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Diagnosis and Treatment of Aggression in Individuals with Developmental Disabilities

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Abstract

Aggressive behavior is a common referral problem for individuals with developmental disabilities (DD), placing them at risk for institutionalization, social isolation, physical restraint, over-use of medication to treat behavior problems, exclusion from services, and becoming a victim of abuse. Aggression strains relationships between individuals being supported and their caregivers, whether professionals or family members. The treatment of aggression is persons with DD, with or without comorbid mental illness, remains a controversial area and changes in practice have been slow to come. The evidence related to pharmacotherapy and psychological treatment is, in general, either lacking or poor. This does not suggest that these treatments are necessarily ineffective but that there is not enough good quality evidence to support their usefulness. This review considers the prevalence and correlates of aggression, as well as possible causative factors. The relationship between mental illness, intellectual disability and aggression is explored. The psychopharmacological and psychological treatment literature is reviewed with implications for clinical care and future research.

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References

  1. Linaker OM: Assaultiveness among institutionalized adults with mental retardation. British Journal of Psychiatry 164:62–68, 1994

    PubMed  CAS  Google Scholar 

  2. Bruininks RH, Olson K, Larson SA, et al.: Challenging behaviors among persons with mental retardation in residential settings. In: Thompson TE, Gray DB (Eds) Mental Retardation and Mental Health: Classification, Diagnosis, Treatment, Services, Thousand Oaks, CA, Sage, 1994

    Google Scholar 

  3. Nottestad JA, Linaker OM: Predictors for attacks on people after deinstitutionalization. Journal of Intellectual Disability Research 46(6):493–502, 2002. doi:10.1046/j.1365-2788.2002.00418.x

    Article  PubMed  Google Scholar 

  4. Nosttestad JA, Linaker OM: Self-injurious behaviour before and after deinstitutionalization. Journal of Intellectual Disability Research 45(2): 121–129, 2001. doi:10.1046/j.1365-2788.2001.00332.x

    Article  Google Scholar 

  5. Cowley A, Newton J, Sturmey P, et al.: Psychiatric inpatient admissions of adult with intellectual disabilities: Predictive factors. American Journal of Mental Retardation 110(3):216–225, 2005. doi:10.1352/0895-8017(2005)110<216:PIAOAW>2.0.CO;2

    Article  PubMed  Google Scholar 

  6. Jahoda A, Wanless LK: Knowing you: The interpersonal perceptions of staff towards aggressive individuals with mild to moderate intellectual disabilities in situations of conflict. Journal of Intellectual Disability Research 49(7):544–551, 2005. doi:10.1111/j.1365-2788.2005.00693.x

    Article  PubMed  CAS  Google Scholar 

  7. Hare DJ, Pratt C, Burton M, et al.: The health and social care needs of family carers supporting adults with autistic spectrum disorders. Autism 8(4):425–444, 2004. doi:10.1177/1362361304047225

    Article  PubMed  Google Scholar 

  8. Fish R, Culshaw E: The last resort? Staff and client perspectives on physical intervention. Journal of Intellectual Disabilities 9(2):93–107, 2005. doi:10.1177/1744629505049726

    Article  PubMed  Google Scholar 

  9. Jones E, Allen D, Moore K, et al.: Restraint and self-injury in people with intellectual disabilities. Journal of Intellectual Disabilities 11(1):105–118, 2007. doi:10.1177/1744629507074006

    Article  PubMed  Google Scholar 

  10. McGillivray JA, McCabe MP: The relationship between residence and the pharmacological management of challenging behavior in individuals with intellectual disability. Journal of Developmental and Physical Disabilities 17(4):311–325, 2005. doi:10.1007/s10882-005-6614-7

    Article  Google Scholar 

  11. Joyce T, Ditchfield H, Harris P: Challenging behaviour in community services. Journal of Intellectual Disability Research 45(2):130–138, 2001. doi:10.1046/j.1365-2788.2001.00331.x

    Article  PubMed  CAS  Google Scholar 

  12. Strand M, Benzein E, Saveman B: Violence in the care of adult persons with intellectual disabilities. Journal of Clinical Nursing 13:506–514, 2004. doi:10.1046/j.1365-2702.2003.00848.x

