Skip to main content
Log in

The Relationship Between Challenging Behavior and Symptoms of Depression in Intellectually Disabled Adults with and without Autism Spectrum Disorders

  • ORIGINAL ARTICLE
  • Published:
Journal of Developmental and Physical Disabilities Aims and scope Submit manuscript

Abstract

The presence of an intellectual disability (ID) is associated with the presence of co-occurring psychiatric diagnoses, and challenging behavior. Autism spectrum disorders (ASDs) and other comorbid psychopathologies are also commonly–observed in this population. Behavioral profiles of depression may help clinicians to detect depression in individuals with ID. In this study of 332 adults with intellectual disability, we found a significant association between symptoms of depression in those with ASD, PDD-NOS, and those with an ID and no ASD. Aggressive/destructive behavior and stereotyped behavior was significantly predictive in all conditions, but self-injurious behavior appears to be a useful predictor only in those with an ASD. Diagnosticians should consider the possibility of a depressive disorder when individuals with an ID present with challenging behavior.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Advokat, C. D., Mayville, E. A., & Matson, J. L. (2000). Side effect profiles of atypical antipsychotics or no antipsychotic medications in persons with mental retardation. Research in Developmental Disabilities, 21, 75–84.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

  • Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30, 237–243.

    Article  PubMed  Google Scholar 

  • Call, N. A., Findley, A. J., & Reavis, A. R. (2012). The effects of conducting a functional analysis on problem behavior in other settings. Research in Developmental Disabilities, 33, 1990–1995.

    Article  PubMed  Google Scholar 

  • Charlot, L., Deutsch, C. K., Albert, A., Hunt, A., Connor, D. F., & McIlvane, W. J. (2008). Mood and Anxiety symptoms in psychiatric inpatients with autism spectrum disorder and depression. Mental Health research in intellectual disabilities, 4, 258–253.

  • Coe, D. A., Matson, J. L., Russell, D. W., Slifer, K. J., Capone, G. T., Baglio, C., & Stallings, S. (1999). Behavior problems of children with Down syndrome and life events. Journal of Autism and Developmental Disorders, 29, 149–156.

    Article  PubMed  Google Scholar 

  • Croen, L. A., Grether, J. K., & Selvin, S. (2002). Descriptive epidemiology of autism in a California population: Who is at risk? Journal of Autism and Developmental Disorders, 32, 217–224.

    Article  PubMed  Google Scholar 

  • Dinya, E., Csorba, J., Suli, A., & Grosz, Z. (2012). Behaviour profile of Hungarian adolescent outpatients with a dual diagnosis. Research in Developmental Disabilities, 33, 1574–1580.

    Article  PubMed  Google Scholar 

  • Emerson, E., Robertson, J., Gregory, N., Hatton, C., Kessissoglou, S., Hallam, A., & Hillery, J. (2000). Treatment and management of challenging behaviors in residential settings. Journal of Applied Research in Intellectual Disabilities, 13, 197–215.

    Article  Google Scholar 

  • Furnham, A., & Leno, V. C. (2012). Psychiatric literacy and the conduct disorders. Research in Developmental Disabilities, 33, 24–31.

    Article  PubMed  Google Scholar 

  • Ghaziuddin, M., Weidmer-Mikhail, E., & Ghaziuddin, N. (1998). Comorbidity of Asperger syndrome: a preliminary report. Journal of Intellectual Disability Research, 42, 279–283.

    Article  PubMed  Google Scholar 

  • Ghaziuddin, M., Ghaziuddin, N., & Greden, J. F. (2002). Depression in persons with autism: implications for research and clinical care. Journal of Autism and Developmental Disorders, 32, 299–306.

    Article  PubMed  Google Scholar 

  • Giles, A. F., St. Peter, C. C., Pence, S. T., & Gibson, A. B. (2012). Preference for blocking or response redirection during stereotypy treatment. Research in Developmental Disabilities, 33, 1691–1700.

    Article  PubMed  Google Scholar 

  • González, H. M., Tarraf, W., Whitfield, K. E., & Vega, W. A. (2010). The epidemiology of major depression and ethnicity in the United States. Journal of Psychiatric Research, 44, 1043–1051.

