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Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (6 April 2023) | Viewed by 29890

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Prof. Dr. Shoumitro Deb

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Department of Brain Sciences, Imperial College London, Faculty of Medicine, Hammersmith Campus, Du Cane Road, London W12 0NN, UK
Interests: neuropsychiatry; psychopharmacology; neurodevelopmental disorders; traumatic brain injury
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Special Issue Information

Dear Colleagues,

Psychopathology including functional psychiatric disorders such as schizophrenia, bipolar disorder, major depressive disorder, and anxiety disorders, and also dementia, behaviours that challenge is common in people with neurodevelopmental disorders such as intellectual and developmental disabilities (IDD), autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) and causes a major public health concern. Much research has been carried out in the last three decades to understand this issue and develop effective interventions, but a lot remains unknown for which good quality translational research is urgently needed. In this Special Issue we would like to draw together research in recent advances addressing these issues. We are inviting for this Special Issue papers related to psychiatric disorders and behaviours that challenge in both children and adults with IDD, ASD, ADHD or a combination of these disorders. Although not an exhaustive list but some examples of types of papers that could be submitted include:

(a) original articles, reviews, systematic reviews/meta-analysis,
(b) epidemiological studies,
(c) genetics, neuroimaging, biomarkers or any other laboratory-based studies with clinical implications,
(d) pharmacological and psychosocial interventions,
(e) qualitative studies involving people with IDD and their caregivers,
(f) assessment including rating scales,
(g) training issues, and (h) quality of life.

Prof. Dr. Shoumitro Deb
Guest Editor

Manuscript Submission Information

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Keywords

intellectual developmental disabilities
autism spectrum disorder
attention-deficit hyperactivity disorder
psychopathology
challenging behaviors
neurodevelopmental disorders
epidemiology
risk factors
assessment
intervention
training

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Published Papers (10 papers)

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Research

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18 pages, 425 KiB

Open AccessArticle

The Global Deterioration Scale for Down Syndrome Population (GDS-DS): A Rating Scale to Assess the Progression of Alzheimer’s Disease

by Emili Rodríguez-Hidalgo, Javier García-Alba, Ramon Novell and Susanna Esteba-Castillo

Int. J. Environ. Res. Public Health 2023, 20(6), 5096; https://doi.org/10.3390/ijerph20065096 - 14 Mar 2023

Cited by 2 | Viewed by 2448

Abstract

The aim of this study is to adapt and validate the global deterioration scale (GDS) for the systematic tracking of Alzheimer’s disease (AD) progression in a population with Down syndrome (DS). A retrospective dual-center cohort study was conducted with 83 participants with DS (46.65 ± 5.08 years) who formed the primary diagnosis (PD) group: cognitive stability (n = 48), mild cognitive impairment (n = 24), and Alzheimer’s disease (n = 11). The proposed scale for adults with DS (GDS-DS) comprises six stages, from cognitive and/or behavioral stability to advanced AD. Two neuropsychologists placed the participants of the PD group in each stage of the GDS-DS according to cognitive, behavioral and daily living skills data. Inter-rater reliability in staging with the GDS-DS was excellent (ICC = 0.86; CI: 0.80–0.93), and the agreement with the diagnosis categories of the PD group ranged from substantial to excellent with κ values of 0.82 (95% CI: 0.73–0.92) and 0.85 (95% CI: 0.72, 0.99). Performance with regard to the CAMCOG-DS total score and orientation subtest of the Barcelona test for intellectual disability showed a slight progressive decline across all the GDS-DS stages. The GDS-DS scale is a sensitive tool for staging the progression of AD in the DS population, with special relevance in daily clinical practice. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

10 pages, 365 KiB

Open AccessArticle

More than a Physical Problem: The Effects of Physical and Sensory Impairments on the Emotional Development of Adults with Intellectual Disabilities

by Paula S. Sterkenburg, Marie Ilic, Miriam Flachsmeyer and Tanja Sappok

Int. J. Environ. Res. Public Health 2022, 19(24), 17080; https://doi.org/10.3390/ijerph192417080 - 19 Dec 2022

