TABLE 1.
Summary of included publications
| Author(s) and country | Study sample | Data collection method | Type(s) of aggressive behaviour (instruments) | Psychosocial factor(s) (instruments) | Association | Outcome | Statistical analysis |
|---|---|---|---|---|---|---|---|
|
Alexander et al. (2010), UK Low quality |
n = 138 adults (109M, 29F) with mild intellectual disability and offending behaviours in an inpatient service for offenders | Retrospective chart review | Physically aggressive behaviour (case file: defined as history of aggression, recorded as either present or absent) | Psychiatric diagnosis: personality disorder (ICD‐10 diagnosis derived from case file) | NS | OR = 1.53, CI [0.49; 4.83] | Univariate, odds ratio a |
| Verbally aggressive behaviour (case file: defined as history of aggression, recorded as either present or absent) | Psychiatric diagnosis: personality disorder (ICD‐10 diagnosis derived from case file) | NS | OR = 2.20, CI [0.50; 9.61] | Univariate, odds ratio a | |||
| Destructive behaviour (case file: defined as history of aggression, recorded as either present or absent) | Psychiatric diagnosis: personality disorder (ICD‐10 diagnosis derived from case file) | NS | OR = 1.51, CI [0.52; 4.42] | Univariate, odds ratio a | |||
| Self‐injurious behaviour (case file: defined as history of aggression, recorded as either present or absent) | Psychiatric diagnosis: personality disorder (ICD‐10 diagnosis derived from case file) | NS | OR = 1.47, CI [0.63; 3.41] | Univariate, odds ratio a | |||
| Sexually aggressive behaviour (case file: defined as history of aggression, recorded as either present or absent) | Psychiatric diagnosis: personality disorder (ICD‐10 diagnosis derived from case file) | NS | OR = 1.79, CI [0.91; 3.54] | Univariate, odds ratio a | |||
|
Alexander et al. (2015), UK Low quality |
n = 138 adults (109M, 29F) with mild intellectual disability and offending behaviours in an inpatient service for offenders | Retrospective chart review | Destructive behaviour (case file: defined as history of fire setting or conviction of arson in the case history) | Life events: past experience of any abuse (evidence of child or vulnerable adult protection by Social Services) | + | OR = 2.88, CI [1.21; 6.88] | Univariate, odds ratio a |
| Life events: past experience of sexual abuse (evidence of child or vulnerable adult protection by Social Services) | NS | OR = 1.93, CI [0.85; 4.39] | Univariate, odds ratio a | ||||
| Psychiatric diagnosis: PDD (ICD‐10 diagnosis derived from case file) | NS | OR = 0.50, CI [0.19; 1.34] | Univariate, odds ratio a | ||||
| Psychiatric diagnosis: psychosis (ICD‐10 diagnosis derived from case file) | NS | OR = 1.38, CI [0.52; 3.67] | Univariate, odds ratio a | ||||
| Psychiatric diagnosis: bipolar disorder (ICD‐10 diagnosis derived from case file) | NS | OR = 0.22, CI [0.03; 1.78] | Univariate, odds ratio a | ||||
| Psychiatric diagnosis: depressive disorder (ICD‐10 diagnosis derived from case file) | NS | OR = 1.39, CI [0.49; 3.94] | Univariate, odds ratio a | ||||
| Psychiatric diagnosis: substance dependence (ICD‐10 diagnosis derived from case file) | NS | OR = 1.93, CI [0.82; 4.51] | Univariate, odds ratio a | ||||
| Psychiatric diagnosis: personality disorder (ICD‐10 diagnosis derived from case file) | + | OR = 4.08, CI [1.54; 10.79] | Univariate, odds ratio a | ||||
| Criminal behaviour: history of convictions for violent offences (case file) | + | OR = 3.13, CI [1.36; 7.23] | Univariate, odds ratio a | ||||
| Criminal behaviour: history of convictions for destructive offences (case file) | + | OR = 185.42, CI [10.55; 3,259.22] | Univariate, odds ratio a | ||||
| Criminal behaviour: history of convictions for sex offences (case file) | NS | OR = 0.94, CI [0.34; 2.59] | Univariate, odds ratio a | ||||
| Aggressive behaviour: physical (case file: defined as a history of aggression to people, recorded as either present or absent) | NS | OR = 0.46, CI [0.13; 1.71] | Univariate, odds ratio a | ||||
| Aggressive behaviour: verbal (case file: defined as a history of verbal aggression, recorded as either present or absent) | NS | OR = 1.45, CI [0.16; 12.91] | Univariate, odds ratio a | ||||
| Aggressive behaviour: destructive (case file: defined as a history of aggression against property, recorded as either present or absent) | NS | OR = 0.41, CI [0.12; 1.37] | Univariate, odds ratio a | ||||
| Aggressive behaviour: sexual (case file: defined as a history of sexual aggression, recorded as either present or absent) | NS | OR = 1.90, CI [0.82; 4.38] | Univariate, odds ratio a | ||||
| Aggressive behaviour: self‐injurious (case file: defined as a history of aggression to self, recorded as either present or absent) | NS | OR = 2.39, CI [0.66; 8.60] | Univariate, odds ratio a | ||||
|
Allen et al. (2012), UK Low quality |
n = 707 adults (410M, 297F) with intellectual disability and challenging behaviour (M age = 42, range 18–93), living in different settings | Informant reports by primary carers | Destructive behaviour (Individual Schedule) | Psychiatric symptoms: affective/neurotic, possible organic (PAS‐ADD) | + | ρ = .081 | Univariate, Spearman rank correlation |
| Psychiatric symptoms: possible organic (PAS‐ADD) | + | ρ = .11 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: psychotic disorder (PAS‐ADD) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Self‐injurious behaviour (Individual Schedule) | Psychiatric symptoms: affective/neurotic (PAS‐ADD) | NS | Not reported | Univariate, Spearman rank correlation | |||
| Psychiatric symptoms: possible organic (PAS‐ADD) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: psychotic disorder (PAS‐ADD) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Aggressive behaviour in general (Individual Schedule) | Psychiatric symptoms: affective/neurotic (PAS‐ADD) | + | ρ = .10 | Univariate, Spearman rank correlation | |||
| Psychiatric symptoms: possible organic (PAS‐ADD) | + | ρ = .14 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: psychotic disorder (PAS‐ADD) | NS | Not reported | Univariate, Spearman rank correlation | ||||
|
Bernstein et al. (2015), Hungary High quality |
n = 50 adults (38M, 12F) with moderate, severe, or profound intellectual disability, residing in a developmental habilitation home (M age = 31.38, SD = 7.63, range 19–49) | Informant reports by care staff | Physically aggressive behaviour (CBI) | Psychiatric symptoms: mood (MIPQ‐S) | NS | ρ = .02 | Univariate, Spearman correlation |
| Psychiatric symptoms: interest/pleasure (MIPQ‐S) | NS | ρ = −.11 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: general (BPI‐S) | + | ρ = .78 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (BPI‐S, CBI) | NS |
ρ = .27 (BPI‐S) ρ = .45 (CBI) |
Univariate, Spearman correlation | ||||
| Self‐injurious behaviour (BPI‐S, CBI) | Psychiatric symptoms: mood (MIPQ‐S) | NS |
ρ = −.17 (BPI‐S) ρ = −.12 (CBI) |
Univariate, Spearman correlation | |||
| Psychiatric symptoms: interest/pleasure (MIPQ‐S) | NS |
ρ = −.44 (BPI‐S) ρ = −.23 (CBI) |
Univariate, Spearman correlation | ||||
| Aggressive behaviour: physical (CBI) | NS | ρ = .45 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: general (BPI‐S) | + | ρ = .57 | Univariate, Spearman correlation | ||||
| Aggressive behaviour in general (BPI‐S) | Psychiatric symptoms: mood (MIPQ‐S) | NS | ρ = .13 | Univariate, Spearman correlation | |||
| Psychiatric symptoms: interest/pleasure (MIPQ‐S) | NS | ρ = .01 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: physical (CBI) | + | ρ = .78 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (CBI) | + | ρ = .57 | Univariate, Spearman correlation | ||||
|
Bowring et al. (2017), USA Low quality |
n = 265 adults (134M, 131F) with mild, moderate, severe, or profound intellectual disability who (had) received support from services (M age = 41.44, SD = 16.28) and lived in different settings | Informant reports by family members or care staff | Self‐injurious behaviour (BPI‐S) | Communication skills: non‐verbal b (Individual survey) | − | RR = 4.705, CI [1.953; 11.333] | Univariate, relative risk estimation |
| Communication skills: no clear speech b (Individual survey) | − | RR = 3.681, CI [1.378; 9.834] | Univariate, relative risk estimation | ||||
| Communication skills: limited understanding b (Individual survey) | − | RR = 3.658, CI [1.571; 8.52] | Univariate, relative risk estimation | ||||
| Adaptive behaviour: no daytime engagement b (Individual survey) | − | RR = 3.729, CI [1.48; 9.392] | Univariate, relative risk estimation | ||||
