRT). Their results were compared with those of 34 typically developing (TD) children matched for gender and receptive vocabulary. The relationships among the SRT experimental task, cognitive competences (receptive and productive vocabulary, non‐verbal reasoning, inhibition, selective attention) and a caregiver‐rated measure of socio‐emotional behaviour were examined in the DS group. Results The DS participants' global SRT scores did not differ from those of the controls. However, analyses of the SRT subscores revealed that the DS group identified significantly fewer inappropriate situations than the control group. Nevertheless, when they correctly identified the behaviour as inappropriate, they were as well as the controls to explain the rules underlying their responses. Regression analyses showed that receptive vocabulary and selective attention and a specific dimension of the socio‐emotional profile (social relating skills) constituted the best predictors of the DS adults' performance on the SRT. Conclusions The main findings show that the DS participants demonstrate relatively good social reasoning skills in comparison with TD children matched for verbal age. However, the two groups present distinctions in their response patterns, and the influence of cognitive variables on success on the SRT also appears different. While selective attention skills are found to be significant predictors for both groups, the influence of receptive vocabulary level is much stronger in the DS group. The implications of particular cognitive and socio‐emotional factors for success on the SRT in this group are considered in more detail.     

Reducing aggressive responses to social exclusion using transcranial direct current stimulation

A vast body of research showed that social exclusion can trigger aggression. However, the neural mechanisms involved in regulating aggressive responses to social exclusion are still largely unknown. Transcranial direct current stimulation (tDCS) modulates the excitability of a target region. Building on studies suggesting that activity in the right ventrolateral pre-frontal cortex (rVLPFC) might aid the regulation or inhibition of social exclusion-related distress, we hypothesized that non-invasive brain polarization through tDCS over the rVLPFC would reduce behavioral aggression following social exclusion. Participants were socially excluded or included while they received tDCS or sham stimulation to the rVLPFC. Next, they received an opportunity to aggress. Excluded participants demonstrated cognitive awareness of their inclusionary status, yet tDCS (but not sham stimulation) reduced their behavioral aggression. Excluded participants who received tDCS stimulation were no more aggressive than included participants. tDCS stimulation did not influence socially included participants’ aggression. Our findings provide the first causal test for the role of rVLPFC in modulating aggressive responses to social exclusion. Our findings suggest that modulating activity in a brain area (i.e. the rVLPFC) implicated in self-control and emotion regulation can break the link between social exclusion and aggression.     

Brain Coding of Social Network Structure

Humans have large social networks, with hundreds of interacting individuals. How does the brain represent the complex connectivity structure of these networks? Here we used social media (Facebook) data to objectively map participants'' real-life social networks. We then used representational similarity analysis (RSA) of functional magnetic resonance imaging (fMRI) activity patterns to investigate the neural coding of these social networks as participants reflected on each individual. We found coding of social network distances in the default-mode network (medial prefrontal, medial parietal, and lateral parietal cortices). When using partial correlation RSA to control for other factors that can be correlated to social distance (personal affiliation, personality traits. and visual appearance, as subjectively rated by the participants), we found that social network distance information was uniquely coded in the retrosplenial complex, a region involved in spatial processing. In contrast, information on individuals'' personal affiliation to the participants and personality traits was found in the medial parietal and prefrontal cortices, respectively. These findings demonstrate a cortical division between representations of non-self-referenced (allocentric) social network structure, self-referenced (egocentric) social distance, and trait-based social knowledge.SIGNIFICANCE STATEMENT Each of us has a social network composed of hundreds of individuals, with different characteristics and different relations among them. How does our brain represent this complexity? To find out, we mapped participants'' social connections using Facebook data and then asked them to think about individuals from their network while undergoing functional MRI scanning. We found that the position of individuals within the social network, as well as their affiliation to the participant, are mapped in the retrosplenial complex, a region involved in spatial processing. Individuals'' personality traits were coded in another region, the medial prefrontal cortex. Our findings demonstrate a neural dissociation among different aspects of social knowledge and suggest a link between spatial and social cognitive mapping.     

Relationship between theory of mind and language ability in children and adolescents with intellectual disability

Background The present study was designed to evaluate the validity of the false belief task as a measure of theory of mind development in individuals with intellectual disability (ID). In most if it variants, the false belief task is linguistically demanding. This raises the possibility that the finding that individuals with ID do poorly on it might reflect language difficulties rather than theory of mind difficulties. Complicating matters further, however, is the fact that there are theoretical reasons to suppose that there might be a relationship between some dimensions of language ability and theory of mind development in individuals with ID (as well as in other populations). Method In the present study, children and adolescents with ID and typically developing (non‐verbal) mental age matches completed a standard false belief task and several tasks designed to measure language ability. Results We reasoned that a pattern in which false belief performance was correlated with all measures of language ability would reflect an artefactual relationship, whereas a more highly circumscribed, theoretically sensible pattern of correlations that was similar across both groups would support the validity of the false belief task. Conclusions The results indicated that for individuals with ID who have limited narrative language skills, those limitations contribute substantially to their failure on the false belief task. For individuals with ID who have more highly developed narrative language skills (about 40% of the sample tested), however, the false belief task may provide a valid measure of their progress towards acquiring an adequate theory of mind. This latter conclusion was suggested by the fact screening out individuals who failed to meet linguistic and cognitive prerequisites for dealing with the performance demands of the false belief task yielded non‐significant correlations between false belief performance and the language measures for both the group with ID and the typically developing comparison group.     