    Article  PubMed  Google Scholar 

  13. Lowe K, Allen D, Jones E, et al.: Challenging behaviors: Prevalence and topographies. Journal of Intellectual Disability Research 51(8):625–636, 2007. doi:10.1111/j.1365-2788.2006.00948.x

    Article  PubMed  CAS  Google Scholar 

  14. Sigafoos J, Elkins J, Kerr M, et al.: A survey of aggressive behaviour among a population of persons with intellectual disability in Queensland. Journal of Intellectual Disability Research 38:369–381, 1994

    PubMed  Google Scholar 

  15. McClintock K, Hall S, Oliver C: Risk markers associated with challenging behaviours in people with intellectual disabilities: A meta-analytic study. Journal of Intellectual Disability Research 47:405–416, 2003. doi:10.1046/j.1365-2788.2003.00517.x

    Article  PubMed  CAS  Google Scholar 

  16. Emerson E, Kiernan C, Alborz A, et al.: The prevalence of challenging behaviors: A total population study. Research in Developmental Disabilities 22:77–93, 2001. doi:10.1016/S0891-4222(00)00061-5

    Article  PubMed  CAS  Google Scholar 

  17. Tenneij NH, Koot HM: Incidence, types and characteristics of aggressive behavior in treatment facilities for adults with mild intellectual disability and severe challenging behavior. Journal of Intellectual Disability Research 52(2):114–124, 2008

    PubMed  CAS  Google Scholar 

  18. Deb S, Thomas M, Bright C: Mental disorder in adults with intellectual disability 2: The rate of behaviour disorders among a community-based population aged between 16 and 64 years. Journal of Intellectual Disability Research 45(6):506–514, 2001. doi:10.1046/j.1365-2788.2001.00373.x

    Article  PubMed  CAS  Google Scholar 

  19. Tyrer F, McGrother C, Thorp CF, et al.: Physical aggression toward others in adults with learning disabilities: prevalence and associated factors. Journal of Intellectual Disability Research 50:295–304, 2006. doi:10.1111/j.1365-2788.2005.00774.x

    Article  PubMed  CAS  Google Scholar 

  20. Crocker AG, Mercier C, Lachapelle Y, et al.: Prevalence and types of aggressive behaviour among adults with intellectual disabilities. Journal of Intellectual Disability Research 50(9):652–661, 2006. doi:10.1111/j.1365-2788.2006.00815.x

    Article  PubMed  CAS  Google Scholar 

  21. Allen D: Recent research on physical aggression in persons with intellectual disability: an overview. Journal of Intellectual and Developmental Disability 25(1):41–57, 2000. doi:10.1080/132697800112776

    Article  Google Scholar 

  22. Murphy GH, Beadle-Brown J, Wing, L et al.: Chronicity of challenging behaviours in people with severe intellectual disabilities and/or autism: A total population sample. Journal of Autism and Developmental Disorders 35(4):405–418, 2005. doi:10.1007/s10803-005-5030-2

    Article  PubMed  Google Scholar 

  23. Crocker AG, Mercier C, Allaire JF: Profiles and correlates of aggressive behavior among adults with intellectual disabilities. Journal of Intellectual Disability Research 51(10):786–801, 2007. doi:10.1111/j.1365-2788.2007.00953.x

    Article  PubMed  CAS  Google Scholar 

  24. Bouras N: Psychiatric and Behavioural Disorders in Developmental Disabilities and Mental Retardation. Cambridge, Cambridge University Press, 1999

    Google Scholar 

  25. Matson JL, Mayville EA: The relationship of functional variables and psychopathology to aggressive behavior in persons with severe and profound mental retardation. Journal of Psychopathology and Behavioral Assessment 23(1):3–9, 2001. doi:10.1023/A:1011083221991

  26. Gardner WI: Aggression and Other Disruptive Behavioral Challenges: Biomedical and Psychosocial Assessment and Treatment, Kingston NY, NADD Press, 2002

  27. Marcangelo MJ, Ovsiew F: Psychiatric aspects of epilepsy. Psychiatric Clinics of North America 30, 781–802, 2007. doi:10.1016/j.psc.2007.07.005