Cited by 3 | Viewed by 3191

Abstract

With the introduction of the ICD-11 and DSM-5, indicators of adaptive behavior, including social–emotional skills, are in focus for a more comprehensive understanding of neurodevelopmental disorders. Emotional skills can be assessed with the Scale of Emotional Development-Short (SED-S). To date, little is known about the effects of physical disorders and sensory impairments on a person’s developmental trajectory. The SED-S was applied in 724 adults with intellectual disabilities, of whom 246 persons had an additional physical and/or sensory impairment. Ordinal regression analyses revealed an association of movement disorders with more severe intellectual disability and lower levels of emotional development (ED) on the overall and domain levels (Others, Body, Material, and Communication). Visual impairments predicted lower levels of ED in the SED-S domains Material and Body, but not the overall level of ED. Hearing impairments were not associated with intellectual disability or ED. Epilepsy correlated only with the severity of intellectual disability. Multiple impairments predicted more severe intellectual disabilities and lower levels of overall ED. In conclusion, physical and sensory impairments may not only affect physical development but may also compromise intellectual and emotional development, which should be addressed in early interventions. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

10 pages, 321 KiB

Open AccessArticle

Withdrawing Antipsychotics for Challenging Behaviours in Adults with Intellectual Disabilities: Experiences and Views of Experts by Experience

by Gerda de Kuijper, Joke de Haan, Shoumitro Deb and Rohit Shankar

Int. J. Environ. Res. Public Health 2022, 19(23), 15637; https://doi.org/10.3390/ijerph192315637 - 24 Nov 2022

Cited by 9 | Viewed by 2529

Abstract

People with intellectual disabilities (PwID) are frequently prescribed long-term antipsychotics for behaviours that challenge (BtC) despite the lack of proven effectiveness and the increased risks for side effects of these medications in this population. National and international good clinical practice guidelines recommend deprescribing antipsychotics for BtC, which is often not successful due to environmental and other factors. The involvement of all stakeholders, including PwID, is crucial for deprescribing. However, studies showed that PwID and/or their families are often not involved in decision-making regarding the (de)prescribing of antipsychotics despite their desire to get involved. Moreover, studies on the views of PwID regarding their experiences of withdrawing from antipsychotics are lacking. The aim of this study was to gain insight into the views of PwID by investigating their experiences of discontinuation of long-term prescribed antipsychotics for BtC. A qualitative study was set up. Seven experts by experience with mild intellectual disabilities were interviewed. After six interviews, data saturation was achieved. Interviews were transcribed verbatim. Using phenomenological analysis, themes on lived experiences were extracted. Each consecutive interview was analysed. The four main themes extracted from the interviews were the quality of treatment, knowledge and information about psychotropics and the process of withdrawal, support from the participants’ environment and the coping style of the interviewees themselves. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

11 pages, 763 KiB

Open AccessArticle

Predictors of Change in Stepping Stones Triple Interventions: The Relationship between Parental Adjustment, Parenting Behaviors and Child Outcomes

by Matthew Sanders, Nam-Phuong T. Hoang, Julie Hodges, Kate Sofronoff, Stewart Einfeld, Bruce Tonge, Kylie Gray and The MHYPEDD Team

Int. J. Environ. Res. Public Health 2022, 19(20), 13200; https://doi.org/10.3390/ijerph192013200 - 13 Oct 2022

Cited by 6 | Viewed by 2373

Abstract

The current study explored the process of change in Stepping Stones Triple P (SSTP) using a community-based sample of 891 families of children with developmental disabilities (DD) who participated in an SSTP intervention at a community level. A preliminary analysis of outcome data indicated that SSTP intervention was effective in reducing parental adjustment difficulties, coercive parenting, and children’s behavioral and emotional difficulties immediately after the intervention. The effects were maintained at 12-month follow-up. The results also indicated that change in parental adjustment over the course of intervention was significantly associated with a change in parenting behaviors. However, change in parenting behaviors but not change in parental adjustment, predicted children’s behavioral and emotional problems following the intervention. The results suggest that positive parenting skills are the most salient ingredient driving the change in child behaviors in SSTP interventions. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

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16 pages, 541 KiB

Open AccessArticle

The Pictorial Screening Memory Test (P-MIS) for Adults with Moderate Intellectual Disability and Alzheimer’s Disease

by Emili Rodríguez-Hidalgo, Javier García-Alba, Maria Buxó, Ramon Novell and Susana Esteba-Castillo

Int. J. Environ. Res. Public Health 2022, 19(17), 10780; https://doi.org/10.3390/ijerph191710780 - 30 Aug 2022

Cited by 1 | Viewed by 2047

Abstract

In this study, we examined normative data and diagnostic accuracy of a pictorial screening test to detect memory impairment for mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in Spanish-speaking adults with intellectual disability (ID). A total of 94 volunteers with ID (60 controls, 17 MCI, and 17 AD), were evaluated by neuropsychological tests including the PMIS-ID in a cross-sectional validation study. Discriminative validity between the MCI, AD, and control group was analyzed by the area under the ROC curve. A cut-off score of 4.5 on the immediate recall trial had a sensitivity of 69% and a specificity of 80% to detect memory impairment (AUC = 0.685; 95% CI = 0.506–0.863) in the AD group. The PMIS-ID is a useful screening test to rule out a diagnosis of memory decline in people with moderate level of ID and AD, and it shows good psychometric properties. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