| Living situation: paid care (Individual survey) | + | RR = 3.023, CI [1.131; 8.079] | Univariate, relative risk estimation | ||||
| Living situation: with partner (Individual survey) | NS | RR = 0.301, CI [0.017; 5.202] | Univariate, relative risk estimation | ||||
| Psychiatric diagnosis: ASD (Individual survey) | NS | RR = 1.208, CI [0.454; 3.218] | Univariate, relative risk estimation | ||||
| Psychiatric diagnosis: any (Individual survey) | NS | RR = 2.256, CI [0.976; 5.212] | Univariate, relative risk estimation | ||||
| Aggressive behaviour: general (BPI‐S) | + | ρ = .253 | Univariate, Spearman corerlation | ||||
| Aggressive behaviour in general (BPI‐S) | Aggressive behaviour: self‐injurious (BPI‐S) | + | ρ = .253 | Univariate, Spearman corerlation | |||
| Communication skills: limited understanding b (Individual survey) | − | RR = 3.882, CI [1.761; 8.559] | Univariate, relative risk estimation | ||||
| Communication skills: non‐verbal b (Individual survey) | − | RR = 3.04, CI [1.372; 6.735] | Univariate, relative risk estimation | ||||
| Communication skills: no clear speech b (Individual survey) | NS | RR = 2.147, CI [0.932; 4.945] | Univariate, relative risk estimation | ||||
| Adaptive behaviour: no daytime engagement b (Individual survey) | NS | RR = 1.918, CI [0.86; 4.276] | Univariate, relative risk estimation | ||||
| Living situation: paid care (Individual survey) | NS | RR = 2.159, CI [0.91; 5.124] | Univariate, relative risk estimation | ||||
| Living situation: with partner (Individual survey) | NS | RR = 0.271, CI [0.016; 4.67] | Univariate, relative risk estimation | ||||
| Psychiatric diagnosis: any (Individual survey) | NS | RR = 1.034, CI [0.421; 2.537] | Univariate, relative risk estimation | ||||
| Psychiatric diagnosis: ASD (Individual survey) | + | RR = 3.383, CI [1.544; 7.414] | Univariate, relative risk estimation | ||||
|
Cervantes and Matson (2015), USA High quality |
n = 307 adults (156M, 151F) with severe or profound intellectual disability, residing in developmental centres (M age = 51.44, SD = 12.49, range 20–88) | Informant reports by care staff | Sexually aggressive behaviour (DASH‐II) | Psychiatric diagnosis: ASD (DSM−5, case file) | + | F(1, 303) = 10.87 | Multivariate, ANCOVA |
| Self‐injurious behaviour (DASH‐II) | Psychiatric diagnosis: ASD (DSM‐5, case file) | + | F(1, 303) = 13.73 | Multivariate, ANCOVA | |||
|
Clark et al. (2016), Canada High quality |
n = 215 adults with mild or moderate intellectual disability who (had) received services, living in different settings (M age = 39.90, SD = 11.87, range 18–65). Participants had to be able to understand English or French | Retrospective chart review + informant reports by case managers and persons well known to participants | Aggressive behaviour in general (MOAS) | Life events: victimization history (TESI, informant reports) | + | Path coefficient = 0.99, SE = 0.48, T = 2.05 | Multivariate, bootstrapped simple mediation analysis |
| Psychiatric symptoms: total mental health problems (RSMB) | + | Path coefficient = 0.27, SE = 0.04, T = 6.03 | Multivariate, bootstrapped simple mediation analysis | ||||
| Psychiatric symptoms: psychosis (RSMB) | + | Path coefficient = 0.86, SE = 0.23, T = 3.70 | Multivariate, bootstrapped multiple mediation analysis | ||||
| Psychiatric symptoms: personality disorder (RSMB) | + | Path coefficient = 0.65, SE = 0.23, T = 2.74 | Multivariate, bootstrapped multiple mediation analysis | ||||
| Psychiatric symptoms: depression (RSMB) | NS | Path coefficient = −0.37, SE = 0.27, T = −1.35 | Multivariate, bootstrapped multiple mediation analysis | ||||
| Self‐injurious behaviour (MOAS) | Life events: victimization history (TESI, informant reports) | + | t(213) = −2.05 | Univariate, t test | |||
| Psychiatric symptoms: total mental health problems (RSMB) | + | Not reported | Multivariate, bootstrapped simple mediation analysis | ||||
| Psychiatric symptoms: depression (RSMB) | + | r = .19 | Univariate, Pearson correlation | ||||
| Psychiatric symptoms: psychosis (RSMB) | + | r = .25 | Univariate, Pearson correlation | ||||
| Psychiatric symptoms: personality disorder (RSMB) | + | r = .28 | Univariate, Pearson correlation | ||||
|
Crocker et al. (2006), Canada Low quality |
n = 3,165 adults (1,633M, 1,527F) with mild, moderate, severe, or profound intellectual disability receiving services and living in different settings (M age = 40.63, SD = 13) | Informant reports by case managers and educators | Physically aggressive behaviour (MOAS) | Living situation: family (informant survey) | NS | Not reported | Univariate, χ 2‐test |
| Living situation: family‐type residence (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: group home (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: apartment (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: other (informant survey) | + | Not reported | Univariate, χ 2‐test | ||||
| Criminal behaviour: history of arrest (informant survey: rated as either present or absent) | + | Not reported | Univariate, χ 2‐test | ||||
| Aggressive behaviour: verbal (MOAS) | + | ρ = .53 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: destructive (MOAS) | + | ρ = .59 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS) | + | ρ = .20 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS) | + | ρ = .35 | Univariate, Spearman correlation | ||||
| Verbally aggressive behaviour (MOAS) | Living situation: family (informant survey) | NS | Not reported | Univariate, χ 2‐test | |||
| Living situation: family‐type residence (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: group home (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: apartment (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: other (informant survey) | + | Not reported | Univariate, χ 2‐test | ||||
| Criminal behaviour: history of arrest (informant survey: rated as either present or absent) | + | Not reported | Univariate, χ 2‐test | ||||
| Aggressive behaviour: physical (MOAS) | + | ρ = .53 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: destructive (MOAS) | + | ρ = .54 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS) | + | ρ = .21 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS) | + | ρ = .26 | Univariate, Spearman correlation | ||||
| Destructive behaviour (MOAS) | Living situation: family (informant survey) | NS | Not reported | Univariate, χ 2‐test | |||
| Living situation: family‐type residence (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: group home (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: apartment (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: other (informant survey) | + | Not reported | Univariate, χ 2‐test | ||||
| Criminal behaviour: history of arrest (informant survey: rated as either present or absent) | + | Not reported | Univariate, χ 2‐test | ||||
| Aggressive behaviour: physical (MOAS) | + | ρ = .59 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: verbal (MOAS) | + | ρ = .54 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS) | + | ρ = .19 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS) | + | ρ = .38 | Univariate, Spearman correlation | ||||
| Sexually aggressive behaviour (MOAS) | Living situation: family (informant survey) | NS | Not reported | Univariate, χ 2‐test | |||
| Living situation: family‐type residence (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: group home (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: apartment (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: other (informant survey) | + | Not reported | Univariate, χ 2‐test | ||||
| Criminal behaviour: history of arrest (informant survey: rated as either present or absent) | + | Not reported | Univariate, χ 2‐test | ||||
| Aggressive behaviour: physical (MOAS) | + | ρ = .20 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: verbal (MOAS) | + | ρ = .21 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: destructive (MOAS) | + | ρ = .19 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS) | + | ρ = .13 | Univariate, Spearman correlation | ||||
| Self‐injurious behaviour (MOAS) | Living situation: family (informant survey) | NS | Not reported | Univariate, χ 2‐test | |||
| Living situation: family‐type residence (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: group home (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: apartment (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: other (informant survey) | + | Not reported | Univariate, χ 2‐test | ||||
| Criminal behaviour: history of arrest (informant survey: rated as either present or absent) | NS | Not reported | Univariate, χ 2‐test | ||||