    Article  PubMed  Google Scholar 

  28. Bowley C, Kerr M: Epilepsy and intellectual disability. Journal of Intellectual Disability Research 44(5):529–543, 2000. doi:10.1046/j.1365-2788.2000.00270.x

    Article  PubMed  Google Scholar 

  29. Espie CA, Watkins J, Curtice A, et al.: Psychopathology in people with epilepsy and intellectual disability; an investigation of potential explanatory variables. Journal of Neurology, Neurosurgery and Psychiatry 74 (11):1485–1488, 2003. doi:10.1136/jnnp.74.11.1485

  30. Burke AE, Crenshaw DA, Green J, et al.: Influence of verbal ability on the expression of aggression in physically abused children. Journal of the American Academy of Child and Adolescent Psychiatry 28(2):215–218, 1989. doi:10.1097/00004583-198903000-00011

    Article  PubMed  CAS  Google Scholar 

  31. Cohen RA, Brumm V, Zawacki TM, et al.: Impulsivity and verbal deficits associated with domestic violence. Journal of the International Neuropsychological Society 9:760–770, 2003. doi:10.1017/S1355617703950090

    Article  PubMed  Google Scholar 

  32. Bihm EM, Poindexter AR, Warren ER: Aggression and psychopathology in persons with severe or profound mental retardation. Research in Developmental Disabilities 19(5):423–438, 1998. doi:10.1016/S0891-4222(98)00015-8

    Article  PubMed  CAS  Google Scholar 

  33. Carvill S, Marston G: People with intellectual disability, sensory impairments and behaviour disorder: A case series. Journal of Intellectual Disability Research 46(3):264–272, 2002. doi:10.1046/j.1365-2788.2002.00400.x

    Article  PubMed  CAS  Google Scholar 

  34. Reiss S, Levitan GW, McNally RJ: Emotionally disturbed mentally retarded people: An underserved population. American Psychologist 37:361–367, 1982

    Google Scholar 

  35. Robertson J, Emerson E, Pinkney L et al.: Treatment and management of challenging behaviours in congregate and noncongregate community-based supported accommodation. Journal of Intellectual Disability Research 49(1):63–72, 2005. doi:10.1111/j.1365-2788.2005.00663.x

    Article  PubMed  CAS  Google Scholar 

  36. Bouras N, Szymanski L: Services for people with mental retardation and psychiatric disorders: US-UK comparative overview. International Journal of Social Psychiatry 43(1):64–71, 1997. doi:10.1177/002076409704300106

    Article  PubMed  CAS  Google Scholar 

  37. Matson JL, Sevin JA: Theories of dual diagnosis in mental retardation. Journal of Consulting and Clinical Psychology 62(1):6–16, 1994. doi:10.1037/0022-006X.62.1.6

    Article  PubMed  CAS  Google Scholar 

  38. Borthwick-Duffy SA: Epidemiology and prevalence of psychopathology in persons with mental retardation. Journal of Consulting and Clinical Psychology 62:17–27, 1994. doi:10.1037/0022-006X.62.1.17

    Article  PubMed  CAS  Google Scholar 

  39. Reiss S, Levitan GW, Szyskzo J: Emotional disturbances and mental retardation: Diagnostic overshadowing. American Journal of Mental Deficiency 86:567–574, 1982

    PubMed  CAS  Google Scholar 

  40. Aman MG: Assessing psychopathology and behavior problems in persons with mental retardation: A review of available instruments. Rockville MD, US Department of Health and Human Services, 1991

    Google Scholar 

  41. Smiley E: Epidemiology of mental health problems in adults with learning disability: An update. Advances in Psychiatric Research 11:214–222, 2005. doi:10.1192/apt.11.3.214

    Article  Google Scholar 

  42. Cooper SA, Bailey NM: Psychiatric disorders amongst adults with learning disabilities: Prevalence and relationships to ability level. Irish Journal of Psychological Medicine 18:45–52, 2001

    Google Scholar 

  43. Deb S, Thomas M, Bright C: Mental disorder in adults with intellectual disability: 1: Prevalence of functional psychiatric illness among a community-based population aged between 16 and 64 years. Journal of Intellectual Disability Research 45:495–514, 2001. doi:10.1046/j.1365-2788.2001.00374.x

