Skip to main content
SpringerLink
Log in

Mindfulness-Based Treatment of Aggression in Individuals with Mild Intellectual Disabilities: A Waiting List Control Study

  • ORIGINAL PAPER
  • Published:
Mindfulness Aims and scope Submit manuscript

Abstract

Physical and verbal aggression is a significant problem for some individuals with mild intellectual disabilities who reside in the community. We assessed the effectiveness of a mindfulness-based procedure, Meditation on the Soles of the Feet, to control both physical and verbal aggression. The design was a two-group (experimental and waiting list control) randomized controlled trial with four 12-week phases. A total of 57 individuals were referred to the trial, with 34 eligible for random assignment to the experimental and control conditions. Results showed a significant reduction in physical and verbal aggression commensurate with mindfulness-based training, when compared to the waiting list control condition. Similar reductions in physical and verbal aggression were evident when the same training was introduced in the control condition. The results demonstrate the effectiveness of the mindfulness-based procedure for assisting individuals with mild intellectual disabilities to control their physical and verbal aggression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  • Adkins, A. D., Singh, A. N., Winton, A. S. W., McKeegan, G. F., & Singh, J. (2010). Using a mindfulness-based procedure in the community: translating research to practice. Journal of Child and Family Studies, 19, 175–183.

    Article  Google Scholar 

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

    Article  Google Scholar 

  • Aman, M. G., & Gharabawi, G. (2004). Treatment of behavior disorders in mental retardation: report on transitioning to atypical antipsychotics with an emphasis on risperidone. The Journal of Clinical Psychiatry, 65, 1197–1210.

    Article  PubMed  Google Scholar 

  • Barlow, D. H., Nock, M., & Hersen, M. (2009). Single-case experimental designs: strategies for studying behavior change (3rd ed.). New York: Allyn & Bacon.

    Google Scholar 

  • Benson, B. A., Rice, C. J., & Miranti, S. V. (1986). Effects of anger management training with mentally retarded adults in group treatment. Journal of Consulting and Clinical Psychology, 54, 728–729.

    Article  PubMed  Google Scholar 

  • Carr, E. G., & Carlson, J. I. (1993). Reduction of severe behavior problems in the community using a multicomponent treatment approach. Journal of Applied Behavior Analysis, 26, 157–172.

    Article  PubMed  Google Scholar 

  • Carr, J. E., Severtson, J. M., & Lepper, T. L. (2009). Noncontingent reinforcement is an empirically supported treatment for problem behavior exhibited by individuals with developmental disabilities. Research in Developmental Disabilities, 30, 44–57.

    Article  PubMed  Google Scholar 

  • Chowdhury, M., & Benson, B. A. (2011). Use of differential reinforcement to reduce behavior problems in adults with intellectual disabilities: a methodological review. Research in Developmental Disabilities, 32, 383–394.

    Article  PubMed  Google Scholar 

  • Clarke, D. J., Kelley, S., Thinn, K., & Corbett, J. A. (1990). Psychotropic drugs and mental retardation: 1. Disabilities and the prescription of drugs for behavior and for epilepsy in three residential settings. Journal of Mental Deficiency Research, 34, 385–395.

    PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Erlbaum.

    Google Scholar 

  • De Leon, J. (2012). Evidence-based medicine versus personalized medicine: are they enemies? Journal of Clinical Psychopharmacology, 32, 153–164.

    Article  PubMed  Google Scholar 

  • Deb, S., Sohanpal, S. K., Soni, R., Lenôtre, L., & Unwin, G. (2007). The effectiveness of antipsychotic medication in the management of behaviour problems in adults with intellectual disabilities. Journal of Intellectual Disability Research, 51, 766–777.

    Article  PubMed  Google Scholar 

  • Deffenbacher, J. L. (2011). Cognitive–behavioral conceptualization and treatment of anger. Cognitive and Behavioral Practice, 18, 212–221.

    Article  Google Scholar 

  • Durlak, J. A., & Lipsey, M. W. (1991). A practitioner’s guide to meta-analysis. American Journal of Community Psychology, 19, 291–332.

    PubMed  Google Scholar 

  • Foerde, K., Knowlton, B. J., & Poldrack, R. A. (2006). Modulation of competing memory systems by distraction. Proceedings of the National Academy of Sciences, 103, 11778–11783.

    Article  Google Scholar 

  • Grey, I. M., & Hastings, R. P. (2005). Evidence-based practices in intellectual disability and behaviour disorders. Current Opinion in Psychiatry, 18, 469–475.

    Article  PubMed  Google Scholar 

  • Hwang, Y.-S., & Kearney, P. (2013). A systematic review of mindfulness intervention for individuals with developmental disabilities: long-term practice and long lasting effects. Research in Developmental Disabilities, 34, 314–326.