Facing stress and conflict: a comparison of the predicted responses and self-concepts of aggressive and non-aggressive people with intellectual disability

The present research consisted of two studies. A total of 44 participants were involved in the first study: 22 individuals with problems of aggression (Ag) and 22 non-aggressive (NAg) individuals. A sentence completion test was used to explore whether there were differences between the two groups' predicted coping responses in stressful situations. While the Ag group provided most aggressive responses, the NAg participants were more assertive. However, gender differences also emerged, with women proving to be less aggressive. A high number of passive answers were given across all the groups, suggesting that background experience could have influenced the participants' sense of efficacy in stressful situations. In the second study, a subsample of the participants were interviewed. The aim was to explore whether particular background experience coloured their perceptions of self and others, in situations of conflict. While nine out of the 10 Ag participants described incidents where they felt treated in a derogatory manner which could be linked to their disability, only two out of the nine NAg participants felt slighted in this fashion. Hence, a vulnerable sense of self could contribute to greater sensitivity in interpersonal situations, increasing the likelihood of an aggressive response. The clinical relevance of this work is discussed, alongside the possibilities for future research in this area.     

Shifting impairment and aggression in intellectual disability and Autism Spectrum Disorder

Aggressive behaviour is a major problem in individuals with an intellectual disability (ID) as well as in individuals with an Autism Spectrum Disorder (ASD). There are indications that suggest a link between cognitive shifting and aggression. In this study, reports of aggressive incidents of adolescents and young adults with different clinical diagnoses (ID, ID + ASD, ASD) were collected during 1 year, using the Staff Observation Aggression Scale-Revised. Whether they were diagnosed with ID, ASD or both; individuals who displayed aggression were found to face more cognitive shifting difficulties than non-aggressive individuals, while no significant differences were found on severity of ASD symptoms. Study results support the assumption that a cognition-based model for aggression may be more adequate than a diagnose-based model.     

Reduced social investigation and increased injurious behavior in transgenic 5xFAD mice

Social withdrawal and agitation/aggression are common behavioral and psychological symptoms of dementia presented by Alzheimer's disease (AD) patients, with males exhibiting more aggressive behaviors than females. Some transgenic mouse models of AD also exhibit social withdrawal and aggression, but many of these models only recapitulate the early stages of the disease. By comparison, the 5xFAD mouse model of AD exhibits rapid, progressive neurodegeneration, and is suitable for modeling cognitive and behavioral deficits at early, mid‐, and late‐stage disease progression. Anecdotal reports suggest that transgenic 5xFAD males exhibit high levels of aggression compared to wild‐type controls, but to date, indirect genetic effects in this strain have not been studied. We measured home‐cage behaviors in 5xFAD males housed in three different group‐housing conditions (transgenic‐only, wild‐type only, and mixed‐genotype) and social approach behaviors when exposed to a novel free‐roaming or restrained, wild‐type or transgenic conspecific. Transgenic‐only home cages required earlier separation due to injuries arising from aggression compared to wild‐type‐only or mixed‐genotype cages, despite no obvious increase in the frequency of aggressive behaviors. Transgenic 5xFAD males and females also spent less time investigating free‐roaming conspecifics compared to wild‐type controls, but they showed normal investigation of restrained conspecifics; the genotype of the conspecific did not affect approach behavior, and there was no aggression observed in transgenic males. These findings provide evidence in an animal model that amyloid pathology ultimately leads to avoidance of novel social stimuli, and that frequent interactions between individuals exhibiting an AD phenotype further exacerbates aggressive behaviors.     