    Article  PubMed  CAS  Google Scholar 

  44. Whitaker S, Read S: The prevalence of psychiatric disorders among people with intellectual disabilities: an analysis of the literature. Journal of Applied Research in Intellectual Disabilities 19:330–345, 2006. doi:10.1111/j.1468-3148.2006.00293.x

    Article  Google Scholar 

  45. Cooper SA, Smiley E, Morrison J, et al.: Mental ill-health in adults with intellectual disabilities: prevalence and associated factors. British Journal of Psychiatry 190:27–35, 2007. doi:10.1192/bjp.bp.106.022483

    Article  PubMed  Google Scholar 

  46. Sparrow SS, Balla DA, Cicchetti DV: Revision of the Vineland Social Maturity Scale by EA Doll, American Guidance Service

  47. Cooper SA: Epidemiology of psychiatric disorders in elderly compared with younger adults with learning disabilities. British Journal of Psychiatry 170:375–380, 1997

    PubMed  CAS  Google Scholar 

  48. Sturmey P: DSM-IIIR and persons with dual diagnosis: Conceptual issues and strategies for future research. Journal of Intellectual Disability Research 39:357–364, 1995

    Article  PubMed  Google Scholar 

  49. Einfeld SL, Tonge BJ: Observations on the use of the ICD-10 guide for mental retardation. Journal of Intellectual Disability Research 45:408–412, 1999. doi:10.1046/j.1365-2788.1999.043005408.x

    Article  Google Scholar 

  50. King BH, DeAntonio C, McCracken JT, et al.: Psychiatric consultation in severe and profound mental retardation. American Journal of Psychiatry 151(12):1802–1808, 1994

    PubMed  CAS  Google Scholar 

  51. Rojahn J, Matson JL, Naglieri JA, et al.: Relationships between psychiatric conditions and behavior problems among adults with mental retardation. American Journal on Mental Retardation, 109(1):21–23, 2004. doi:10.1352/0895-8017(2004)109<21:RBPCAB>2.0.CO;2

    Article  PubMed  Google Scholar 

  52. Matson JL, Coe DA, Gardner WI, et al.: A factor analytic study of the Diagnostic Assessment for the Severely Handicapped Scale. Journal of Nervous and Mental Disease 179:553–557, 1991. doi:10.1097/00005053-199109000-00006

    PubMed  CAS  Google Scholar 

  53. Rojahn J, Matson JL, Lott D, et al.: The Behavior Problems Inventory: An instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities. Journal of Autism & Developmental Disorders 31(6):577–588, 2001. doi:10.1023/A:1013299028321

    Article  CAS  Google Scholar 

  54. Hemmings CP, Gravestock S, Pickard M, et al.: Psychiatric symptoms and problem behaviours in people with intellectual disabilities. Journal of Intellectual Disability Research 50(4):269–276, 2006. doi:10.1111/j.1365-2788.2006.00827.x

    Article  PubMed  CAS  Google Scholar 

  55. Moss SC, Emerson E, Kiernan C, et al.: Psychiatric symptoms in adults with learning disability and challenging behaviour. British Journal of Psychiatry 177:452–456, 2000. doi:10.1192/bjp.177.5.452

    Article  PubMed  CAS  Google Scholar 

  56. Holden B, Gitleson JP: Prevalence of psychiatric symptoms in adults with mental retardation and challenging behaviour. Research in Developmental Disabilities 24:323–332, 2003. doi:10.1016/S0891-4222(03)00060-X

    Article  PubMed  Google Scholar 

  57. Prosser H, Moss SC, Costello H, et al.: Reliability and validity of the mini-PAS-ADD for assessing psychiatric disorders in adults with intellectual disability. Journal of Intellectual Disability Research 42:264–272, 1998. doi:10.1046/j.1365-2788.1998.00146.x

    Article  PubMed  Google Scholar 

  58. Reiss S, Rojahn J: Joint occurrence of depression and aggression in children and adults with mental retardation. Journal of Intellectual Disability Research 37:287–294, 1994

    Google Scholar 

  59. McBrien JA: Assessment and diagnosis of depression in people with intellectual disability. Journal of Intellectual Disability Research 47:1–13, 2003. doi:10.1046/j.1365-2788.2003.00455.x

