The association between challenging behaviour and symptoms of post-traumatic stress disorder in people with intellectual disabilities: a Bayesian mediation analysis approach.
D Rittmannsberger, T Yanagida, G Weber and 1 others
PMID 32378249WHAT IT FOUND
Informant ratings linked trauma exposure to irritability and hyperactivity via PTSD symptoms.
Self-reported trauma showed no such links. The disconnect between self-report and informant data suggests behavioural signs may mask internal trauma symptoms.
Key findings
01Informant-reported trauma exposure was associated with irritability and hyperactivity through the severity and frequency of PTSD symptoms.
02Self-reported trauma exposure showed no significant association with any challenging behaviour subscale.
03Self-reported PTSD symptoms correlated poorly with informant-rated symptom frequency and severity.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample was small and pre-selected by institutions as sufficiently stable, potentially excluding those with more severe challenging behaviour or trauma impacts. Data was cross-sectional and relied on retrospective accounts, making it prone to recall bias. Self-reported and informant-rated data were distinct and poorly correlated, complicating interpretation of which source is more valid for internal states. The study did not assess whether participants met full diagnostic criteria for PTSD.
Declared interests
The authors reported no conflicts of interest and received no external funding.
The easy way to misread this
Do not assume that self-reported trauma history is sufficient to rule out PTSD-related challenging behaviour. The study found significant associations only in informant-rated data, suggesting internal symptoms may not be accurately captured by self-report alone.