| Aggressive behaviour: physical (MOAS) | + | ρ = .35 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: verbal (MOAS) | + | ρ = .26 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: destructive (MOAS) | + | ρ = .38 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS) | + | ρ = .13 | Univariate, Spearman correlation | ||||
| Aggressive behaviour in general (MOAS) | Living situation: family (informant survey) | NS | Not reported | Univariate, χ 2‐test | |||
| Living situation: family‐type residence (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: group home (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: apartment (informant survey) | NS | Not reported | Univariate, χ 2‐test | ||||
| Living situation: other (informant survey) | + | Not reported | Univariate, χ 2‐test | ||||
| Criminal behaviour: history of arrest (informant survey: rated as either present or absent) | + | t(137.91) = −5.84 | Univariate, t test | ||||
|
Crocker et al. (2014), Canada High quality |
n = 296 adults (162M, 134F) with mild or moderate intellectual disability living in the community and receiving services (M age = 40.67, SD = 12.21, range 18–65). Participants had to be able to understand English or French | Retrospective chart review + self‐reports + informant reports by a case manager and significant others | Physically aggressive behaviour (MOAS) | Psychiatric diagnosis: number of mental disorders (case file) | NS | Incidence rate ratio = 1.450, CI [0.980; 2.146] | Multivariate, logistic regression |
| Psychiatric diagnosis: severity of mental disorders (SF‐36) | NS | Incidence rate ratio = 0.972, CI [0.936; 1.009] | Multivariate, logistic regression | ||||
| Verbally aggressive behaviour (MOAS) | Psychiatric diagnosis: number of mental disorders (case file) | + | Incidence rate ratio = 3.200, CI [1.294; 7.914] | Multivariate, logistic regression | |||
| Psychiatric diagnosis: severity of mental disorders (SF‐36) | + | Incidence rate ratio = 0.937, CI [0.890; 0.986] | Multivariate, logistic regression | ||||
| Destructive behaviour (MOAS) | Psychiatric diagnosis: number of mental disorders (case file) | NS | Incidence rate ratio = 1.258, CI [0.849; 1.863] | Multivariate, logistic regression | |||
| Psychiatric diagnosis: severity of mental disorders (SF‐36) | − | Incidence rate ratio = 0.956, CI [0.920; 0.993] | Multivariate, logistic regression | ||||
| Sexually aggressive behaviour (MOAS) | Psychiatric diagnosis: anxiety disorder (SF‐36, case file) | + | Incidence rate ratio = 3.224, CI [1.311; 7.923] | Multivariate, logistic regression | |||
|
Davies et al. (2015), UK High quality |
n = 96 adults (50M, 46F) with mild or moderate intellectual disability (M age = 39.68, SD = 13.32, range 18–79). Participants had to be able to complete the questionnaires | Self‐reports + informant reports by carers | Aggressive behaviour in general (CCB) | Psychiatric symptoms: alexithymia (self‐report using AQC) | NS | ρ = .133 | Univariate, Spearman correlation |
| Psychiatric symptoms: alexithymia (informant report using OAS) | + | ρ = .298 | Univariate, Spearman correlation | ||||
|
Didden et al. (2009), the Netherlands Low quality |
n = 39 adult inpatients of a specialized treatment unit, with mild intellectual disability (age range 19–51) | Retrospective chart review | Aggressive behaviour in general (ABCL) | Psychiatric symptoms: substance abuse (case file: use of much more than 14 (females) or 21 (males) standard units of alcohol per week, with similar criteria for drug use) | + | z = 2.187 | Univariate, Mann–Whitney analysis |
|
Drieschner et al. (2013), the Netherlands Low quality |
n = 218 adults (188M, 30F) with mild intellectual disability, living in residential treatment centres for adults with intellectual disability who display serious dangerous behaviour (M age = 33.8, SD = 11.5) | Informant reports | Physically aggressive behaviour (MOAS+) | Aggressive behaviour: verbal (MOAS+) | + | ρ = .70 | Univariate, Spearman correlation |
| Aggressive behaviour: destructive (MOAS+) | + | ρ = .73 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS+) | + | ρ = .30 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS+) | + | ρ = .47 | Univariate, Spearman correlation | ||||
| Psychiatric diagnosis: ADHD (DSM‐IV) | + | Incidence rate ratio = 2.53 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: Borderline personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: substance‐related disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: psychotic disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: mood or anxiety disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: PDD (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: paraphilia (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: antisocial personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Criminal behaviour: admission on the basis of criminal law (informant reports) | ‐ | Incidence rate ratio = −1.86 | Univariate, Mann–Whitney U‐test | ||||
| Verbally aggressive behaviour (MOAS+) | Aggressive behaviour: physical (MOAS+) | + | ρ = .70 | Univariate, Spearman correlation | |||
| Aggressive behaviour: destructive (MOAS+) | + | ρ = .80 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS+) | + | ρ = .35 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS+) | + | ρ = .39 | Univariate, Spearman correlation | ||||
| Psychiatric diagnosis: ADHD (DSM‐IV) | + | Incidence rate ratio = 1.88 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: Borderline personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: substance‐related disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: psychotic disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: mood or anxiety disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: PDD (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: paraphilia (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: antisocial personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Criminal behaviour: admission on the basis of criminal law (informant reports) | − | Incidence rate ratio = −1.59 | Univariate, Mann–Whitney U‐test | ||||
| Destructive behaviour (MOAS+) | Aggressive behaviour: physical (MOAS+) | + | ρ = .73 | Univariate, Spearman correlation | |||
| Aggressive behaviour: verbal (MOAS+) | + | ρ = .80 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS+) | + | ρ = .29 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS+) | + | ρ = .50 | Univariate, Spearman correlation | ||||
| Psychiatric diagnosis: ADHD (DSM‐IV) | + | Incidence rate ratio = 2.75 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: Borderline personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: substance‐related disorder (DSM‐IV) | − | Incidence rate ratio = −1.67 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: psychotic disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: mood or anxiety disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: PDD (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: paraphilia (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: antisocial personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Criminal behaviour: admission on the basis of criminal law (informant reports) | − | Incidence rate ratio = −2.06 | Univariate, Mann–Whitney U‐test | ||||
| Sexually aggressive behaviour (MOAS+) | Aggressive behaviour: physical (MOAS+) | + | ρ = .30 | Univariate, Spearman correlation | |||
| Aggressive behaviour: verbal (MOAS+) | + | ρ = .35 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: destructive (MOAS+) | + | ρ = .29 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: self‐injurious (MOAS+) | + | ρ = .24 | Univariate, Spearman correlation | ||||
| Psychiatric diagnosis: ADHD (DSM‐IV) | + | Incidence rate ratio = 3.08 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: Borderline personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: substance‐related disorder (DSM‐IV) | − | Incidence rate ratio = −1.45 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: psychotic disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: mood or anxiety disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: PDD (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: paraphilia (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: antisocial personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Criminal behaviour: admission on the basis of criminal law (informant reports) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Self‐injurious behaviour (MOAS+) | Aggressive behaviour: physical (MOAS+) | + | ρ = .47 | Univariate, Spearman correlation | |||
