The PAS-ADD (Psychiatric Assessment Schedule for Adults with a Developmental Disability) checklist is a 25 item questionnaire which uses non technical language and was designed to be used by support staff and families. The thinking was that it was these groups of people who spent the most time with the disabled person and so would have a good idea about how and when their behaviour might change. The checklist is used to see whether there is a need for further assessment of an individual’s mental health, although it can also be used to screen groups or for regular monitoring of people considered at risk of mental ill health.
The researchers in this study used the checklist to help explore the possible relationships between the presence of symptoms of psychiatric disorder and challenging behaviours in people with learning disabilities.
They worked with people in 800 service settings in a single geographical area using the checklist as a screening tool. They were looking for people identified in those services as having challenging behaviour. They collected behavioural data, PAS-ADD checklist information and they also used the Adaptive Behaviour Scale (a measure of personal and social skills for everyday living)
They found that under 17% of participants reached threshold scores on one on more subscales of the PAS-ADD checklist.
In terms of associations they found some evidence that increasing behavioural severity might be associated with increasing psychiatric symptoms.
However, they did not find any evidence of any associations between specific forms of challenging behaviour and individual symptoms.
The authors conclude that their study adds to the existing view from the evidence that
it is unlikely that the majority of challenging behaviours in adults with intellectual disability are underpinned by psychiatric disorder.
Screening for Psychiatric Disorders in a Total Population of Adults with Intellectual Disability and Challenging Behaviour Using the PAS-ADD Checklist, Allen D et al., in Journal of Applied Research in Intellectual Disabilities, 25: 342–349.
There appears to be no distinction in this paper between chronic (longstanding) and acute (recent onset) challenging behaviour. I would expect acute psychiatric disorders to have a higher prevalence in recent onset changes in behaviour, whether challenging or not.
Hi Gavin, thanks for your comments. The study authors state that using the pas-add checklist they found no association between specific forms of challenging behaviour and individual psychiatric symptoms. Given that they screened people in 800 service settings, they would have come across people with recent onset challenging behaviour in their sample, but as you say make no specific distinction in their reporting (in the abstract at least which is what we have reported on) Although of course they will also have found recent onset in people with no psychiatric symptoms. john