Assessment and treatment of posttraumatic stress disorder in individuals with intellectual disabilities

Individuals with intellectual disabilities (ID), including individuals with borderline intellectual functioning (BIF; IQ 70-85), are a large minority in mental health care services. Evidence indicates that they are more often exposed to potentially traumatic events than individuals without ID. They also display an increased risk for the development of posttraumatic stress disorder (PTSD), a mental health condition leading to severe and long-term impairments, high costs of care and low levels of quality of life. A review of the literature published until 2010 showed that prevalence rates of posttraumatic stress disorder (PTSD) in people with ID were lacking, that it was unknown how PTSD manifests itself in individuals with ID, and that there were no studies on PTSD treatments for individuals with ID. That was the reason for the present research project. For the assessment of PTSD in ID, a clinical interview, the Adapted ADIS-C PTSD, was developed and validated. Based upon this work we found no evidence that PTSD would manifest atypically in individuals with ID. More importantly, the guideline treatment for PTSD, EMDR-therapy, proved applicable and effective for both children and adults, irrespective of their level of ID. The findings of the current research project are of great importance because they not only offer opportunities for timely detection of trauma-related psychopathology, but also for the application of evidence based treatment for PTSD in this vulnerable target group.