| Aggressive behaviour: verbal (MOAS+) | + | ρ = .39 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: destructive (MOAS+) | + | ρ = .50 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: sexual (MOAS+) | + | ρ = .24 | Univariate, Spearman correlation | ||||
| Psychiatric diagnosis: ADHD (DSM‐IV) | + | Incidence rate ratio = 5.71 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: borderline personality disorder (DSM‐IV) | + | Incidence rate ratio = 4.29 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: substance‐related disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: psychotic disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: mood or anxiety disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: PDD (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: paraphilia (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: antisocial personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Criminal behaviour: admission on the basis of criminal law (informant reports) | − | Incidence rate ratio = −2.85 | Univariate, Mann–Whitney U‐test | ||||
| Aggressive behaviour in general (MOAS+) | Psychiatric diagnosis: ADHD (DSM‐IV) | + | Incidence rate ratio = 2.28 | Univariate, Mann–Whitney U‐test | |||
| Psychiatric diagnosis: Borderline personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: substance‐related disorder (DSM‐IV) | − | Incidence rate ratio = −1.57 | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: psychotic disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: mood or anxiety disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: PDD (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: paraphilia (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Psychiatric diagnosis: antisocial personality disorder (DSM‐IV) | NS | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Criminal behaviour: admission on the basis of criminal law (informant reports) | − | Incidence rate ratio = −1.70 | Univariate, Mann–Whitney U‐test | ||||
|
Esbensen and Benson (2006), USA High quality |
n = 104 adults (58M, 46F) with mild, moderate, or severe intellectual disability (M age = 42.0, SD = 12.4, range 21–79 years) and living in different settings | Informant reports by care staff | Aggressive behaviour in general (SIB‐R externalized) | Life events: positive life events (LES) | NS | r = .05 | Univariate, Pearson correlation |
| Life events: negative life events (LES) | + | r = .39 | Univariate, Pearson correlation | ||||
| Life events: total life events (LES) | + | r = .24 | Univariate, Pearson correlation | ||||
|
Hartley and MacLean (2007), USA High quality |
n = 132 adults ≥50 years (66M, 66F, M age = 59.22, SD = 7.60), with mild, moderate, severe, or profound intellectual disability receiving services and living in different settings | Informant reports by care staff | Physically aggressive behaviour (ICAP) | Adaptive behaviour: motor skills, social and communication skills, personal living skills, community living skills (ICAP Broad Independence age equivalent) | − | τ = −.32 | Univariate, Kendall Tau C correlation |
| Destructive behaviour (ICAP) | Adaptive behaviour: motor skills, social and communication skills, personal living skills, community living skills (ICAP Broad Independence age equivalent) | − | τ = −.29 | Univariate, Kendall Tau C correlation | |||
|
Hemmings et al. (2006), UK High quality |
n = 214 adults (108M, 106F) with mild/moderate or severe/profound intellectual disability (range 18–85 years), living in a variety of settings | Retrospective chart review + self‐reports | Destructive behaviour (DAS) | Psychiatric symptoms: low energy (PAS‐ADD Checklist) | + | OR = 4.36, CI [1.43; 13.3] | Multivariate, stepwise logistic regression |
| Psychiatric symptoms: delayed sleep (PAS‐ADD Checklist) | + | OR = 3.28, CI [1.1; 9.76] | Multivariate, stepwise logistic regression | ||||
| Psychiatric symptoms: anhedonia, sad or down, fearful/panicky, repetitive actions, too high or happy, suicidal, loss of appetite, weight change, loss of confidence, avoiding social contact, worthlessness, early waking, restlessness, irritable mood, loss of self‐care, odd language (PAS‐ADD Checklist) | NS | Not reported | Multivariate, stepwise logistic regression | ||||
| Social skills: social functioning (DAS) | − | OR = 4.09, CI [1.7; 9.82] | Multivariate, stepwise logistic regression | ||||
| Self‐injurious behaviour (DAS) | Psychiatric symptoms: irritable mood (PAS‐ADD Checklist) | + | OR = 5.52, CI [1.99; 15.3] | Multivariate, stepwise logistic regression | |||
| Psychiatric symptoms: suicidal (PAS‐ADD Checklist) | + | OR = 5.19, CI [1.22; 22.1] | Multivariate, stepwise logistic regression | ||||
| Psychiatric symptoms: low energy, anhedonia, sad or down, fearful/panicky, repetitive actions, too high or happy, loss of appetite, weight change, loss of confidence, avoiding social contact, worthlessness, delayed sleep, early waking, restlessness, loss of self‐care, odd language (PAS‐ADD Checklist) | NS | Not reported | Multivariate, stepwise logistic regression | ||||
| Social skills: social functioning (DAS) | NS | Not reported | Multivariate, stepwise logistic regression | ||||
| Aggressive behaviour in general (DAS) | Psychiatric symptoms: early waking (PAS‐ADD Checklist) | + | OR = 4.04, CI [1.08; 15.1] | Multivariate, stepwise logistic regression | |||
| Psychiatric symptoms: low energy (PAS‐ADD Checklist) | + | OR = 3.72, CI [1.21; 11.4] | Multivariate, stepwise logistic regression | ||||
| Psychiatric symptoms: irritable mood (PAS‐ADD Checklist) | + | OR = 3.0, CI [1.16; 7.8] | Multivariate, stepwise logistic regression | ||||
| Psychiatric symptoms: anhedonia, sad or down, fearful/panicky, repetitive actions, too high or happy, suicidal, loss of appetite, weight change, loss of confidence, avoiding social contact, worthlessness, delayed sleep, restlessness, loss of self‐care, odd language (PAS‐ADD Checklist) | NS | Not reported | Multivariate, stepwise logistic regression | ||||
| Social skills: social functioning (DAS) | NS | Not reported | Multivariate, stepwise logistic regression | ||||
|
Horovitz et al. (2013), USA High quality |
n = 175 adults (94M, 81F) with mild, moderate, severe, or profound intellectual disability residing in developmental centres (M age = 52.18, SD = 13.41, range 20–87 years) | Informant reports by care staff | Self‐injurious behaviour (ASD‐BPA) | Psychiatric diagnosis: ASD (DSM‐IV‐TR and ICD‐10) | + | F(1, 170) = 11.28 | Multivariate, two‐way between‐subjects ANOVA |
| Aggressive behaviour in general (ASD‐BPA) | Psychiatric diagnosis: ASD (DSM‐IV‐TR and ICD‐10) | NS | F(1, 170) = 2.11 | Multivariate, two‐way between‐subjects ANOVA | |||
|
Hurley (2008), USA Low quality |
n = 300 patients with mild, moderate, severe, or profound intellectual disability seen in a specialty clinic of a medical centre | Retrospective chart review | Self‐injurious behaviour (case file: any form of self‐injurious behaviour, excluding suicidality but including skin picking) | Psychiatric diagnosis: depression (DSM‐IV, DSM‐IV‐TR diagnosis derived from case file) | + | OR = 8.53, CI [1.09; 66.75] | Univariate, odds ratio a |
| Aggressive behaviour in general (case file: any physical aggression towards others, objects, or verbal threats of aggression) | Psychiatric diagnosis: depression (DSM‐IV, DSM‐IV‐TR diagnosis derived from case file) | + | OR = 21.02, CI [2.73; 162.09] | Univariate, odds ratio a | |||
|
Koritsas and Iacono (2015), Australia High quality |
n = 74 adults (49M, 25F) with intellectual disability (M age = 36.56, SD = 13.14, range 19–73 years) and living in different settings | Informant reports by care staff + brief observation | Aggressive behaviour in general (Interview Protocol, ICAP, CCB) | Psychiatric symptoms: anxiety (DBC‐A) | + | β = 0.52, SE = 0.06, t = 4.16 | Multivariate, multiple regression |
| Psychiatric symptoms: disruption (DBC‐A) | + | ρ = .28 | Univariate, Spearman correlation | ||||
| Psychiatric symptoms: total (DBC‐A) | + | ρ = .24 | Univariate, Spearman correlation | ||||
| Psychiatric symptoms: depressive (DBC‐A) | NS | β = −0.16, SE = 0.03, t = −1.36 | Multivariate, multiple regression | ||||
| Psychiatric symptoms: self‐absorbed (DBC‐A) | NS | ρ = .19 | Univariate, Spearman correlation | ||||
| Psychiatric symptoms: communication disturbance (DBC‐A) | NS | ρ = .12 | Univariate, Spearman correlation | ||||
| Psychiatric symptoms: social relating (DBC‐A) | NS | ρ = .02 | Univariate, Spearman correlation | ||||
