Construct validity of the Nutrition and Activity Knowledge Scale in a French sample of adolescents with mild to moderate intellectual disability

The purpose of this study was to test the reliability (i.e. internal consistency and test–retest reliability) and construct validity (i.e. content validity, factor validity, measurement invariance, and latent mean invariance) of the Nutrition and Activity Knowledge Scale (NAKS) in a sample of French adolescents with mild to moderate Intellectual Disability (ID). A total sample of 260 adolescents (144 boys and 116 girls), aged between 12 and 18 years old, with mild to moderate ID was involved in two studies. In the first study, analysis of items’ content reveals that many words from the original version were not understood or induced confusion. These items were reworded and simplified while retaining their original meaning. In the second study, results provided support for: (i) the factor validity and reliability of a 15-item French version of the NAKS; (ii) the measurement invariance of the resulting NAKS across genders and ID levels; (iii) the partial measurement invariance of the resulting NAKS across age groups and type of school placement. In addition, the latent means of the 15-item French version of the NAKS proved to be invariant across gender, age categories, and ID levels, but to vary across type of school placement (with adolescents schooled in self-contained classes from regular schools presenting higher levels of NAK than adolescents placed in specialized establishments). The present results thus provide preliminary evidence regarding the construct validity of a 15-item French version of the NAKS in a sample of adolescents with ID.     

Assessment of Physical Self-Concept in Adolescents with Intellectual Disability: Content and Factor Validity of the Very Short Form of the Physical Self-Inventory

The purpose of this study was to test the factor validity and reliability of the Very Short Form of the Physical Self-Inventory- (PSI-VSF) within a sample of adolescents with mild to moderate Intellectual Disability (ID). A total of 362 ID adolescents were involved in two studies. In Study 1, the content and format scale response of the PSI-VSF were adapted for adolescents with ID. This instrument was thus renamed PSI-VSF-ID and two versions with two alternative responses scales format, were developed: Likert and graphical. In Study 2, results provided support for: (1) the factorial validity and reliability; and (2) factorial invariance across gender, age, type of school placement and ID level of the PSI-VSF-ID associated with a graphical response scale format.     

The overweight: obesity and plasma lipids in adults with intellectual disability and mental illness

Background Previous studies in adults with intellectual disabilities (ID) have reported a higher prevalence of obesity than in the general population, and a trend to an increase in the prevalence of excess weight. However, little information is available on body weight status and lipids levels of adults with ID and co‐existing mental illness. The aim of this study was to address this information gap, by conducting a stepwise multiple regression analysis to predict BMI, thereby allowing the investigation of (semi‐)partial correlations, which assess the extent to which a particular predictor variable is associated with BMI over and above the other predictors. Methods A study of the patients with ID and psychiatric illness registered in the service. Collected data included body mass index (BMI), age, gender, the presence of additional physical conditions, residential status, mental illness and use the psychotropic medication. We analysed the lipid profile including serum cholesterol together with low‐density lipoprotein, high‐density lipoprotein (HDL), triglycerides and the serum cholesterol/HDL ratio. Data for these variables were entered into a stepwise multiple linear regression to predict BMI. Results 28% of the participants were overweight and 41% obese. Most of the obese patients were men with mild ID (P = 0.039). Level of ID (P = 0.003), gender (P = 0.001) and serum triglycerides (P = 0.026) had significant predictive value in the regression model. There were no significant differences in either the mean serum cholesterol levels or the mean triglyceride levels between those taking and those not taking first‐generation antipsychotics, second‐generation antipsychotics or anti‐epileptic medication. Conclusions The rate of obesity in our sample was higher than in previous studies. The most predictive combination of predictors to predict BMI was ID level, gender and serum triglyceride levels. Serum triglyceride and cholesterol levels did not appear to be unduly affected by first‐ or second‐generation antipsychotic medication or by antiepileptic medication.     