    Article  PubMed  CAS  Google Scholar 

  60. Aman MG, Crismon ML, Frances A, et al.: Treatment of psychiatric and behavioral problems in individuals with mental retardation: An update of the expert consensus guidelines. Expert Consensus Guidelines, 2004

  61. Branford D: A study of the prescribing for people with learning disabilities in the community and in National Health Service care. Journal of Intellectual Disability Research 38:577–586, 1994

    PubMed  Google Scholar 

  62. Tyrer P, Oliver-Africano P, Ahmed Z, et al.: Risperidone, haloperidol, and placebo in the treatment of aggressive challenging behaviour in patients with intellectual disability: a randomized control trial. The Lancet 371(9606):57–63, 2008. doi:10.1016/S0140-6736(08)60072-0

    Article  CAS  Google Scholar 

  63. Matson JL, Bamburg JW, Mayville EA, et al.: Psychopharmacology and mental retardation: A 10 year review (1990–1999). Research in Developmental Disabilities 21:263–296, 2000. doi:10.1016/S0891-4222(00)00042-1

    Article  PubMed  CAS  Google Scholar 

  64. King BH: Psychopharmacology in mental retardation. Current Opinion in Psychiatry 15(5):497–502, 2002. doi:10.1097/00001504-200209000-00006

    Article  Google Scholar 

  65. Brylewski J, Duggan L: Antipsychotic medication for challenging behaviour in people with learning disability. The Cochrane Database of Systematic Reviews. Art. No: CD000377. doi: 10.1002/14651858.CD000377.pub2.

  66. Deb S, Sohanpal R, Soni L, et al.: The effectiveness of antipsychotic medication in the management of behaviour problems in adults with intellectual disabilities. Journal of Intellectual Disability Research 51(10):766–777, 2007. doi:10.1111/j.1365-2788.2007.00950.x

    Article  PubMed  CAS  Google Scholar 

  67. Janowsky DS, Barnhill LJ, Davis JM: Olanzapine for self-injurious, aggressive, and disruptive behaviors in intellectually disabled adults: A retrospective, open-label, naturalistic trial. Journal of Clinical Psychiatry 64:1258–1265, 2003

    Article  PubMed  CAS  Google Scholar 

  68. Williams H, Clarke R, Bouras N, et al.: Use of the atypical antipsychotics olanzapine and risperidone in adults with intellectual disability. Journal of Intellectual Disability Research 44(2):164–169, 2000. doi:10.1046/j.1365-2788.2000.00284.x

    Article  PubMed  Google Scholar 

  69. Cohen S, Fitzgerald B, Okos A, et al.: Weight, lipids, glucose, and behavioral measures with ziprasidone treatment in a population with mental retardation. Journal of Clinical Psychiatry 64:60–62, 2003

    Article  PubMed  CAS  Google Scholar 

  70. Hammock R, Levine WR, Schroeder SR: Brief report: Effects of clozapine on self-injurious behavior of two risperidone nonresponders with mental retardation. Journal of Autism and Developmental Disorder 31(1):109–113, 2001. doi:10.1023/A:1005626100084

    Article  CAS  Google Scholar 

  71. Matson JL, Wilkins J: Antipsychotic drugs for aggression in intellectual disability. The Lancet 371:9–10, 2008. doi:10.1016/S0140-6736(08)60046-X

    Article  Google Scholar 

  72. Fava M: Psychopharmacologic treatment of pathologic aggression. The Psychiatric Clinics of North America 20(2):427–451, 1997. doi:10.1016/S0193-953X(05)70321-X

    Article  PubMed  CAS  Google Scholar 

  73. Robertson J, Emerson E, Gregory N, et al.: Receipt of psychotropic medication by people with intellectual disability in residential settings. Journal of Intellectual Disability Research 44:666–676, 2000. doi:10.1046/j.1365-2788.2000.00307.x

    Article  PubMed  Google Scholar 

  74. Lindenmayer JP, Kotsaftis A: Use of sodium valproate in violent and aggressive behaviors: A critical review. Journal of Clinical Psychiatry 2000(61):123–126, 2000