| Communication skills: ability to make needs known (informant report about communication forms and functions, combined with brief observations. Overall judgment of communication skills was determined by a speech pathologist based on these instruments) | NS | ρ = .06 | Univariate, Spearman correlation | ||||
| Living situation: with parents (compared to not living with parents) (questionnaire) | NS | ρ = .14 | Univariate, Spearman correlation | ||||
| Aggressive behaviour: learned function of aggressive behaviour (sensory) (MAS) | NS | β = −0.22, SE = 0.02, t = −1.78 | Multivariate, multiple regression | ||||
| Aggressive behaviour: learned function of aggressive behaviour (escape) (MAS) | NS | β = −0.06, SE = 0.03, t = 0.41 | Multivariate, multiple regression | ||||
| Aggressive behaviour: learned function of aggressive behaviour (attention) (MAS) | NS | β = 0.14, SE = 0.03, t = −0.32 | Multivariate, multiple regression | ||||
| Aggressive behaviour: learned function of aggressive behaviour (tangible) (MAS) | NS | ρ = .18 | Univariate, Spearman correlation | ||||
|
Larson et al. (2011), UK Low quality |
n = 60 adults (31M, 29F) with mild or moderate intellectual disability, that had to be able to read and respond to the questionnaire independently; n = 39 supporting persons |
Informant reports by supporting persons + self‐reports | Aggressive behaviour in general (questionnaire: not specified, challenging behaviour selected from a list of commonly occurring examples of challenging behaviour) | Psychiatric symptoms: attachment style (questionnaire: secure, insecure‐anxious/ambivalent, or insecure‐avoidant) | NS | Not reported | Univariate, χ 2‐test |
| Self‐injurious behaviour (questionnaire: behaviour not specified, challenging behaviour selected from a list of commonly occurring examples of challenging behaviour) | Psychiatric symptoms: attachment style (questionnaire: secure, insecure‐anxious/ambivalent, or insecure‐avoidant) | NS | Not reported | Univariate, χ 2‐test | |||
|
Lindsay et al. (2013), UK Low quality |
n = 477 adults referred to maximum secure services for antisocial or offending behaviour | Retrospective chart review | Physically aggressive behaviour (case file: behaviour leading to referral to maximum secure services | Psychiatric diagnosis: ADHD (case file) | + | OR = 1.76, CI [1.06; 2.93] | Univariate, odds ratio a |
| Verbally aggressive behaviour (case file: behaviour leading to referral to maximum secure services) | Psychiatric diagnosis: ADHD (case file) | NS | OR = 0.85, CI [0.49; 1.46] | Univariate, odds ratio a | |||
| Destructive behaviour (case file: behaviour leading to referral to maximum secure services) | Psychiatric diagnosis: ADHD (case file) | + | OR = 1.77, CI [1.00; 3.14] | Univariate, odds ratio a | |||
| Sexually aggressive behaviour (case file: behaviour leading to referral to maximum secure services) | Psychiatric diagnosis: ADHD (case file) | NS |
Contact sex OR = 0.81, CI [0.38; 1.71] Non‐contact sex OR = 0.72, CI [0.33; 1.58] |
Univariate, odds ratio a | |||
|
Lundqvist (2013), Sweden Low quality |
n = 915 adults (504M, 411F) with mild, moderate, or severe/profound intellectual disability receiving care from local health authorities and living in different settings (M age = 43.4, SD = 14.8, range 18–87 years) | Informant reports by care staff | Self‐injurious behaviour (BPI) | Psychiatric symptoms: autism (questionnaire based on the ICF) | + | OR = 1.70, CI [1.03; 2.80] | Multivariate, backward stepwise likelihood ratio multiple logistic regression |
| Psychiatric symptoms: schizophrenia (questionnaire based on the ICF) | NS | OR = 1.61, CI [0.51; 5.13] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: psychosis (questionnaire based on the ICF) | NS | OR = 0.00, CI not reported | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: depression (questionnaire based on the ICF) | NS | OR = 0.28, CI [0.03; 2.22] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: OCD (questionnaire based on the ICF) | NS | OR = 0.64, CI [0.13; 3.08] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: ADHD (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Psychiatric symptoms: general psychopathology (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating in writing (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with speech (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with signs (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with gestures (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with sounds (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with pictures (questionnaire based on the ICF) | + | OR = 1.93, CI [1.21; 3.09] | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Social skills: group functioning (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Social skills: initiating social interaction (questionnaire based on the ICF, rated on a five‐point scale from never to always) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Aggressive behaviour in general (BPI) | Psychiatric symptoms: autism (questionnaire based on the ICF) | + | OR = 1.78, CI [1.14; 2.77] | Multivariate, backward stepwise likelihood ratio multiple logistic regression | |||
| Psychiatric symptoms: schizophrenia (questionnaire based on the ICF) | NS | OR = 1.92, CI [0.62; 6.01] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: psychosis (questionnaire based on the ICF) | NS | OR = 2.40, CI [0.64; 9.01] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: depression (questionnaire based on the ICF) | NS | OR = 2.40, CI [0.64; 9.01] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: OCD (questionnaire based on the ICF) | NS | OR = 0.96, CI [0.24; 3.85] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: ADHD (questionnaire based on the ICF) | NS | OR = 1.15, CI [0.55; 2.38] | Univariate, binary logistic regression | ||||
| Psychiatric symptoms: general psychopathology (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating in writing (questionnaire based on the ICF) | NS | OR = 1.12, CI [0.79; 1.58] | Univariate, binary logistic regression | ||||
| Communication skills: communicating with speech (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with signs (questionnaire based on the ICF) | + | OR = 2.28, CI [1.49; 3.49] | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with gestures (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with sounds (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Communication skills: communicating with pictures (questionnaire based on the ICF) | NS | Not reported | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Social skills: group functioning (questionnaire based on the ICF) | − | OR = 0.54, CI [0.46; 0.64] | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
| Social skills: initiating social interaction (questionnaire based on the ICF, rated on a five‐point scale from never to always) | + | OR = 1.27, CI [1.10; 1.48] | Multivariate, backward stepwise likelihood ratio multiple logistic regression | ||||
|
Lunsky et al. (2012), Canada Low quality |
n = 747 adults with mild or moderate/severe intellectual disability that have experienced crisis and living in different settings | Retrospective chart review + informant reports by care staff | Physically aggressive behaviour (case file, informant report: written description of what led up to the crisis, the crisis itself and the outcome of the crisis) | Criminal behaviour: history of legal involvement (case file) | NS | b = −0.247, OR = 0.781, CI [0.477; 1.280] | Multivariate, logistic regressions |
| Psychiatric diagnosis: autism (case file) | NS | b = −0.329, OR = 0.720, CI [0.479; 1.081] | Multivariate, logistic regressions | ||||
| Psychiatric diagnosis: substance abuse disorder (case file) | NS | b = −0.714, OR = 0.490, CI [0.124; 1.930] | Multivariate, logistic regressions | ||||
| Living situation: minimal support (compared to group home) (case file) | − | b = −0.617, OR = 0.540, CI [0.337; 0.864] | Multivariate, logistic regressions | ||||
| Living situation: with family (compared to group home) (case file) | NS | b = −0.245, OR = 0.783, CI [0.496; 1.235] | Multivariate, logistic regressions | ||||
| Life events: negative life events (modified PAS‐ADD Checklist) | NS |
One life event b = 0.010, OR = 1.010, CI [0.645; 1.583] Two or more life events b = 0.098, OR = 1.103, CI [0.719; 1.693] |
Multivariate, logistic regressions | ||||
| Destructive behaviour (case file, informant report: written description of what led up to the crisis, the crisis itself and the outcome of the crisis) | Criminal behaviour: history of legal involvement (case file) | + | χ 2(1) = 6.428 | Univariate, χ 2‐test | |||