Physical education teachers' attitudes towards children with intellectual disability: the impact of time in service,gender, and previous acquaintance

Background This study investigated attitudes towards teaching students with intellectual disability (ID) within a representative sample of secondary school physical education (PE) teachers, and to determine the effects of age, gender, teaching experience, and having acquaintance with ID and students with ID on their attitudes. Methods Participants were 729 secondary school PE teachers who worked in 81 major cities of Turkey. The Teachers Attitudes towards Children with Intellectual Disability Scale was administered. Results The statistical analysis revealed that there was no significant effect on factors and total attitudes scores of gender and having students with ID. Significant effects on factors and total attitudes score were found in teaching experiences and having acquaintance with ID. Conclusions It is encouraged to maintain and further develop in‐service education programmes of adapted physical activity for PE teachers.     

Prevalence of selected clinical problems in older adults with autism and intellectual disability

Background

Originally described as a disorder of childhood, evidence now demonstrates the lifelong nature of autism spectrum disorder (ASD). Despite the increase of the population over age 65, older adults with ASD remain a scarcely explored subpopulation. This study set out to investigate the prevalence of clinically relevant behaviors and medical problems in a sample of US adults aged 30 to 59 with ASD and intellectual disability (ID), in comparison to those with ID only.

Methods

A cross-sectional study, with both an exploratory and replication analysis, was conducted using National Core Indicators (NCI) multi-state surveys from 2009 to 2010 and 2010 to 2011. There were 4,989 and 4,261 adults aged 30–59 with ID examined from the 2009 to 2010 and 2010 to 2011 samples, respectively. The two consecutive annual samples consisted of 438 (9%) and 298 (7%) individuals with ASD and ID. Variables were chosen from the NCI data as outcomes, including medication use for behavior problems, severe or aggressive behavior problems and selected medical conditions.

Results

No age-associated disparities were observed between adults with ASD and ID versus adults with ID only in either sample. For the 2009 to 2010 sample, the prevalence of support needed to manage self-injurious, disruptive and destructive behavior in subjects with ASD and ID ranged from 40 to 60%. Similarly, the prevalence estimates of self-injurious, disruptive and destructive behavior were each almost double in adults with ASD and ID relative to those with ID only. These results were replicated in the 2010 to 2011 sample.

Conclusions

The findings of this study highlight the urgent need for research on the nature and treatment of severe behavior problems in the rapidly increasing population of older adults with ASD. They also suggest the importance of developing policies that expand our capacity to care for these individuals.     

Reliability and validity of the SPAID-G checklist for detecting psychiatric disorders in adults with intellectual disability

SPAID (Psychiatric Instrument for the Intellectually Disabled Adult) is the first Italian tool-package for carrying out psychiatric diagnosis in adults with Intellectual Disabilities (ID). It includes the “G” form, for general diagnostic orientation, and specific checklists for all groups of syndromes stated by the available classification systems. SPAID was established to provide an easy and quick tool for daily practice of the personnel working with ID. The present study was aimed at evaluating psychometric and psychodiagnostic characteristics of the SPAID-G and at supplying new data on the prevalence rate of psychiatric disorders in a multicentric Italian sample of people with ID living in different settings. The SPAID-G was randomly applied to 304 participants with ID attending residential facilities or assessment services across Italy. A part of the sample was also consecutively assessed through the use of DASH, PDD-MRS and by the clinical application of the DSM-IV TR criteria. The correlation between SPAID-G scores and those provided by other evaluation tools was over 60%. Additionally, the internal consistency and inter-rater reliability resulted to be good. Psychopathological symptoms were detected in approximately 40% of the sample. Respectively, autistic spectrum disorders, impulse control disorders, mood disorders, and dramatic personality disorders were the diagnostic orientations providing the most prevalent over-threshold scores. SPAID-G seems to be a valid diagnostic tool, quick and easy to use in psychiatric disorders assessment within the Italian population with ID.     

