Developmental trauma in a forensic intellectual disability population

Abstract

Purpose

People with an intellectual disability (ID) are more at risk of experiencing adverse childhood events. Moreover, prolonged exposure to ACEs results in enduring changes and impairments in neurological, physiological and psycho-social systems and functioning. In response, van der Kolk et al. (2009) have put forward the concept of developmental trauma disorder (DTD) to reflect the “constellation of enduring symptoms” and complex care needs of this population. The purpose of this paper is to ascertain the level of exposure to adverse childhood events and the prevalence of DTD in an inpatient forensic ID population.

Design/methodology/approach

A retrospective file review and consensus approach to diagnosis were used in a sample of adults with an ID detained in a secure forensic service.

Findings

Results revealed that 89 admissions (N=123) had been exposed to at least one significant ACE, with 81 being exposed to prolonged ACEs. A total of 58 admissions (47 per cent) met criteria for PTSD and 80 (65 per cent) met the criteria for DTD. Significant gender differences were noted in MHA status, primary psychiatric diagnoses, exposure to ACEs and DTD.

Research limitations/implications

The discussion explores the implications for working with forensic ID populations who report high incidents of childhood trauma and the utility, strengths and weaknesses of the proposed DTD, its relationship to ID diagnoses is explored.

Originality/value

The study outlines the prevalence of DTD and PTSD in ID forensic populations and suggests additional key assessment and treatment needs for this population.

Citation

Morris, D.J., Shergill, S. and Beber, E. (2018), "Developmental trauma in a forensic intellectual disability population", Journal of Intellectual Disabilities and Offending Behaviour, Vol. 11 No. 1, pp. 35-48. https://doi.org/10.1108/JIDOB-06-2019-0011