    Article  PubMed  Google Scholar 

  • Harris, P. (1993). The nature and extent of aggressive behavior amongst people with learning disabilities (mental handicap) in a single health district. Journal of Intellectual Disability Research, 37, 221–242.

    Article  PubMed  Google Scholar 

  • Heiman, T., & Berger, O. (2008). Parents of children with Asperger syndrome or with learning disabilities: family environment and social support. Research in Developmental Disabilities, 29, 289–300.

    Article  PubMed  Google Scholar 

  • Hermans, H., Jelluma, N., van der Pas, F. H., & Evenhuis, H. M. (2012). Feasibility, reliability, and validity of the Dutch translation of the anxiety, depression, and mood scale in older adults with intellectual disabilities. Research in Developmental Disabilities, 33, 31–323.

    Article  Google Scholar 

  • Hillier, A., Fish, T., Siegel, J., & Beversdorf, D. (2011). Social and vocational skills training reduces self-reported anxiety and depression among young adults on the autism spectrum. Journal Of Developmental and Physical Disabilities, 23, 267–276.

    Article  Google Scholar 

  • Kozlowski, A. M., & Matson, J. L. (2012). An examination of challenging behaviors in autistic disorder versus pervasive developmental disorder not otherwise specified: significant differences and gender effects. Research in Autism Spectrum Disorders, 6, 319–325.

    Article  Google Scholar 

  • Lee, L. C., Harrington, R. A., Chang, J. J., & Connors, S. L. (2008). Increased risk of injury in children with developmental disabilities. Research in Developmental Disabilities, 29, 247–255.

    Article  PubMed  Google Scholar 

  • Lin, J.-D., Chen, Y.-C., & Chou, Y.-C. (2012). Longitudinal analyses of geographic differences in utilization rates of children with developmental delays who participate in early intervention services. Research in Developmental Disabilities, 33, 1757–1762.

    Article  PubMed  Google Scholar 

  • LoVullo, S. V., & Matson, J. L. (2009). Comorbid psychopathology in adults with autism spectrum disorders and intellectual disabilities. Research in Developmental Disabilities, 30, 1288–1296.

    Article  PubMed  Google Scholar 

  • Lucas-Carrasco, R., & Salvador-Carulla, L. (2012). Life satisfaction in persons with intellectual disabilities. Research in Developmental Disabilities, 33, 1103–1109.

    Article  PubMed  Google Scholar 

  • Luiselli, J. K., Blew, P., Keane, J., Thibadeau, S., & Holtzman, T. (2000). Pharmacotherapy for severe aggression in a child with autism: “open label” evaluation of multiple medications on response frequency and intensity of behavioral interventions. Journal of Behavior Therapy and Experimental Psychiatry, 31, 219–230.

    Article  PubMed  Google Scholar 

  • Lunsky, Y., & Paluka, A. M. (2004). Depression and intellectual disability. Current Opinions in Psychiatry, 17, 359–363.

    Article  Google Scholar 

  • Matson, J. L. (1995). The diagnostic assessment for the severely handicapped, revised (DASH-II). Baton Rouge: Disability Consultants, LLC.

    Google Scholar 

  • Matson, J. L., & LoVullo, S. V. (2009). Trends and topics in autism spectrum disorders research. Research in Autism Spectrum Disorders, 3, 252–257.

    Article  Google Scholar 

  • Matson, J. L., & Minshawi, N. F. (2007). Functional assessment of challenging behavior: Toward a strategy for applied settings. Research in Developmental Disabilities, 28, 353–361.

    Google Scholar 

  • Matson, J. L., & Nebel-Schwalm, M. (2007). Comorbid psychopathology with autism spectrum disorder in children: an overview. Research in Developmental Disabilities, 28, 341–352.

    Article  PubMed  Google Scholar 

  • Matson, J. L., & Rivet, T. T. (2008a). Characteristics of challenging behaviors in adults with autistic disorder, PDD-NOS, and intellectual disability. Journal of Intellectual and Developmental Disability, 33, 316–322.