    Google Scholar 

  75. Deb S, Unwin GL, Soni R, et al.: Guide to using psychotropic medication for the management of behaviour problems among adults with intellectual disability: Technical document: Section 3: Systematic reviews. Birmingham UK, University of Birmingham, Available at http://www.ld-medication.bham.ac.uk, 2007

  76. Janowsky DS, Kraus JE, Barnhill J et al.: Effects of topiramate on aggressive, self-injurious, and disruptive/destructive behaviors in the intellectually disabled: An open-label retrospective study. Journal of Clinical Psychopharmacology 23(5):500–504, 2003. doi:10.1097/01.jcp.0000088906.24613.76

    Google Scholar 

  77. Branford D, Bhaumik S, Naik B: Selective serotonin re-uptake inhibitors for the treatment of perseverative and maladaptive behaviours of people with intellectual disability. Journal of Intellectual Disability Research 42(4):301–306, 1998. doi:10.1046/j.1365-2788.1998.00144.x

    Article  PubMed  Google Scholar 

  78. La Malfa G, Bertelli M, Conte M: Fluvoxamine and aggression in mental retardation. Psychiatric Services 52(8):1105, 2001. doi:10.1176/appi.ps.52.8.1105

    Article  PubMed  CAS  Google Scholar 

  79. Wing L: The MRC handicaps, behavior, and skills (HBS) schedule. Acta Psychiatrica Scandinavica 62(suppl 285):241–247, 1980. doi:10.1111/j.1600-0447.1980.tb07696.x

    Article  Google Scholar 

  80. Janowsky DS, Shetty M, Barnhill J: Serotonergic antidepressant effects on aggressive, self-injurious and destructive/disruptive behaviours in intellectually disabled adults: a retrospective, open-label, naturalistic trial. International Journal of Neuropsychopharmacology 8:37–48, 2004. doi:10.1017/S146114570400481X

    Article  PubMed  CAS  Google Scholar 

  81. Davanzo PA, Belin TR, Widawski et al.: Paroxetine treatment of aggression and self-injury in persons with mental retardation. American Journal on Mental Retardation 102(5):427–437, 1998. doi:10.1352/0895-8017(1998)102<0427:PTOAAS>2.0.CO;2

  82. Sohanpal SK, Deb S, Thomas C, Soni R, Lenotre L, Unwin G: The effectiveness of antidepressant medication in the management of behaviour problems in adults with intellectual disabilities: A systematic review. Journal of Intellectual Disability Research 51(Pt 10):750–765, 2007. doi:10.1111/j.1365-2788.2006.00935.x

    Article  PubMed  CAS  Google Scholar 

  83. Antochi R, Stavrakaki C, Emery PC: Psychopharmacological treatments in persons with dual diagnosis of psychiatric disorders and developmental disabilities. Postgraduate Medical Journal 79(929):139–148, 2003. doi:10.1136/pmj.79.929.139

    Article  PubMed  CAS  Google Scholar 

  84. Deb S, Chaplin R, Sohanpal G, et al.: The effectiveness of mood stabilizers and antiepileptic medication for the management of behaviour problems in adults with intellectual disability: a systematic review. Journal of Intellectual Disability Research 52(2):107–113, 2008

    PubMed  CAS  Google Scholar 

  85. Craft M, Ismail IA, Kristnamurti D, et al.: Lithium in the treatment of aggression in mentally handicapped patients: A double blind trial. British Journal of Psychiatry 150:685–689, 1987

    Article  PubMed  CAS  Google Scholar 

  86. Tyrer SP, Aronson ME, Lauder J: Effect of Lithium on Behavioural Factors in Aggressive Mentally Handicapped Subjects. In: Birch C, Padgham C, Hughes MS (Eds) Lithium in Medicine and Biology, Carnforth, Marius Press, 1993

    Google Scholar 

  87. Langee HR: Retrospective study of lithium use for institutionalized mentally retarded individuals with behavior disorders. American Journal on Mental Retardation 94:448–452, 1990

    PubMed  CAS  Google Scholar 

  88. Pary R: Side effects during lithium treatment for psychiatric disorders in adults with mental retardation. American Journal of Mental Retardation 96:269–273, 1991