| Self‐injurious behaviour (case file, informant report: written description of what led up to the crisis, the crisis itself and the outcome of the crisis) | Criminal behaviour: history of legal involvement (case file) | + | χ 2(1) = 5.966 | Univariate, χ 2‐test | |||
|
Matson and Rivet (2008), USA High quality |
n = 298 adults (167M, 131F) with mild, moderate, severe, or profound intellectual disability residing in a developmental centre (M age = 52.03, SD = 12.78, range 21–88 years) | Informant reports by care staff | Self‐injurious behaviour (ASD‐BPA) | Psychiatric symptoms: restricted/repetitive behaviour (ASD‐DA) | + | B = 0.11, SE = 0.03, β = 0.32 | Multivariate, multiple regression |
| Psychiatric symptoms: social impairment (ASD‐DA) | NS | B = 0.02, SE = 0.02, β = 0.10 | Multivariate, multiple regression | ||||
| Psychiatric symptoms: communication impairment (ASD‐DA) | NS | B = −0.03, SE = 0.03, β = −0.09 | Multivariate, multiple regression | ||||
| Aggressive behaviour in general (ASD‐BPA) | Psychiatric symptoms: communication impairment (ASD‐DA) | + | B = −0.13, SE = 0.06, β = −0.21 | Multivariate, multiple regression | |||
| Psychiatric symptoms: social impairment (ASD‐DA) | NS | B = 0.05, SE = 0.03, β = 0.18 | Multivariate, multiple regression | ||||
| Psychiatric symptoms: restricted/repetitive behaviour (ASD‐DA) | NS | B = 0.05, SE = 0.06, β = 0.09 | Multivariate, multiple regression | ||||
|
Matson et al. (2009), USA High quality |
n = 257 adults (139M, 118F) with severe or profound intellectual disability, living in a developmental centre (M age = 49.78, SD = 11.83, range 20–81 years) | Informant reports by care staff | Self‐injurious behaviour (ASD‐BPA) | Social skills: general positive social skills (MESSIER) | − | B = −0.01, SE = 0.00, β = −0.54 | Multivariate, multiple regression |
| Social skills: general negative social skills (MESSIER) | NS | B = 0.01, SE = 0.01, β = 0.20 | Multivariate, multiple regression | ||||
| Aggressive behaviour in general (ASD‐BPA) | Social skills: general positive social skills (MESSIER) | − |
B = −0.04, SE = 0.01, β = −0.62 |
Multivariate, multiple regression | |||
| Social skills: general negative social skills (MESSIER) | + |
B = 0.11, SE = 0.03, β = 0.61 |
Multivariate, multiple regression | ||||
|
Nøttestad and Linaker (2002), Norway Low quality |
n = 22 adults with mild, moderate, severe, or profound intellectual disability, displaying physically aggressive behaviour (M = 37, range 22–75) n = 41 controls with intellectual disability (M age = 44, range 22–75 years) and living in different settings |
Informant reports by caretakers | Physically aggressive behaviour (caretaker reports: participant attacked people in the previous year) | Aggressive behaviour: destructive (caretaker reports: attacks on objects/property in the previous year) | + | Not reported | Univariate, Mann–Whitney U‐test |
| Aggressive behaviour: self‐injurious (caretaker reports: behaviour not specified) | + | Not reported | Univariate, Mann–Whitney U‐test | ||||
| Destructive behaviour (caretaker reports: attacks on property in the previous year) | Aggressive behaviour: physical (caretaker reports) | + | Not reported | Univariate, Mann–Whitney U‐test | |||
| Self‐injurious behaviour (caretaker reports: behaviour not specified) | Aggressive behaviour: physical (caretaker reports: attacks on people in the previous year) | + | Not reported | Univariate, Mann–Whitney U‐test | |||
|
Novaco and Taylor (2004), UK High quality |
129 male adults with intellectual disability residing in a forensic service (M age = 33.2, SD = 11.6) | Self‐reports + retrospective case review + informant ratings by staff | Physically aggressive behaviour (case file: defined as an act that resulted in or could potentially have resulted in physical injury, displayed since admission) | Personality type: psychoticism (EPQ‐R Short Scale) | NS | B = 0.0121, SE = 0.019, β = 0.064, t = 0.63 | Multivariate, hierarchical regression |
| Personality type: neuroticism (EPQ‐R Short Scale) | NS | B = 0.0114, SE = 0.008, β = 0.132, t = 1.35 | Multivariate, hierarchical regression | ||||
| Personality type: lie (EPQ‐R Short Scale) | NS | B = −0.0122, SE = 0.010, β = −0.125, t = 1.28 | Multivariate, hierarchical regression | ||||
| Personality type: extraversion (EPQ‐R Short Scale) | + | B = 0.0245, SE = 0.010, β = 0.237, t = 2.55 | Multivariate, hierarchical regression | ||||
| Self‐reported anger (NAS, PI, STAXI State Anger) | + |
NAS B = 0.0078, SE = 003, β = 0.381, t = 3.08 |
Multivariate, hierarchical regression | ||||
| NS |
PI B = −0.0018, SE = 0.002, β = −0.085, t = 0.74 |
Multivariate, hierarchical regression | |||||
| NS |
STAXI B = −0.0129, SE = 0.008, β = −0.150, t = 1.55 |
Multivariate, hierarchical regression | |||||
|
Owen et al. (2004), UK Low quality |
n = 93 adults (61M, 32F) with intellectual disability living in a long‐stay residential hospital (M age = 55.2, SD = 12.7, range 24–93 years) | Informant reports by care staff | Self‐injurious behaviour (BPI) | Life events: negative life events (LEL) | NS | r(93) = .09 | Univariate, Pearson correlation |
| Aggressive behaviour in general (BPI) | Life events: negative life events (LEL) | + | r(88) = .27 | Multivariate, Pearson partial correlation | |||
|
Phillips and Rose (2010), UK Low quality |
n = 20 adults (15M, 5F) with mild intellectual disability and challenging behaviour experiencing placement breakdown (M age = 47.9, range 25.3–65.7 years) n = 23 adults (17M, 6F) with mild intellectual disability and challenging behaviour, that did not experience placement breakdown (M age = 43.2, range 22.7–79.2 years). All participants were living in residential facilities |
Informant reports by care staff | Physically aggressive behaviour (DAS‐B) | Life events: moves between community services (informant reports) | NS | OR = 1.19, CI [0.23; 6.11] | Univariate, odds ratio a |
|
Rojahn et al. (2004), USA Low quality |
n = 180 adults (97M, 83F) with mild, moderate, severe, or profound intellectual disability residing at a developmental centre (M age = 50.6, SD = 14.5, range 20–91 years) | Informant reports by care staff | Self‐injurious behaviour (BPI) | Aggressive behaviour: general (BPI) | + | ρ = .25 | Univariate, Spearman rank correlation |
| Psychiatric symptoms: mania (DASH‐II) | + | ρ = .18 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: PDD/autism (DASH‐II) | + | ρ = .19 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: stereotypies/tics (DASH‐II) | + | ρ = .19 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: organic syndromes (DASH‐II) | + | ρ = .24 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: impulse control (DASH‐II) | + | ρ = .17 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: self‐injurious behaviour (DASH‐II) | + | ρ = .27 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: eating disorder (DASH‐II) | + | ρ = .15 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: sexual disorder (DASH‐II) | + | ρ = .18 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: total (DASH‐II) | + | ρ = .27 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: anxiety (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: schizophrenia (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: elimination disorder (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: sleep disorder (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Aggressive behaviour in general (BPI) | Aggressive behaviour: self‐injurious (BPI) | + | ρ = .25 | Univariate, Spearman rank correlation | |||
| Psychiatric symptoms: total (DASH‐II) | + | ρ = .25 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: depression (DASH‐II) | + | ρ = .16 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: mania (DASH‐II) | + | ρ = .20 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: impulse control (DASH‐II) | + | ρ = .33 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: self‐injurious behaviour (DASH‐II) | + | ρ = .25 | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: anxiety (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: PDD/autism(DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: schizophrenia (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: stereotypies/tics (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: organic syndromes (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: elimination disorder (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: eating disorder (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: sleep disorder (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