Factorial validity and consistency of the Maslach Burnout Inventory among staff working with persons with intellectual disability and dementia

Background Burnout has been considered important to understanding the well‐being of workers in the intellectual disabilities (ID) field and the quality of services delivered to clients/consumers. However, little research has examined the psychometric properties and applicability to staff in ID services of one of the most widely used burnout measurements – the Human Services Survey version of the Maslach Burnout Inventory (MBI‐HSS). Methods Data were gathered using a mailed questionnaire comprising the MBI‐HSS and demographic information. The sample consisted of 435 staff delivering direct care and working in out‐of‐home community placements for persons with ID in New York state. The factorial structure of the scale was examined using confirmatory and exploratory factor analysis. Internal consistency estimates of reliability of the MBI‐HSS were determined using Cronbach's alpha. Results Confirmatory factor analysis supported the MBI‐HSS as an acceptable measure to evaluate burnout in ID services staff. However, the reliability statistics obtained for the Depersonalization (DP) sub‐scale was much lower than what has been reported in studies with other staff populations. An exploratory factor analysis suggested that a four‐factor solution, dividing the DP sub‐scale into two factors, provided a somewhat better fit for the sample. Conclusions The use of the MBI‐HHS as an instrument for measuring burnout among ID workers has its attraction but also its limitations. In particular, the DP sub‐scale should be used with caution because there appear to be wording issues for staff in ID settings that may lead to inconsistent responses.     

The Center for Epidemiologic Studies Depression Scale: factor validity and reliability in a French sample of adolescents with Intellectual Disability

The purpose of this study was to test the factor validity and reliability of the Center for Epidemiologic Studies Depression Scale (CES-D) within a sample of adolescents with mild to moderate Intellectual Disability (ID). A total sample of 189 adolescents (121 boys and 68 girls), aged between 12 and 18 years old, with mild to moderate ID were involved in two studies. In study 1, the content, phrasing and answering format of the CES-D were adapted for adolescents with ID. This instrument was renamed CES-D for ID (CES-D-ID) and two different versions based on two alternative answer scales (Likert and Likert-graphical) were developed and their psychometric properties were verified in study 2. The results provided support for the factor validity, reliability and invariance across gender and age of a 14-item version of the CES-D-ID based on a Likert-graphical answer scale.     

Development and validation of an instrument to assess future orientation and resilience in adolescence

The study is aimed at providing the development and initial validation of the Design My Future (DMF), which may be administered in career counseling and research activities to assess adolescents' future orientation and resilience. Two studies with two independent samples of Italian adolescents were conducted to examine psychometric requisites of DMF. Specifically, in the first study, after developing items and examined the content validity, the factorial structure, reliability and discriminant validity of the DMF were tested. In the second study, the measurement invariance across gender, conducing a sequence of nested CFA models, was evaluated. Results showed good psychometric support for the instrument with Italian adolescents.     

Underweight, obesity and exercise among adults with intellectual disabilities in supported accommodation in Northern England

Background Significant deviation from normal weight (obesity and underweight) and lack of physical exercise have been identified as three of the most significant global behavioural risks to health. Methods Body mass index (BMI) and levels of physical activity were measured in a sample of 1542 adults with intellectual disabilities (ID) receiving supported accommodation in nine geographical localities in Northern England. Comparative population data were extracted from the Health Survey for England 1998 and 2001. Results Men and women with ID living in supported accommodation are at increased risk of being significantly underweight and physically inactive. Women with ID living in supported accommodation are at increased risk of obesity. Within the population of people with ID living in supported accommodation increased behavioural health risks are associated with gender, severity of ID, age and location. Conclusion Significant deviation from normal weight and lack of physical exercise are significant behavioural risks to health among people with ID.     

Psychiatric co-morbidity and gender differences in intellectual disability

Background Although gender differences in psychopathology among the general psychiatric population appear to be well documented, such differences have been either ignored or inconsistently investigated among people with intellectual disability (ID). Methods The study examined psychiatric co‐ morbidity in 295 men and 295 women with ID and significant social impairments living in community settings. The sample was drawn from consecutive clinical referrals to a specialist mental heath service of South‐East London. Psychiatric diagnoses were based on ICD‐10 criteria. Results Personality disorder was more common among men, although dementia and adjustment reaction were more common among women. There were also gender differences in marital status, with a larger percentage of women being either married or in a stable relationship. Gender differences in the source of referral were also observed, with more women being referred through primary care and more men being referred through generic mental health services. Conclusions Female patients seem to have at some extent different mental health needs from male patients. Such differences should be taken into account in the design and delivery of clinical service for people with ID.     

