The relationship between adverse interpersonal experiences and self-esteem in people with intellectual disabilities: The role of shame, self-compassion and social support.

BACKGROUND: People with intellectual disabilities are reported to have low self-esteem and to experience high rates of adverse interpersonal experiences (AIEs). This study aimed to investigate whether shame and self-compassion mediate the relationship between AIEs and self-esteem for people with intellectual disabilities and whether perceived social support moderates this relationship. METHOD: This study employed a cross-sectional design, involving between-group comparisons. Forty-seven people with intellectual disabilities and 50 people without intellectual disabilities completed self-report questionnaires measuring shame, self-compassion, self-esteem, early AIEs and social support. RESULTS: Shame and self-compassion were found to mediate the relationship between AIEs and self-esteem for people with intellectual disabilities. There was no evidence for a moderating effect of social support and no difference between groups in shame or self-compassion. CONCLUSIONS: The findings suggest shame and self-compassion are important concepts for people with intellectual disabilities. Clinical and research implications are discussed.

People with intellectual disabilities' experiences of psychological therapy: A systematic review and meta-ethnography.

The effectiveness of a range of psychological models adapted for use with people with intellectual disabilities has been well documented. A number of studies have used qualitative methods to examine people with intellectual disabilities' experiences of these adapted interventions. Such research is important for identifying service users' views on the helpful and challenging aspects of psychological interventions to ensure that they meet the needs of people with intellectual disabilities. To consolidate this research, a systematic review using a meta-ethnographic approach was undertaken. A systematic search identified 16 relevant studies. These studies were reviewed, critically appraised and key themes were extracted. Five key concepts were identified: adapting to therapy, the therapeutic environment, group dynamics, the therapeutic relationship and the impact of therapy on life. The need for further consideration of power differentials within the therapeutic relationship and further adaptations to ensure accessibility of therapy for people with intellectual disabilities is discussed.

Compassion-focused therapy for trauma in people with intellectual disabilities: A conceptual review.

Trauma exposure and post-traumatic stress disorder are more prevalent in people with intellectual disabilities (PWID) than in the general population, yet the evidence base for trauma interventions in this population is sparse. Compassion-focused therapy (CFT) may be particularly well-suited to PWID for a number of reasons, including its adaptability to different developmental levels. PWID are more likely to have issues with self-relating (e.g. shame and self-criticism) and attachment than the general population, two issues that are compounded by trauma and which CFT explicitly seeks to address. Furthermore, compassion-focused approaches emphasize cultivating a sense of safeness while empowering people to make behavioural changes; this is particularly pertinent to PWID who have been traumatized and may feel unsafe and disempowered. An overview of CFT and its application to trauma are given, as well as some case studies using CFT with PWID.

People with intellectual disabilities' experiences of primary care health checks, screenings and GP consultations: a systematic review and meta-ethnography.

Primary care health checks, screenings and GP consultations are often the gateway for people with intellectual disabilities to access their physical and mental healthcare. For a population who experience greater levels of health difficulties alongside significant health inequality, improving care quality and access is of major importance. This meta-ethnographic, qualitative review aims to explore people with intellectual disabilities experiences of health checks, screenings and GP visits, while assessing the quality of the current literature and synthesising findings to consider clinical and research recommendations based on third order constructs. A systematic search identified 20 studies that met inclusion criteria. Quality assessment of each paper was conducted. Meta-ethnography methods were used to analyse and synthesis findings. One overarching concept was identified: Include Me, along with seven core concepts; Empowerment and Disempowerment, Communication and Interpersonal Factors, Access and Adaptations and Biased Narratives and Shifting Perspectives. Implications for practice and future direction are discussed.

Exploration of body perception and body dissatisfaction in young adults with intellectual disability.

BACKGROUND: People with intellectual disability (ID) are more likely to be overweight or obese. Research has shown that body dissatisfaction is a key factor in influencing unhealthy eating behaviour. More evidence is needed relating to how people with ID perceive their bodies in order to provide effectively targeted weight management programmes. AIMS: This study aimed to investigate whether people with ID have concepts for underweight, overweight and healthyweight, and whether they can apply these concepts to themselves. It also aimed to explore body perception bias through comparison of perceived self to independent figure ratings, and body dissatisfaction through perceived-ideal body discrepancy measurement and a series of open-ended questions. METHOD: Mixed methodology was used to explore body perception and body dissatisfaction in 40 young adults with ID compared to 48 individuals without ID. The Stunkard Figure Rating Scale assessed how participants would like to look, and their concepts of weight categories. RESULTS: Young adults with ID tend to hold positive beliefs about their bodies. Females with ID were likely to underestimate their body size. Individuals with ID understood what is meant by 'overweight', 'healthy-weight' and 'underweight' although these concepts were different to those without ID. Individuals with ID were unable to accurately apply these body size categories to themselves. CONCLUSION: These findings suggest that individuals with ID will first need support to understand how concepts of body size apply to themselves in order to facilitate weight management.