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14 pages, 343 KiB

Open AccessArticle

Causes of and Alternatives to Medication for Behaviours That Challenge in People with Intellectual Disabilities: Direct Care Providers’ Perspectives

by Shoumitro (Shoumi) Deb, Bharati Limbu, Gemma L. Unwin and Tim Weaver

Int. J. Environ. Res. Public Health 2022, 19(16), 9988; https://doi.org/10.3390/ijerph19169988 - 13 Aug 2022

Cited by 13 | Viewed by 2182

Abstract

Behaviours that challenge (BtC), such as aggression and self-injury, are manifested by many people with intellectual disabilities (ID). National and international guidelines recommend non-pharmacological psychosocial intervention before considering medication to address BtC. Support staff play a pivotal role in the prescription process. Using coproduction, we developed a training programme for support staff, called SPECTROM, to give them knowledge and empower them to question inappropriate prescriptions and ask for the discontinuation of medication if appropriate and instead look for ways to help people with ID when they are distressed without relying on medication. We have presented data from two focus groups that we conducted during the development of SPECTROM: one that included support staff, and another that had service managers and trainers. In these focus groups, we explored participants’ views on the use of medication to address BtC with a particular emphasis on the causes of and alternatives to medication for BtC. Along with the participants’ views, we have also presented how we have addressed these issues in the SPECTROM resources. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

11 pages, 602 KiB

Open AccessArticle

Intellectual Disability Profiles, Quality of Life and Maladaptive Behavior in Deaf Adults: An Exploratory Study

by Johanna Eisinger, Magdalena Dall, Jason Fogler, Daniel Holzinger and Johannes Fellinger

Int. J. Environ. Res. Public Health 2022, 19(16), 9919; https://doi.org/10.3390/ijerph19169919 - 11 Aug 2022

Cited by 1 | Viewed by 2152

Abstract

Individuals who are prelingually deaf and have intellectual disabilities experience great challenges in their language, cognitive and social development, leading to heterogeneous profiles of intellectual and adaptive functioning. The present study describes these profiles, paying particular attention to domain discrepancies, and explores their associations with quality of life and maladaptive behavior. Twenty-nine adults with prelingual deafness (31% female) and mild intellectual functioning deficits (mean IQ = 67.3, SD = 6.5) were administered the Vineland Adaptive Behavior Scales-II (VABS-II) and an adapted sign language version of a quality of life scale (EUROHIS-QOL 8). Intellectual disability domain discrepancies were characterized as at least one standard deviation difference between the social domain and IQ and the practical domain and IQ, and a significant difference, according to the VABS-II manual, between the social and practical domains. Domain discrepancies were found between intellectual functioning and both the practical (58.6%) and social domain (65.5%). A discrepancy between intellectual and social functioning was significantly associated with a higher level of internalizing maladaptive behavior (T = 1.89, p < 0.05). The heterogeneous profiles highlight the importance of comprehensive assessments for adequate service provision. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

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12 pages, 1285 KiB

Open AccessArticle

Health Needs and Their Relationship with Life Expectancy in People with and without Intellectual Disabilities in England

by Freya Tyrer, Richard Morriss, Reza Kiani, Satheesh K. Gangadharan, Harish Kundaje and Mark J. Rutherford

Int. J. Environ. Res. Public Health 2022, 19(11), 6602; https://doi.org/10.3390/ijerph19116602 - 28 May 2022

Cited by 3 | Viewed by 2545

Abstract

Health needs are common in people living with intellectual disabilities, but we do not know how they contribute to life expectancy. We used the Clinical Practice Research Datalink (CPRD) linked with hospital/mortality data in England (2017–2019) to explore life expectancy among people with or without intellectual disabilities, indicated by the presence or absence, respectively, of: epilepsy; incontinence; severe visual loss; severe visual impairment; severe mobility difficulties; cerebral palsy and PEG feeding. Life expectancy and 95% confidence intervals were compared using flexible parametric methods. At baseline, 46.4% (total n = 7794) of individuals with intellectual disabilities compared with 9.7% (total n = 176,807) in the comparison group had ≥1 health need. Epilepsy was the most common health need (18.7% vs. 1.1%). All health needs except hearing impairment were associated with shorter life expectancy: PEG feeding and mobility difficulties were associated with the greatest loss in life years (65–68% and 41–44%, respectively). Differential life expectancy attenuated but remained (≈12% life years lost) even after restricting the population to those without health needs (additional years expected to live at 10 years: 65.5 [60.3, 71.1] vs. 74.3 [73.8, 74.7]). We conclude that health needs play a significant role but do not explain all of the differential life expectancy experienced by people with intellectual disabilities. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