Bullying and people with severe intellectual disability

Although bullying has been shown to reduce quality of life in many spheres, anti‐bullying strategies have yet to be incorporated into services for adults with severe intellectual disability (ID). The present study employed a survey of staff and parent concerns about 54 previously surveyed students who had left a school for pupils with severe ID. A content analysis of follow‐up interviews was performed in 10 cases. Staff identified 19% of the survey sample as bullying others and 11% as being picked on. Neither gender nor communication ability had an impact. There was no significant change in bully or victim status over time, although some people did change. Parents or staff raised bully/victim problems in more than half of the interviews. There is sufficient evidence of bullying behaviour to warrant the adoption of anti‐bullying strategies.     

The Cannabis Abuse Screening Test (CAST) revisited: examining measurement invariance by age

Defensible use of self‐reported cannabis use problem scales in age comparative frameworks requires that measured constructs have equal psychometric properties across age groups. This study compares the psychometric properties of the Cannabis Abuse Screening Test (CAST) across three age groups (18–24, 25–29, 30–40). Data was collected online from an accessible sample of 1316 cannabis users. Factor analysis compared the optimal factor structure and dimensionality diffraction. Multi‐group Model Invariance tests examined measurement invariance across the three age groups. CAST was two‐dimensional in all age groups with one factor measuring cannabis use problems and the other measuring deviation from a common standard of use. The two‐dimensional structure was more pronounced in older age groups. Weak factorial invariance was supported, suggesting that the meaning of the CAST factors is equivalent across age groups. Partial, but not full, strong factorial invariance was supported, indicating that only the cannabis use problem factor can be defensibly used to measure age group mean differences. Results confirm a well‐defined two‐dimensional CAST structure and factorial invariance across age groups. However, caution is needed when using the two items measuring deviation from a common standard in an age‐comparative framework. Replication studies based on a representative sample are needed.     

The Penn State Worry Questionnaire for Children: Age,Gender and Clinical Invariance

The Penn State Worry Questionnaire for Children (PSWQ-C) is one of the most frequently used instruments to assess worry in children. The current study examines the measurement invariance of the PSWQ-C in a Romanian sample. Participants (n = 759) were recruited from both community and clinical populations. Our findings have replicated the good psychometric properties of the PSWQ-C and of the short PSWQ-C (the original scale with the negative items deleted). Multigroup confirmatory factor analysis has supported measurement invariance (configural, metric, scalar) across gender, age and clinical diagnosis. Convergent validity with other assessment measures has also been established. Finally, the implications of the use of the PSWQ-C in the assessment of anxiety in children and adolescents are discussed.     

Attitudes towards people with intellectual disability in the UK and Libya: A cross-cultural comparison

BackgroundThe attitude of the general population towards people with intellectual disability (ID) provides important background for policy development. Furthermore, because of changes in attitudes across cultures, it is vital to ground policy development for each country in data from that country.AimsThis paper aimed to undertake a cross-cultural study, investigating attitudes to people with ID in Libya in the year 2011, and to compare the Libyan data with those for the UK.Methods and proceduresThis paper provides a cross-cultural analysis of attitudes to people with ID, using a questionnaire study of three groups in Libya and in the UK: science students, psychology students and professionals in ID support. The questionnaire used was the established Community Living Attitude Scales for Mental Retardation (CLAS-MR).Outcomes and resultsIn terms of the four CLAS-MR sub-scales, the Libyan sample showed significantly less favourable scores on Empowerment, Similarity and Exclusion than the UK sample, but no significant difference on the Sheltering sub-scale. Within-country analysis indicated no main effects of gender on all four sub-scales in Libya and the UK.ConclusionsThis study is the first to undertake quantitative analysis of attitudes to people with ID in Libya. The attitudes were in general less favourable than in the UK and other Western countries, but showed similarities with studies of attitudes to people with ID in Pakistan.     