    PubMed  CAS  Google Scholar 

  89. Symons FJ, Thompson A, Rodriquez MC: Self-injurious behavior and the efficacy of naltrexone: A quantitative synthesis. Mental Retardation and Developmental Disabilities Research Review 10:193–200, 2004. doi:10.1002/mrdd.20031

    Article  Google Scholar 

  90. Deb S, Unwin G: Psychotropic medication for behaviour problems in people with intellectual disability: A review of the current literature. Current Opinion in Psychiatry 20:461–466, 2007. doi:10.1097/YCO.0b013e3282ab9952

    Article  PubMed  Google Scholar 

  91. King BH, Davanzo P: Buspirone treatment of aggression and self-injury in autistic and nonautistic persons with severe mental retardation. Developmental Brain Dysfunction 90:22–31, 1996

    Google Scholar 

  92. Kalachnik JE, Hanzel TE, Sevenich R, et al.: Benzodiazepine behavioral side effects: Review and implications for individuals with mental retardation. American Journal on Mental Retardation 107(5):376–410, 2002. doi:10.1352/0895-8017(2002)107<0376:BBSERA>2.0.CO;2

    Article  PubMed  Google Scholar 

  93. Hanley GP, Iwata BA, McCord BE: Functional analysis of problem behavior: A review. Journal of Applied Behavior Analysis 36:147–185, 2003. doi:10.1901/jaba.2003.36-147

    Article  PubMed  Google Scholar 

  94. Sturmey P: Against psychotherapy with people who have mental retardation. Mental Retardation 45(1):55–57, 2005. doi:10.1352/0047-6765(2005)43<55:APWPWH>2.0.CO;2

    Article  Google Scholar 

  95. Sturmey P: Against psychotherapy with people who have mental retardation: In response to the responses. Mental Retardation 44(1):71–74, 2006. doi:10.1352/0047-6765(2006)44[71:APWPWH]2.0.CO;2

    Article  PubMed  Google Scholar 

  96. Beail N: What works for people with mental retardation? Critical commentary on cognitive-behavioral and psychodynamic psychotherapy research. Mental Retardation 41:468–472, 2003. doi:10.1352/0047-6765(2003)41<468:WWFPWM>2.0.CO;2

    Article  PubMed  Google Scholar 

  97. Hurley A: Psychotherapy is an essential tool in the treatment of psychiatric disorders for people with mental retardation. Mental Retardation 43(6):445–448, 2005. doi:10.1352/0047-6765(2005)43[445:PIAETI]2.0.CO;2

    Article  PubMed  Google Scholar 

  98. King R: Proceeding with compassion while awaiting the evidence: psychotherapy and individuals with mental retardation. Mental Retardation 43(6):448–450, 2005. doi:10.1352/0047-6765(2005)43[448:PWCWAT]2.0.CO;2

  99. Taylor JL: In support of psychotherapy for people who have mental retardation. Mental Retardation 43(6):450–453, 2005. doi:10.1352/0047-6765(2005)43[450:ISOPFP]2.0.CO;2

    Article  PubMed  Google Scholar 

  100. Prout HT, Nowak-Drabik KM: Psychotherapy with persons who have mental retardation: An evaluation of effectiveness. American Journal on Mental Retardation 108:82–93, 2003. doi:10.1352/0895-8017(2003)108<0082:PWPWHM>2.0.CO;2

    Article  PubMed  Google Scholar 

  101. Beail N: Evidence base for behavioral interventions: critical commentary. Mental Retardation 43(6):442–445, 2005. doi:10.1352/0047-6765(2005)43[442:RTSOPE]2.0.CO;2

    Article  PubMed  Google Scholar 

  102. Beail N: What works for people with mental retardation? Critical commentary on cognitive-behavioral and psychodynamic psychotherapy research. Mental Retardation 41(6):468–472, 2003. doi:10.1352/0047-6765(2003)41<468:WWFPWM>2.0.CO;2

    Article  PubMed  Google Scholar 

  103. Willner P: The effectiveness of psychotherapeutic interventions for people with learning disabilities: A critical overview. Journal of Intellectual Disability Research 49(1):73–85, 2005. doi:10.1111/j.1365-2788.2005.00633.x