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Review

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35 pages, 980 KiB

Open AccessReview

The Association between Physical Environment and Externalising Problems in Typically Developing and Neurodiverse Children and Young People: A Narrative Review

by Alister Baird, Bridget Candy, Eirini Flouri, Nick Tyler and Angela Hassiotis

Int. J. Environ. Res. Public Health 2023, 20(3), 2549; https://doi.org/10.3390/ijerph20032549 - 31 Jan 2023

Cited by 4 | Viewed by 4284

Abstract

The physical environment is of critical importance to child development. Understanding how exposure to physical environmental domains such as greenspace, urbanicity, air pollution or noise affects aggressive behaviours in typical and neurodiverse children is of particular importance given the significant long-term impact of those problems. In this narrative review, we investigated the evidence for domains of the physical environment that may ameliorate or contribute to the display of aggressive behaviours. We have considered a broad range of study designs that include typically developing and neurodiverse children and young people aged 0–18 years. We used the GRADE system to appraise the evidence. Searches were performed in eight databases in July 2020 and updated in June 2022. Additional articles were further identified by hand-searching reference lists of included papers. The protocol for the review was preregistered with PROSPERO. Results: We retrieved 7174 studies of which 67 are included in this review. The studies reported on green space, environmental noise and music, air pollution, meteorological effects, spatial density, urban or rural setting, and interior home elements (e.g., damp/sensory aspects/colour). They all used well validated parent and child reported measures of aggressive behaviour. Most of the studies were rated as having low or unclear risk of bias. As expected, noise, air pollution, urbanicity, spatial density, colour and humidity appeared to increase the display of aggressive behaviours. There was a dearth of studies on the role of the physical environment in neurodiverse children. The studies were heterogeneous and measured a range of aggressive behaviours from symptoms to full syndromes. Greenspace exposure was the most common domain studied but certainty of evidence for the association between environmental exposures and aggression problems in the child or young person was low across all domains. We found a large knowledge gap in the literature concerning neurodiverse children, which suggests that future studies should focus on these children, who are also more likely to experience adverse early life experiences including living in more deprived environments as well as being highly vulnerable to the onset of mental ill health. Such research should also aim to dis-aggregate the underlying aetiological mechanisms for environmental influences on aggression, the results of which may point to pathways for public health interventions and policy development to address inequities that can be relevant to ill health in neurodiverse young people. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

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14 pages, 1249 KiB

Open AccessReview

Developmental Delays in Socio-Emotional Brain Functions in Persons with an Intellectual Disability: Impact on Treatment and Support

by Tanja Sappok, Angela Hassiotis, Marco Bertelli, Isabel Dziobek and Paula Sterkenburg

Int. J. Environ. Res. Public Health 2022, 19(20), 13109; https://doi.org/10.3390/ijerph192013109 - 12 Oct 2022

Cited by 12 | Viewed by 4785

Abstract

Intellectual disability is a neurodevelopmental disorder with a related co-occurrence of mental health issues and challenging behaviors. In addition to purely cognitive functions, socio-emotional competencies may also be affected. In this paper, the lens of developmental social neuroscience is used to better understand the origins of mental disorders and challenging behaviors in people with an intellectual disability. The current concept of intelligence is broadened by socio-emotional brain functions. The emergence of these socio-emotional brain functions is linked to the formation of the respective neuronal networks located within the different parts of the limbic system. Thus, high order networks build on circuits that process more basic information. The socio-emotional skills can be assessed and complement the results of a standardized IQ-test. Disturbances of the brain cytoarchitecture and function that occur at a certain developmental period may increase the susceptibility to certain mental disorders. Insights into the current mental and socio-emotional functioning of a person may support clinicians in the calibration of treatment and support. Acknowledging the trajectories of the socio-emotional brain development may result in a more comprehensive understanding of behaviors and mental health in people with developmental delays and thus underpin supports for promotion of good mental health in this highly vulnerable population. Full article

(This article belongs to the Special Issue Recent Advances in Psychopathology in Neurodevelopmental Disorders: From Bench to Bedside)

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