Prevalence of hypertension in adults with intellectual disability in the Netherlands

Background   Literature on the prevalence of hypertension in people with intellectual disability (ID) is mostly based on file studies or on measurements limited to the age group below 50 years. We measured and calculated the prevalence of hypertension in adults with ID and studied the distribution of hypertension in relation to age, gender, diagnosis of Down's syndrome and level of ID.
Methods   In an observational cross-sectional study, standardized blood pressure measurements were obtained from 258 randomly selected adult clients of three Dutch care providers for people with ID. Hypertension was defined as a mean systolic blood pressure above 140 mm Hg on repeated measurements.
Results   The overall prevalence rate of hypertension was 17.4% (95% CI 12.28–22.46). This was comparable to the prevalence in the general Dutch population. No accurate blood pressure measurement could be performed in 28.4% of people with severe and profound ID owing to repetitive physical activity or resistance. Hypertension was significantly related to older age and absence of Down's syndrome; no correlation with gender or level of ID could be shown.
Recommendation   The risk factor hypertension should be detected and treated in the same manner as in the general population following national guidelines.     

An evaluation of the performance of the WISC-IV eight-subtest short form with children who may have an intellectual disability

Background There has been only limited research into the psychometric properties of short-form intellectual assessments when used with children who may have an intellectual disability (ID). The aim of this study was to evaluate an 8-subtest short form of the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) in children assessed for ID, which was initially used by Donders and colleagues (2013) with children with traumatic brain injury.

Methods Data from 253 individuals with (n?=?94) and without (n?=?159) ID referred to clinical services were utilised.

Results At the Full-Scale IQ (FSIQ) cut-off point of 69, the short form had a sensitivity of 0.98 and specificity of 0.89.

Conclusion The short form performed well in discriminating between those with an estimated FSIQ within and outside the ID range. The inclusion of the Letter–Number Sequencing subtest may, however, make it less attractive to clinicians working in ID services.     

Social anxiety across ethnicity: A confirmatory factor analysis of the FNE and SAD

Previous research has established that social anxiety occurs at different rates in African American and European American populations (Grant et al., 2005), while psychometric investigations of widely used measures of psychopathology show differences in factor structure based on ethnic background (Carter et al., 1999, Chapman et al., 2009b). The current study examined response characteristics of 1276 African American and European American undergraduates completing the Fear of Negative Evaluation and Social Avoidance and Distress Scales (Watson & Friend, 1969). Confirmatory factor analyses failed to demonstrate factorial invariance in the two ethnic samples, and Wald tests suggested several items on both measures be dropped for African Americans. Results suggest the FNE and SAD operate differently across ethnic groups. Implications for the cross-cultural measurement of social anxiety and the importance of continued rigorous psychometric inquiry of commonly used measures are discussed.     

Social Anxiety Scale for Adolescents: Factorial invariance and latent mean differences across gender and age in Spanish adolescents

Little is known about the factorial invariance across gender and age for self-report measures of social anxiety in adolescence. This study examined the factorial invariance and latent mean differences of the Social Anxiety Scale for Adolescents (SAS-A) across gender and age groups in 1570 Spanish adolescents (54% girls), ranging in age from 14 to 17 years. Equality of factor structures was compared using multi-group confirmatory factor analyses. Measurement invariance for the correlated three-factor model of the SAS-A was found across gender and age samples. Analyses of latent mean differences revealed that girls exhibited higher means than boys on two SAS-A subscales, Fear of Negative Evaluation and Social Avoidance and Distress-New (SAD-New). In addition, on the SAD-New subscale, the structured means significantly diminished from 14-year olds to 16- and 17-year olds and from 15-year olds to 17-year olds. Findings are discussed in terms of the use of the SAS-A with Spanish adolescents.