| Psychiatric symptoms: sexual disorder (DASH‐II) | NS | Not reported | Univariate, Spearman rank correlation | ||||
|
Rojahn et al. (2010), USA Low quality |
n = 57 adults (38M, 19F) with mild, moderate, severe, or profound intellectual disability residing at a developmental centre (M age = 50.98, SD = 11.55, range 23–81) | Informant reports by care staff | Self‐injurious behaviour (BPI‐01) | Psychiatric symptoms: ASD (ASD‐DA) | + | F(1, 55) = 6.32, η 2 = .10 | Multivariate, ANOVA |
| Self‐injurious behaviour (ASD‐BPA) | NS | Not reported | Multivariate, MANOVA | ||||
| Aggressive behaviour in general (BPI‐01, ASD‐BPA) | Psychiatric symptoms: ASD (ASD‐DA) | NS | F(1, 55) = 0.34, η 2 = .06 | Multivariate, ANOVA | |||
|
Ross and Oliver (2002), UK Low quality |
n = 24 adults (15M, 9F) with severe or profound intellectual disability (M age = 39.96, SD = 10.88) | Informant reports by care staff | Physically aggressive behaviour (CBI) | Psychiatric symptoms: mood, interest, pleasure (MIPQ) | NS | Not reported | Univariate, Fisher's Exact test |
| Verbally aggressive behaviour (CBI) | Psychiatric symptoms: mood, interest, pleasure (MIPQ) | NS | Not reported | Univariate, Fisher's Exact test | |||
| Destructive behaviour (CBI) | Psychiatric symptoms: mood, interest, pleasure (MIPQ) | NS | Not reported | Univariate, Fisher's Exact test | |||
| Self‐injurious behaviour (CBI) | Psychiatric symptoms: mood, interest, pleasure (MIPQ) | NS | Not reported | Univariate, χ 2‐test | |||
|
Sappok et al. (2014), Germany High quality |
n = 203 adult patients of a psychiatric department (139M, 64F), with mild, moderate, or severe/profound intellectual disability (M age = 35.8, SD = 12.6) and living in different settings | Retrospective chart review | Physically aggressive behaviour (MOAS) | Social skills: emotional development (SAED) | NS | Not reported | Univariate, Pearson correlation |
| Psychiatric diagnosis: schizophrenia, mood disorders, neurotic disorders, personality disorders, ASD (ICD‐10 diagnosis as derived from case file) | NS | Not reported | Univariate, Pearson correlation | ||||
| Psychiatric diagnosis: dependency disorder (ICD‐10 diagnosis as derived from case file) | NS | r = .19 | Univariate, Pearson correlation | ||||
| Verbally aggressive behaviour (MOAS) | Social skills: emotional development (SAED) | + | β = 0.26, CI [0.10; 0.43] | Multivariate, regression analysis | |||
| Psychiatric diagnosis: schizophrenia (ICD‐10 diagnosis as derived from case file) | NS | r = −.19 | Univariate, Pearson correlation | ||||
| Psychiatric diagnosis: mood disorders (ICD‐10 diagnosis as derived from case file) | NS | r = .17 | Univariate, Pearson correlation | ||||
| Psychiatric diagnosis: neurotic disorders, ASD, dependency disorders (ICD‐10 diagnosis as derived from case file) | NS | Not reported | Univariate, Pearson correlation | ||||
| Psychiatric diagnosis: personality disorder (ICD‐10 diagnosis as derived from case file) | + | β = 1.05, CI [0.34; 1.76] | Multivariate, regression analysis | ||||
| Destructive behaviour (MOAS) | Social skills: emotional development (SAED) | NS | Not reported | Univariate, Pearson correlation | |||
| Psychiatric diagnosis: schizophrenia, mood disorders, neurotic disorders, personality disorders, ASD, dependency disorders (ICD‐10 diagnosis as derived from case file) | NS | Not reported | Univariate, Pearson correlation | ||||
| Self‐injurious behaviour (MOAS) | Social skills: emotional development (SAED) | − | β = −0.38, CI [−0.53; −0.23] | Multivariate, regression analysis | |||
| Psychiatric diagnosis: schizophrenia, mood disorders, neurotic disorders, personality disorders (ICD‐10 diagnosis as derived from case file) | NS | Not reported | Univariate, Pearson correlation | ||||
| Psychiatric diagnosis: dependency disorders (ICD‐10 diagnosis as derived from case file) | NS | r = .15 | Univariate, Pearson correlation | ||||
| Psychiatric diagnosis: ASD (ICD‐10 diagnosis as derived from case file) | + | β = 0.49, CI [0.17; 0.80] | Multivariate, regression analysis | ||||
| Aggressive behaviour in general (MOAS) | Social skills: emotional development (SAED) | NS | Not reported | Univariate, Pearson correlation | |||
| Psychiatric diagnosis: schizophrenia, mood disorders, neurotic disorders, personality disorders, ASD, dependency disorders (ICD‐10 diagnosis as derived from case file) | NS | Not reported | Univariate, Pearson correlation | ||||
|
Tenneij et al. (2009), the Netherlands High quality |
n = 108 adults (82M, 26F) with mild intellectual disability residing in inpatient treatment facilities for individuals with severe behavioural and emotional problems (M age = 26.4, SD = 7.5) | Informant reports by care staff | Aggressive behaviour in general (SOAS‐R) | Aggressive behaviour: self‐injurious (SOAS‐R) | + | OR = 6.2, CI [1; 38.9] | Multivariate, stepwise regression analysis |
| Self‐injurious behaviour (SOAS‐R) | Aggressive behaviour: general (SOAS‐R) | + | OR = 6.2, CI [1; 38.9] | Multivariate, stepwise regression analysis | |||
|
Thorson et al. (2008), USA Low quality |
n = 58 adults (19M, 39F) older than 21 years, with mild, moderate, severe, or profound intellectual disability residing in developmental centres | Informant reports by care staff | Self‐injurious behaviour (BPI) | Psychiatric diagnosis: any axis I disorder (DSM‐IV‐TR, DASH‐II) | NS | Not reported | Multivariate, MANOVA post hoc pairwise comparisons |
| Psychiatric diagnosis: schizophrenia (DSM‐IV‐TR, DASH‐II) | NS | Not reported | Multivariate, MANOVA post hoc pairwise comparisons | ||||
| Aggressive behaviour in general (BPI) | Psychiatric diagnosis: any axis I disorder (DSM‐IV‐TR, DASH‐II) | NS | Not reported | Multivariate, MANOVA post hoc pairwise comparisons | |||
| Psychiatric diagnosis: schizophrenia (DSM‐IV‐TR, DASH‐II) | NS | Not reported | Multivariate, MANOVA post hoc pairwise comparisons | ||||
|
Totsika et al. (2008), UK Low quality |
n = 58 adults (36M, 22F) with moderate or severe intellectual disability, living in a long‐term residential facility (M age = 45.26, SD = 12, range 23–83 years) | Informant reports by care staff | Physically aggressive behaviour (Individual Schedule) | Psychiatric diagnosis: any (Individual Schedule) | NS | OR = 2.57, CI [0.57; 11.69] | Univariate, odds ratio a |
| Self‐injurious behaviour (Individual Schedule) | Psychiatric diagnosis: any (Individual Schedule) | NS | OR = 0.42, CI [0.12; 1.38] | Univariate, odds ratio a | |||
|
Tsiouris et al. (2011), USA High quality |
n = 4,069 adults (2,445M, 1,624F) with mild, moderate, severe, or profound intellectual disability living in the community and receiving services (M age = 49.6, SD = 14.0) | Retrospective chart review + informant reports by care staff | Physically aggressive behaviour (IBR‐MOAS) | Psychiatric diagnosis: autism (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.285 | Multivariate, incidence rate ratio a |
| Psychiatric diagnosis: anxiety (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.121 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: bipolar (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.560 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: psychosis (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.477 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: impulse control disorder (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.752 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: personality (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.271 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: OCD (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | NS | Incidence rate ratio = 1.132 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: depression (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | NS | Incidence rate ratio = 1.093 | Multivariate, incidence rate ratio a | ||||
| Verbally aggressive behaviour (against self and against others) (IBR‐MOAS) | Psychiatric diagnosis: depression (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + |
Against self Incidence rate ratio = 1.271 Against others Incidence rate ratio = 1.154 |
Multivariate, incidence rate ratio a | |||
| Psychiatric diagnosis: bipolar (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + |
Against self Incidence rate ratio = 1.292 Against others Incidence rate ratio = 1.402 |
Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: psychosis (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + |
Against self Incidence rate ratio = 1.388 Against others Incidence rate ratio = 1.322 |
Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: impulse control disorder (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + |
Against self Incidence rate ratio 1.401 Against others Incidence rate ratio = 1.560 |
Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: personality (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + |
Against self Incidence rate ratio = 1.422 Against others Incidence rate ratio = 1.257 |
Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: anxiety (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + |
Against self Incidence rate ratio = 1.208 |
Multivariate, incidence rate ratio a | ||||
| NS |
Against others Incidence rate ratio = 1.083 |
Multivariate, incidence rate ratio a | |||||
| Psychiatric diagnosis: autism (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | NS |
Against self Incidence rate ratio = 1.014 Against others Incidence ratio = 0.925 |
Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: OCD (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | NS |
Against self Incidence rate ratio = 1.099 Against others Incidence rate ratio = 1.055 |
Multivariate, incidence rate ratio a | ||||
| Destructive behaviour (IBR‐MOAS) | Psychiatric diagnosis: autism (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.257 | Multivariate, incidence rate ratio a | |||
| Psychiatric diagnosis: anxiety (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.200 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: OCD (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.232 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: bipolar (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.517 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: psychosis (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.294 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: impulse control disorder (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.839 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: personality (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.300 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: depression (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | NS | Incidence rate ratio = 1.051 | Multivariate, incidence rate ratio a | ||||
| Self‐injurious behaviour (IBR‐MOAS) | Psychiatric diagnosis: ASD (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.383 | Multivariate, incidence rate ratio a | |||
| Psychiatric diagnosis: anxiety (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.343 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: bipolar (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.495 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: psychosis (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.176 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: impulse control disorder (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.664 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: personality (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | + | Incidence rate ratio = 1.598 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: depression (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | NS | Incidence rate ratio = 1.126 | Multivariate, incidence rate ratio a | ||||
| Psychiatric diagnosis: OCD (DSM‐IV or DSM‐IV‐TR diagnosis derived from case file) | NS | Incidence rate ratio = 1.190 | Multivariate, incidence rate ratio a | ||||
|
Turygin et al. (2013), USA Low quality |
n = 332 adults (180M, 152F) with mild, moderate, severe, or profound intellectual disability residing in a developmental centre | Informant reports by | Self‐injurious behaviour (ASD‐BPA) | Psychiatric symptoms: depression (DASH‐II depression subscale) | + |
r = .15, CI [−0.01; 0.30] |
Univariate, Pearson correlation |
| Aggressive behaviour in general (ASD‐BPA) | Psychiatric symptoms: depression (DASH‐II depression subscale) | + | r = .40, CI [.26; 0.52] | Univariate, Pearson correlation | |||
|
Tyrer et al. (2006), UK Low quality |
n = 3,062 adults (1,745M, 1,317F) with mild, moderate, severe or profound intellectual disability living in Leicester (range 19–92 years) and living in different settings | Retrospective case review | Physically aggressive behaviour (case file: defined as physically aggressive behaviour towards others that occurred within the last 12 months and that was rated by a carer as either frequent or severe, or both frequent and severe) | Living situation: residential home (compared to independent living) (case file) | + | OR = 2.79, CI [1.55; 5.02] | Multivariate, logistic regression |
| Living situation: NHS accommodation (compared to independent living) (case file) | + | OR = 4.90, CI [2.52; 9.52] | Multivariate, logistic regression | ||||
| Living situation: living with relatives (compared to independent living) (case file) | + | OR = 1.11, CI [0.61; 2.01] | Multivariate, logistic regression | ||||
| Living situation: other (compared to independent living) (case file) | + | OR = 1.22, CI [0.24; 6.08] | Multivariate, logistic regression | ||||
| Psychiatric diagnosis: ASD (case file) | NS | OR = 1.32, CI [0.74; 2.35] | Multivariate, logistic regression | ||||
| Psychiatric symptoms: frustration (case file: carers were asked whether the symptom had been present recently) | + |
Minor OR = 0.90–1.79 Major OR = 2.15–4.44 |
Multivariate, logistic regression | ||||
| Psychiatric symptoms: mood swings (case file: carers were asked whether the symptom had been present recently) | + |
Minor OR = 1.34–2.73 Major OR = 6.43–13.40 |
Multivariate, logistic regression | ||||
| Psychiatric symptoms: unhappiness/upset/crying (case file: carers were asked whether the symptom had been present recently) | NS |
Minor OR = 0.85–1.60 Major OR = 0.94–2.19 |
Multivariate, logistic regression | ||||
| Psychiatric symptoms: withdrawal (case file: carers were asked whether the symptom had been present recently) | NS |
Minor OR = 0.82–1.54 Major OR = 0.60–1.50 |
Multivariate, logistic regression | ||||
| Psychiatric symptoms: anxiousness/phobias/irrational fears (case file: carers were asked whether the symptom had been present recently) | NS |
Minor OR = 0.72–1.38 Major OR = 0.85–1.72 |
Multivariate, logistic regression | ||||
| Psychiatric symptoms: feeling things always set against them (case file: carers were asked whether the symptom had been present recently) | NS |
Minor OR = 0.67–1.46 Major OR = 0.56–1.46 |
Multivariate, logistic regression | ||||
| Psychiatric symptoms: lethargy (case file: carers were asked whether the symptom had been present recently) | NS |
Minor OR = 0.64–1.23 Major OR = 0.63–1.48 |
Multivariate, logistic regression |
Abbreviations: ABC, Aberrant Behaviour Checklist; ABCL, Adult Behaviour Checklist; AQC, Attachment Questionnaire for Children; ASD‐BPA, Autism Spectrum Disorder‐Behaviour Problems for Adults; ASD‐DA, Autism Spectrum Disorder‐Diagnosis for intellectually disabled adults; BPI, Behaviour Problems Inventory; BPI‐S, Behaviour Problems Inventory Short Form; CBI, Challenging Behaviour Interview; CCB, Checklist of Challenging Behaviour; DAS, Disability Assessment Schedule; DAS‐B, Disability Assessment Schedule for behaviour problems; DASH‐II, Diagnostic Assessment of the Severely Handicapped‐II; DBC‐A, Developmental Behaviour Checklist for Adults; DSM, Diagnostic and Statistical Manual of Mental Disorders; EPQ‐R, Eysenck Personality Questionnaire‐Revised; IBR‐MOAS, Institute for Basic Research‐Modified Overt Aggression Scale; ICAP, Inventory for Client and Agency Planning; ICD, International Classification of Diseases and Related Health Problems; LEL, Life Events List; LES, Life Event Scale; MESSIER, Matson Evaluation of Social skills in Individuals with Severe Retardation; MIPQ, Mood, Interest and Pleasure Questionnaire; MIPQ‐S, Mood, Interest and Pleasure Questionnaire‐Short Form; MOAS(+), Modified Over Aggression Scale; NAS, Novaco Anger Scale; OAS, Observer Alexithymia Scale; PAS‐ADD, Psychiatric Assessment Schedule for Adults with Developmental Disabilities; PI, Provocation Inventory; PIMRA, Psychopathology Instrument for Mentally Retarded Adults; RSMB, Reiss Screen for Maladaptive Behaviour; SF‐36, Short Form Health Survey; SIB‐R, Scales of Independent Behaviour‐Revised; SOAS‐R, Staff Observation Aggression Scale‐Revised; STAXI, Spielberger State‐Trait Anger Expression Inventory; TESI, Traumatic Events Screening Inventory; WARS, Ward Anger Rating Scale.
a
Odds ratio or incidence rate ratio calculated based on information reported in the study.
b
For the purpose of correctly interpreting results, the direction of this association was changed.