    Article  PubMed  CAS  Google Scholar 

  104. Scotti JR, Evans IM, Meyer LH, et al.: A meta-analysis of intervention research with problem behavior: Treatment validity and standards of practice. American Journal on Mental Retardation 96:233–256, 1991

    PubMed  CAS  Google Scholar 

  105. Didden R, Duker P, Korzilius H: Meta-analytic study on treatment effectiveness for problem behaviors with individuals who have mental retardation. American Journal on Mental Retardation 101(4):387–399, 1997

    PubMed  CAS  Google Scholar 

  106. Carr JE, Coriaty S, Wilder DA, et al.: A review of ‘noncontingent’ reinforcement as treatment for the aberrant behavior of individuals with developmental disabilities. Research in Developmental Disabilities 21:377–391, 2000. doi:10.1016/S0891-4222(00)00050-0

    Article  PubMed  CAS  Google Scholar 

  107. Whitaker S: The reduction of aggression in people with learning disabilities: A review of psychological methods. British Journal of Clinical Psychology 32:1–37, 1993

    PubMed  Google Scholar 

  108. Novaco RW: Anger Control: The Development and Evaluation of an Experimental Treatment. Lexington MA, Heath, 1975

    Google Scholar 

  109. Whitaker S: Anger control for people with learning disabilities: A critical review. Behavioural and Cognitive Psychotherapy 29:277–293, 2001. doi:10.1017/S1352465801003022

    Article  Google Scholar 

  110. Taylor JL: A review of the assessment and treatment of anger and aggression in offenders with intellectual disability. Journal of Intellectual Disability Research 46(suppl 1):57–73, 2002. doi:10.1046/j.1365-2788.2002.00005.x

    Article  PubMed  Google Scholar 

  111. Taylor JL, Novaco, RW, Gillmer, BT et al.: Individual cognitive-behavioural anger treatment for people with mild-borderline intellectual disabilities and histories of aggression: A controlled trial. British Journal of Clinical Psychology 44:367–382, 2005. doi:10.1348/014466505X29990

    Article  PubMed  Google Scholar 

  112. Taylor JL, Novaco RW: Anger Treatment for People with Developmental Disabilities: A Theory, Evidence and Manual Based Approach. New York, Wiley, 2005

  113. Spielberger CD: State-Trait Anger Expression Inventory Professional Manual. Florida: Psychological Assessment Resources, 1996

  114. Novaco RW: Anger as a Risk Factor for Violence among the Mentally Disordered. In: Monahan J, Steadman HJ (Eds) Violence and Mental Disorder: Developments in Risk Assessment, Chicago, University of Chicago Press, 1994

  115. Basquill MF, Nezu CM, Nezu AM, et al.: Aggression-related hostility bias and social problem-solving deficits in adult males with mental retardation. American Journal on Mental Retardation 109(3):255–263, 2004. doi:10.1352/0895-8017(2004)109<255:AHBASP>2.0.CO;2

    Article  PubMed  Google Scholar 

  116. Matheson E, Jahoda A: Emotional understanding in aggressive and nonaggressive individuals with mild or moderate mental retardation. American Journal on Mental Retardation 110(1):57–67, 2005. doi:10.1352/0895–8017(2005)110<57:EUIAAN>2.0.CO;2

    Article  PubMed  Google Scholar 

  117. Jahoda A, Pert C, Trower P: Socioemotional understanding and frequent aggression in people with mild to moderate intellectual disabilities. American Journal on Mental Retardation 111(2):77–89, 2006. doi:10.1352/0895-8017(2006)111[77:SUAFAI]2.0.CO;2

    Article  PubMed  Google Scholar 

  118. Jahoda A, Pert C, Trower P: Frequent aggression and attribution of hostile intent in people with mild to moderate intellectual disabilities: An empirical investigation. American Journal on Mental Retardation 111(2):90–99, 2006. doi:10.1352/0895-8017(2006)111[90:FAAAOH]2.0.CO;2

    Article  PubMed  Google Scholar 

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Correspondence to Diana J. Antonacci.

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Antonacci, D.J., Manuel, C. & Davis, E. Diagnosis and Treatment of Aggression in Individuals with Developmental Disabilities. Psychiatr Q 79, 225–247 (2008). https://doi.org/10.1007/s11126-008-9080-4

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