Young people with intellectual disabilities attending mainstream and segregated schooling: perceived stigma, social comparison and future aspirations

Background Mainstream schooling is a key policy in the promotion of social inclusion of young people with learning disabilities. Yet there is limited evidence about the school experience of young people about to leave mainstream as compared with segregated education, and how it impacts on their relative view of self and future aspirations. Methods Sixty young people with mild to moderate intellectual disabilities in their final year of secondary school participated in this study. Twenty‐eight individuals came from mainstream schools and 32 attended segregated school. They completed a series of self‐report measures on perceptions of stigma, social comparison to a more disabled and non‐disabled peer and the likelihood involved in attaining their future goals. Results The majority of participants from both groups reported experiencing stigmatized treatment in the local area where they lived. The mainstream group reported significant additional stigma at school. In terms of social comparisons, both groups compared themselves positively with a more disabled peer and with a non‐disabled peer. While the mainstream pupils had more ambitious work‐related aspirations, both groups felt it equally likely that they would attain their future goals. Although the participants from segregated schools came from significantly more deprived areas and had lower scores on tests of cognitive functioning, neither of these factors appeared to have an impact on their experience of stigma, social comparisons or future aspirations. Conclusions Irrespective of schooling environment, the young people appeared to be able to cope with the threats to their identities and retained a sense of optimism about their future. Nevertheless, negative treatment reported by the children was a serious source of concern and there is a need for schools to promote the emotional well‐being of pupils with intellectual disabilities.     

Do children do what they say? Responses to hypothetical and real-life social problems in children with mild intellectual disabilities and behaviour problems

Background Most research on children's social problem-solving skills is based on responses to hypothetical vignettes. Just how these responses relate to actual behaviour in real-life social situations is, however, unclear, particularly for children with mild intellectual disabilities (MID). Method In the present study, the spontaneous and selected responses of 56 children with MID to hypothetical situations from the Social Problem-Solving Test for children with MID (SPT-MID) were compared to their actual behaviour in comparable staged standardized real-life conflict situations. Correlations to externalizing behaviour problems were assessed using the Teacher's Report Form (TRF). Results The results show children with MID and accompanying externalizing behaviour problems to behave more aggressively in the staged real-life conflicts and provide more spontaneous aggressive responses to the hypothetical vignettes than children with MID and no accompanying externalizing behaviour problems; they did not, however, select more aggressive responses from the hypothetical options provided. A moderate correlation was found between the aggressiveness of the spontaneous responses in the hypothetical situations and actual behaviour in the staged real-life situations. In addition, both the spontaneous aggressive responses under hypothetical circumstances and the actual aggressive behaviour under staged real-life circumstances were related to teacher-rated aggressive behaviour in the classroom. Conclusions It is concluded that the hypothetical vignettes from the SPT-MID do provide information on both the actual behaviour and knowledge of social problem-solving skills of children with MID.     

Do individuals with intellectual disability select appropriate objects as landmarks when learning a new route?

Background The present study was aimed at investigating the selection of landmarks by individuals with intellectual disability (ID). The hypothesis was that they would be less efficient than individuals without IDs in the selection of landmarks when learning a new route. Methods The experiment took place in a natural setting with a group of participants with ID and a group of control participants matched by chronological age. The participants were first guided along a route situated in an unfamiliar district. Then, they had to guide the experimenter along the route while pointing to all the objects and features they found useful for wayfinding. Results The designated objects were categorised as a function of their landmarks properties. There were significant differences between the two groups for non‐permanent landmarks, distant landmarks and non‐unique landmarks. The two groups selected landmarks near intersections in the same proportions. However, the individuals with ID selected more non‐unique landmarks and less textual signage than the control group at these decision points. Conclusion Individuals with ID seem to be less efficient than individuals without disability in landmark selection. This may limit their wayfinding abilities in their day‐to‐day travelling. This may also account for their difficulties in obtaining the kind of spatial knowledge which relates to the configural structure of their environment.     

Combining CBT and Behavior-Analytic Approaches to Target Severe Emotion Dysregulation in Verbal Youth With ASD and ID

ABSTRACT

This article presents an individual intervention combining cognitive-behavioral and behavior-analytic approaches to target severe emotion dysregulation in verbal youth with autism spectrum disorder (ASD) concurrent with intellectual disability (ID). The article focuses on two specific individuals who received the treatment within a therapeutic school setting. Single-subject methodology utilizing a nonconcurrent multiple-baseline design across behaviors and participants was used to evaluate the intervention. The two participants presented with severe behavioral challenges, including physical aggression and verbal threats to harm others. Results suggest positive outcomes, including a reduction in the frequency and intensity of severe aggressive behavior and an increase in the use of coping skills, self-advocacy, and social participation. The planning and implementation of specific skills-generalization strategies was one innovative element of the intervention that proved to be pivotal to its successful application. Assessment and treatment techniques for different intervention phases are detailed along with two case examples. Intervention challenges, treatment outcomes, and future directions for clinical research are discussed.     

A review of behavioral interventions for the treatment of aggression in individuals with developmental disabilities

Aggression can present as a significant problem behavior in individuals with a diagnosis of developmental disability. Much research has focused on the prevalence of aggression in individuals with varying degrees of severity of intellectual disability (AD), autism spectrum disorders (ASD) and co-morbidity of ID and ASD. Research has also focused on the impact of aggressive behavior on individuals’ development including cognitive, adaptive and social functioning. The literature on Applied Behavior Analysis provides abundant examples of various interventions that are effective in reducing or eliminating aggressive behavior across a range of ages and degrees of developmental disabilities. Many interventions report success using antecedent alterations, reinforcement-based strategies and consequence manipulations. The current review provides a focused, comprehensive examination of aggressive behavior intervention research for individuals with developmental disabilities aged 3-18 years published between 1980 and 2009.     