    Article  PubMed  Google Scholar 

  • Iacoboni, M. (2008). Mirroring people: the new science of how we connect with others. New York: Farrar, Straus and Giroux.

    Google Scholar 

  • Jensen, U. J. (2007). The struggle for clinical authority: shifting ontologies and the politics of evidence. BioSocieties, 2, 101–114.

    Article  Google Scholar 

  • Jesner, O. S., Aref-Adib, M., & Coren, E. (2007). Risperidone for autism spectrum disorder. Cochrane Database of Systematic Reviews, 1. doi:10.1002/14651858.CD005040.pub2 (Art. No.: CD005040).

  • Kagohara, D. M., van der Meer, L., Ramdoss, S., O’Reilly, M. F., Lancioni, G. E., Davis, T. N., et al. (2013). Using iPods® and iPads® in teaching programs for individuals with developmental disabilities: a systematic review. Research in Developmental Disabilities, 34, 147–156.

    Article  PubMed  Google Scholar 

  • Kent, D. M., & Hayward, R. A. (2007). Limitations of applying summary results of clinical trials to individual patients: the need for risk stratification. Journal of the American Medical Association, 298, 1209–1212.

    Article  PubMed  Google Scholar 

  • Kurtz, P. F., Boelter, E. W., Jarmolowicz, D. P., Chin, M. D., & Hagopian, L. P. (2011). An analysis of functional communication training as an empirically supported treatment for problem behavior displayed by individuals with intellectual disabilities. Research in Developmental Disabilities, 32, 2935–2942.

    Article  PubMed  Google Scholar 

  • Lama, D. (2002). How to practice: the way to a meaningful life. New York: Atria Books.

    Google Scholar 

  • Rizzolatti, G., & Craighero, L. (2004). The mirror–neuron system. Annual Review of Neuroscience, 27, 169–192.

    Article  PubMed  Google Scholar 

  • Roediger, H. L., III. (2012). Psychology’s woes and a partial cure: the value of replication. APS Observer, 25, 9 and 27–29.

  • Rose, J., Loftus, M., Flint, B., & Carey, L. (2005). Factors associated with the efficacy of a group intervention for anger in people with intellectual disabilities. British Journal of Clinical Psychology, 44, 305–317.

    Article  PubMed  Google Scholar 

  • Senn, S. J. (1998). Applying results of randomized trials to patients: N of 1 trials are needed. British Medical Journal, 317, 537–538.

    Article  PubMed  Google Scholar 

  • Singh, N. N., Wahler, R. G., Adkins, A. D., & Myers, R. E. (2003). Soles of the Feet: a mindfulness-based self-control intervention for aggression by an individual with mild mental retardation and mental illness. Research in Developmental Disabilities, 24, 158–169.

    Article  PubMed  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Adkins, A. D., Singh, J., & Singh, A. N. (2007a). Mindfulness training assists individuals with moderate mental retardation to maintain their community placements. Behavior Modification, 31, 800–814.

    Article  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Adkins, A. D., Wahler, R. G., Sabaawi, M., et al. (2007b). Individuals with mental illness can control their aggressive behavior through mindfulness training. Behavior Modification, 31, 313–328.

    Article  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Joy, S. D. S., Winton, A. S. W., Sabaawi, M., Wahler, R. G., et al. (2007c). Adolescents with conduct disorder can be mindful of their aggressive behavior. Journal of Emotional and Behavioral Disorders, 15, 56–63.

    Article  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. N., Adkins, A. D., & Singh, J. (2008). Clinical and benefit-cost outcomes of teaching a mindfulness-based procedure to adult offenders with intellectual disabilities. Behavior Modification, 32, 622–637.

    Article  PubMed  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., & Singh, J. (2011a). Aggression, tantrums, and other externally driven challenging behaviors. In J. L. Matson & P. Sturmey (Eds.), International handbook of autism and pervasive developmental disorders (pp. 413–435). New York: Springer.

    Chapter  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Manikam, R., Winton, A. S. W., Singh, A. N. A., Singh, J., et al. (2011b). A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism. Research in Autism Spectrum Disorders, 5, 1153–1158.

    Article  Google Scholar 

  • Singh, N. N., Lancioni, G. E., Singh, A. D. A., Winton, A. S. W., Singh, A. N. A., & Singh, J. (2011c). Adolescents with Asperger syndrome can use a mindfulness-based strategy to control their aggressive behavior. Research in Autism Spectrum Disorders, 5, 1103–1109.

    Article  Google Scholar 

  • Singh, N. N., Singh, J., Singh, A. D. A., Singh, A. N. A., & Winton, A. S. W. (2011d). Meditation on the Soles of the Feet for anger management: A trainer’s manual. Raleigh: Fernleaf. www.fernleafpub.com.