    Article  Google Scholar 

  • Matson, J. L., & Rivet, T. T. (2008b). Reliability and factor structure of the Autism Spectrum Disorders-Behavior Problems for Adults (ASD-BPA) with intellectual disabilities and autism. Journal of Mental Health Research in Intellectual Disabilities, 1, 34–37

  • Matson, J. L., & Wilkins, J. (2007). A critical review of assessment targets and methods for social skills excesses and deficits for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 1, 28–37.

    Article  Google Scholar 

  • Matson, J. L., & Wilkins, J. (2008). Nosology and diagnosis of Asperger’s syndrome. Research in Autism Spectrum Disorders, 2, 288–300.

    Article  Google Scholar 

  • Matson, J. L., Smirolodo, B. B., & Bamburg, J. W. (1998). The relationship of social skills to psychopathology for individuals with severe or profound mental retardation. Journal of Intellectual and Developmental Disability, 23, 137–145.

    Article  Google Scholar 

  • Matson, J. L., Rush, K. S., Hamilton, M., Anderson, S. J., Bamburg, J. W., Baglio, C. S., Williams, D., & Kirkpatrick-Sanchez, S. (1999). Characteristics of depression as assessed by the diagnostic assessment for the severely handicapped (DASH-II). Research in Developmental Disabilities, 20, 305–313.

    Article  PubMed  Google Scholar 

  • Matson, J. L., Wilkins, J., & Gonzalez, M. (2008). Early identification and diagnosis in autism spectrum disorders in young children and infants: How early is too early? Research in Autism Spectrum Disorders, 2, 75–84.

    Article  Google Scholar 

  • Matson, J. L., Dempsey, T., & Fodstad, J. C. (2009a). The effect of autism spectrum disorders on adaptive independent living skills in adults with severe intellectual disability. Research in Developmental Disabilities, 30, 1203–1211.

    Article  PubMed  Google Scholar 

  • Matson, J. L., Wilkins, J., & Macken, J. (2009b). The relationship of challenging behaviors to severity and symptoms of autism spectrum disorders. Journal of Mental Health Research in Intellectual Disabilities, 2, 29–44.

    Article  Google Scholar 

  • Matson, J. L., Tureck, K., & Rieske, R. (2012). The questions about behavior function (QABF): current status as a method of functional assessment. Research in Developmental Disabilities, 33, 630–634.

    Article  PubMed  Google Scholar 

  • Mattila, M., Hurtig, T., Haapsamo, H., Jussila, K., Kuusikko-Gauffin, S., Kielinen, M., & Moilanen, I. (2010). Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: a community and clinic-based study. Journal of Autism and Developmental Disorders, 40, 1080–1093.

    Article  PubMed  Google Scholar 

  • McTiernan, A., Leader, G., Healy, O., & Mannion, A. (2011). Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorder, 5, 1215–1222.

    Article  Google Scholar 

  • Mudford, O. C., Arnold-Saritepe, A. M., Phillips, K. J., Locke, J. M., Ho, I. C. S., & Taylor, S. A. (2008). Challenging behaviors. In J. L. Matson (Ed.), Clinical assessment and intervention for autism spectrum disorders (pp. 267–297). London: Elsevier Inc.

    Chapter  Google Scholar 

  • Murphy, O., Healy, O., & Leader, G. (2009). Risk factors for challenging behaviors among 157 children with autism spectrum disorder in Ireland. Research in Autism Spectrum Disorders, 3, 474–482.

    Article  Google Scholar 

  • O’Brien, G., & Pearson, K. (2004). Autism and learning disability. Autism, 8, 125–140.

    Article  PubMed  Google Scholar 

  • Paclawskyj, T. R., Matson, J. L., Bamburg, J. W., & Baglio, C. S. (1997). A comparison of the diagnostic assessment of the severely handicapped (DASH-II) and the aberrant behavior checklist (ABC). Research in Developmental Disabilities, 18, 289–298.

    Article  PubMed  Google Scholar 

  • Reiss, S., & Rojahn, J. (1993). Joint occurrence of depression and aggression in children and adults with mental retardation. Journal of Intellectual Disability Research, 37, 287–294.