Self-determination, social abilities and the quality of life of people with intellectual disability

Background The international literature has documented that self‐determination is impacted by environmental factors, including living or work settings; and by intraindividual factors, including intelligence level, age, gender, social skills and adaptive behaviour. In addition, self‐determination has been correlated with improved quality of life (QoL). This study sought to contribute to the growing literature base in this area by examining the relationship among and between personal characteristics, self‐determination, social abilities and the environmental living situations of people with intellectual disabilities (ID). Methods The study involved 141 people with ID residing in Italy. Healthcare professionals and social workers who had known participants for at least 1 year completed measures of self‐determination, QoL and social skills. Analysis of variance was conducted to verify whether different levels of intellectual impairment were associated with different degrees of the dependent variables. The Pearson product–moment correlation was used to examine any relationships among dependent variables and IQ scores. Finally, discriminant function analysis was used to examine the degree to which IQ score, age, self‐determination and social abilities predicted membership in groups that were formed based on living arrangement, and on QoL status (high vs. low). Results The anova determined, as expected, that participants with more severe ID showed the lowest levels of self‐determination, QoL and social abilities. Discriminant function analysis showed that (a) individuals attending day centres were distinguished from those living in institutions in that they were younger and showed greater autonomy of choice and self‐determination in their daily activities; (b) basic social skills and IQ score predicted membership in the high or low QoL groups; and (c) the IQ score predicted membership in the high or low self‐determination groups. A manova conducted to examine gender‐ and age‐level differences on self‐determination found gender differences; women had higher self‐determination scores than men. Conclusions These findings contribute to an emerging knowledge base pertaining to the role of intraindividual and environmental factors in self‐determination and QoL. In general, the study replicated findings pertaining to the relative contribution of intelligence to self‐determination and QoL, added information about the potential contribution of social abilities, and pointed to the potentially important role of opportunities to make choices as a particularly important aspect of becoming more self‐determined, at least in the context of residential settings.     

Aggression-related hostility bias and social problem-solving deficits in adult males with mental retardation

Attributional bias and social problem-solving deficits in two groups of adult males (aggressive vs. nonaggressive) with mild mental retardation were investigated. When presented with vignettes depicting various problem situations, aggressive participants were less accurate in correctly identifying interpersonal intent, characterized by more problem-solving deficits, and generated higher numbers of aggressive solutions to resolve problems as compared to their nonaggressive counterparts. The present results support the applicability of contemporary models of social information processing and adjustment with regard to reactive aggression to men with mental retardation.     

Prevalence and types of aggressive behaviour among adults with intellectual disabilities

Background Aggressive behaviours represent major obstacles to the integration into society of individuals with intellectual disability (ID) and pose significant management issues for carers. Methods The present study assessed the prevalence and severity of five types of aggressive behaviours in 3165 adult men and women with ID receiving services from three rehabilitation agencies in Québec by surveying their carers using the Modified Overt Aggressive Scale. Results The 12‐month prevalence of aggressive behaviour was 51.8%: 24% property damage, 37.6% verbal, 24.4% self‐oriented and 24.4% physical aggression, and 9.8% sexually aggressive behaviour, most of which being mild in severity. Only 4.9% of individuals displayed aggressive behaviour leading to injury of the victim. Few gender differences were observed. Conclusions The capacity to document and assess the types as well as the severity of aggressive behaviour is thus critical, not only to better understand the correlates of various types of behaviours but also to orient intervention programmes whether they be prevention, assessment, monitoring or management of aggressive behaviour.     

Social knowledge in children with language impairments: Examination of strategies,predicted consequences,and goals in peer conflict situations

This study investigated social knowledge in school‐age children, aged 8–12 years, with and without language impairment (LI and TD groups). A hypothetical peer conflict task was administered to examine the relationship among prosocial responses and parent/teacher ratings of children's social behaviours. Stimuli included 12 hypothetical peer conflict vignettes presented in an open‐ended and forced choice condition. The LI group generated (open‐ended) and selected (forced choice) fewer prosocial strategies. When asked to predict a friend's reaction to a selected conflict resolution strategy, the LI group predicted fewer positive consequences; however, the proportion of prosocial strategies followed by prediction of a positive peer consequence was similar across groups. Both groups identified more self‐interest than relationship goals as the rationale for selected strategies. In the LI group, teacher ratings of children's social skills and problems in peer provocation situations were associated with selection of prosocial strategies. Implications for clinical service providers are discussed.