    Google Scholar 

  • Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, A. D. A., Singh, A. N. A., & Singh, J. (2013). Mindfulness-based approaches. In J. L. Taylor, W. R. Lindsay, R. Hastings, & C. Hatton (Eds.), Psychological therapies for adults with intellectual disabilities (pp. 253–266). Chichester, UK: Wiley.

    Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston: Allyn and Bacon.

    Google Scholar 

  • Taylor, J. (2002). A review of the assessment and treatment of anger and aggression in offenders with intellectual disabilities. Journal of Intellectual Disability Research, 46(Suppl. 1), 57–73.

    Article  PubMed  Google Scholar 

  • Taylor, J. L., & Novaco, R. W. (2013). Anger control problems. In J. L. Taylor, W. R. Lindsay, R. Hastings, & C. Hatton (Eds.), Psychological therapies for adults with intellectual disabilities (pp. 133–156). Chichester, UK: Wiley.

    Chapter  Google Scholar 

  • Towns, A. J., Singh, N. N., & Beale, I. L. (1984). Reliability of observations in double- and single-blind drug study: an experimental analysis. In K. Gadow (Ed.), Advances in learning and behavioral disabilities (Vol. 3, pp. 215–240). Greenwich, CT: JAI Press.

    Google Scholar 

  • Tunis, S. R., Stryer, D. B., & Clancy, C. M. (2003). Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy. Journal of the American Medical Association, 290, 1624–1632.

    Article  PubMed  Google Scholar 

  • Tyrer, F., McGrother, C. W., Thorp, C. F., Donaldson, M., Bhaumik, S., Watson, J. M., et al. (2006). Physical aggression toward others in adults with learning disabilities: prevalence and associated factors. Journal of Intellectual Disability Research, 50, 295–304.

    Article  PubMed  Google Scholar 

  • Tyrer, P., Oliver-Africano, P. C., Ahmed, Z., Bouras, N., Cooray, S., Deb, S., et al. (2008). Risperidone, haloperidol and placebo in the treatment of aggressive challenging behavior in intellectual disability: a randomized control trial. Lancet, 371, 57–63.

    Article  PubMed  Google Scholar 

  • Unwin, G. L., & Deb, S. (2008). Use of medication for the management of behavior problems among adults with intellectual disabilities: a clinicians’ consensus survey. American Journal of Mental Retardation, 113, 19–31.

    Article  PubMed  Google Scholar 

  • Unwin, G. L., & Deb, S. (2011). Efficacy of atypical antipsychotic medication in the management of behaviour problems in children with intellectual disabilities and borderline intelligence: a systematic review. Research in Developmental Disabilities, 32, 2121–2133.

    Article  PubMed  Google Scholar 

  • Whittaker, S. (2001). Anger control for people with learning disabilities: a critical review. Behavioural and Cognitive Psychotherapy, 29, 277–293.

    Article  Google Scholar 

  • Willner, P. (2007). Cognitive behavioural therapy for people with learning disabilities: focus on anger. Advances in Mental Health and Intellectual Disabilities, 1(2), 14–21.

    Google Scholar 

Download references

Acknowledgments

Portions of the data in this paper were presented at the NADD 2010 International Congress: Innovations and Interventions (MH/ID), April 14–16, 2010, Toronto, Canada and at the International Conference on Recent Advances in Cognitive Science, December 18–20, 2010, at the Banaras Hindu University, Varanasi, India.

Author information

Authors and Affiliations

  1. ONE Research Institute, P.O. Box 80644, Raleigh, NC, 27623, USA

    Nirbhay N. Singh & Judy Singh

  2. American Health and Wellness Institute, Long Beach, CA, 90803, USA

    Ashvind N. A. Singh & Angela D. A. Singh

  3. Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy

    Giulio E. Lancioni

  4. Department of Psychology, The College of Wooster, Wooster, OH, 44691, USA

    Bryan T. Karazsia

  5. School of Psychology, Massey University, Palmerston North, New Zealand

    Alan S. W. Winton

  6. WellStar School of Nursing, Kennesaw State University, Kennesaw, GA, 30144, USA

    Rachel E. Myers

Authors
  1. Nirbhay N. Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giulio E. Lancioni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bryan T. Karazsia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alan S. W. Winton
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rachel E. Myers
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ashvind N. A. Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Angela D. A. Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Judy Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nirbhay N. Singh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, N.N., Lancioni, G.E., Karazsia, B.T. et al. Mindfulness-Based Treatment of Aggression in Individuals with Mild Intellectual Disabilities: A Waiting List Control Study. Mindfulness 4, 158–167 (2013). https://doi.org/10.1007/s12671-012-0180-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-012-0180-8

Keywords

Search

Navigation