    Article  PubMed  Google Scholar 

  • Rojahn, J., Wilkins, J., Matson, J. L., & Boisjoli, J. (2010). A comparison of adults with intellectual disabilities with and without ASD on parallel measures of challenging behaviour: the behavior problems inventory-01 (BPI-01) and autism spectrum disorders-behavior problems for intellectually disabled adults. Journal of Applied Research In Intellectual Disabilities, 23, 179–185.

    Article  Google Scholar 

  • Rumpf, A. L., Kamp-Becker, K., & Kauschke, C. (2012). Narrative competence and internal state language of children with Asperger Syndrome and ADHD. Research in Developmental Disabilities, 33, 1395–1407.

    Article  PubMed  Google Scholar 

  • Singh, A. N., Matson, J. L., Cooper, C. L., Dixon, D., & Sturmey, P. (2005). The use of risperidone among individuals with mental retardation: clinically supported or not? Research in Developmental Disabilities, 26, 203–218.

    Article  PubMed  Google Scholar 

  • Smith, K. R. M., & Matson, J. L. (2010a). Social skills: differences among adults with intellectual disabilities, co-morbid autism spectrum disorders and epilepsy. Research in Developmental Disabilities, 31, 1366–2172.

    Article  PubMed  Google Scholar 

  • Smith, K. R. M., & Matson, J. L. (2010b). Behavior problems: differences among intellectually disabled adults with co-morbid autism spectrum disorders and epilepsy. Research in Developmental Disabilities, 31, 1062–1069.

    Article  PubMed  Google Scholar 

  • Smith, K. R. M., & Matson, J. L. (2010c). Psychopathology: differences among adults with intellectually disabilities, comorbid autism spectrum disorders, and epilepsy. Research in Developmental Disabilities, 31, 743–749.

    Article  PubMed  Google Scholar 

  • Stewart, M. E., Barnard, L., Parson, J., Hasan, R., & O’Brien, G. (2006). Presentation of depression in autism and Asperger syndrome: a review. Autism, 10, 103–116.

    Article  PubMed  Google Scholar 

  • Sturmey, P., Lott, J. D., Laud, R. B., & Matson, J. L. (2005). Correlates of restraint use in an institutional population: a replication. Journal of Intellectual Disability Research, 49, 501–506.

    Article  PubMed  Google Scholar 

  • Symons, F. J., Sperry, L. A., Dropik, P. L., & Bodfish, J. W. (2005). The early development of stereotypy and self-injury: A review of research methods. Journal of Intellectual and Developmental Disabilities, 49, 144–158.

    Google Scholar 

  • Tsiouris, J. A. (2001). Diagnosis of Depression in people with severe/profound intellectual disability. Journal of Intellectual Disability Research, 45, 115–120

    Google Scholar 

  • Tsiouris, J. A., Mann, R., Patti, P. J., & Sturmey, P. (2003). Challenging behaviours should not be considered as depressive equivalents in individuals with intellectual disability. Journal of Intellectual Disability Research, 47, 14–21.

    Article  PubMed  Google Scholar 

  • Tsiouris, J. A., Kim, S. Y., Brown, W. T., & Cohen, I. L. (2011). Association of aggressive behaviours with psychiatric disorders, age, sex and degree of intellectual disability: a large-scale survey. Journal Of Intellectual Disability Research, 55, 636–649.

    Article  PubMed  Google Scholar 

  • Williams, D. E., & Mcadam, D. (2012). Assessment, behavioral treatment, and prevention of pica: clinical guidelines and recommendations for practice. Research in Developmental Disabilities, 33, 1990–1995.

    Article  Google Scholar 

  • Wong, D. K. P. (2008). Do contact make a difference? The effects of mainstreaming on student attitudes towards people with disabilities. Research in Developmental Disabilities, 29, 70–82.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nicole C. Turygin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Turygin, N.C., Matson, J.L., MacMillan, K. et al. The Relationship Between Challenging Behavior and Symptoms of Depression in Intellectually Disabled Adults with and without Autism Spectrum Disorders. J Dev Phys Disabil 25, 475–484 (2013). https://doi.org/10.1007/s10882-012-9321-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10882-012-9321-1

Keywords

Navigation