Physicians' Attitudes about Individuals with Intellectual Disability and Health Care Practices Toward Them: A Systematic Review.

BACKGROUND: Attitudes of physicians toward intellectual disability (ID) impact access and quality of the health care services provided to individuals with ID. Attitudes are conceptualized as composed of cognitive, affective, and behavioral dimensions. However, research on attitudes toward ID frequently neglects to define the underlying theoretical framework. This work aimed to review research over the past 20 years on physicians' attitudes toward and health care practices for individuals with ID. Findings are reported on the cognitive, affective, and behavioral dimensions of attitudes. METHODS: A systematic review was conducted following the PRISMA guidelines. Articles published in English between 2000 and October 2021 were searched in Scopus and Web of Science. Descriptive statistics and frequencies were used to describe the attitudes of physicians. RESULTS: A total of 14 studies were included in the review. Considering the cognitive dimension of attitudes, physicians had a medium to good but almost always incomplete knowledge of ID and its associated conditions, rights and capabilities of individuals with ID, and health care practices for this population. Concerning the affective dimension, approximately half of physicians expressed feelings of pity, unsatisfaction, frustration, discomfort, and lack of confidence. With respect to the behavioral dimension of attitudes, approximately half of physicians preferred to avoid patients with ID. CONCLUSIONS: Physicians' attitudes are rather complex. From this work emerges a clear need to change these generally unfavorable attitudes, especially in the aspects regarding emotions and behaviors, to provide better health care to individuals with ID. Educational and training programs on ID for physicians should be developed to improve attitudes toward ID and consequently foster the wellbeing of this population.

PsycAssist: A Web-Based Artificial Intelligence System Designed for Adaptive Neuropsychological Assessment and Training.

Assessing executive functions in individuals with disorders or clinical conditions can be challenging, as they may lack the abilities needed for conventional test formats. The use of more personalized test versions, such as adaptive assessments, might be helpful in evaluating individuals with specific needs. This paper introduces PsycAssist, a web-based artificial intelligence system designed for neuropsychological adaptive assessment and training. PsycAssist is a highly flexible and scalable system based on procedural knowledge space theory and may be used potentially with many types of tests. We present the architecture and adaptive assessment engine of PsycAssist and the two currently available tests: Adap-ToL, an adaptive version of the Tower of London-like test to assess planning skills, and MatriKS, a Raven-like test to evaluate fluid intelligence. Finally, we describe the results of an investigation of the usability of Adap-ToL and MatriKS: the evaluators perceived these tools as appropriate and well-suited for their intended purposes, and the test-takers perceived the assessment as a positive experience. To sum up, PsycAssist represents an innovative and promising tool to tailor evaluation and training to the specific characteristics of the individual, useful for clinical practice.

The Effects of the COVID-19-induced Lockdown on the Social Capital and Cultural Capital in Italy.

The present study investigated the effects of the first COVID-19 lockdown on the Cultural and Social Capitals in Italy in a large group of adults (n = 1125). The relationships between the COVID-19 spread and participants' Cultural Capital, Social Capital, educational level, occupational prestige, and age were studied using structural equation models. For women but not for men, pandemic spread was positively affected by occupational prestige and it had a positive relationship with their Social Capital (women: CFI = 0.949; RMSEA = 0.059 [CI = 0.045-0.075]; men: CFI = 0.959; RMSEA = 0.064 [CI = 0.039-0.087]). Moreover, the participants were divided into three validated clusters based on their Cultural and Social Capitals levels to investigate changes in the Capitals compared with the pre-lockdown period. It was found that the lockdown contributed to improving the gap among individuals increasing high levels and decreasing low levels of both the Capitals. People with high Cultural and Social Capitals seemed to have seized the opportunity given by COVID-19 restrictions to cultivate their cultural interests and become more involved within their networks. In contrast, individuals with low Cultural and Social Capitals paid the highest price for the social isolation. Given that the Capitals encourage healthy behavior and influence well-being and mental health, institutions should develop or improve their policies and practices to foster individual resources, and make fairer opportunities available during the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s11205-023-03140-7.

Italian Diagnostic Adaptive Behavior Scale: Reliability and diagnostic accuracy compared with the Vineland-II.

BACKGROUND: The Diagnostic Adaptive Behavior Scale (DABS) is a short scale with excellent properties to assess the conceptual, social, and practical adaptive behavior domains for the diagnosis of intellectual disability (ID) in individuals aged 4-21 years. AIMS: Investigate the test-retest and inter-respondent reliability of the Italian adaptation of the DABS, verify its diagnostic accuracy in identifying individuals with ID and excluding individuals with typical development (TD), and compare its psychometric properties to those of the Vineland-II. METHODS: Test-retest reliability: The same respondent completed the Italian DABS for the same assessed person at two separate times (n = 71). Inter-respondent reliability: Two respondents for the same assessed person completed the Italian DABS independently (n = 57). Diagnostic accuracy: The same respondent completed the Italian DABS and Vineland-II for the same assessed person (n = 378; 50 % ID, 50 % TD). RESULTS: Italian DABS test-retest and inter-respondent correlation coefficients were excellent. Italian DABS sensitivity was 86 % and specificity was 99 %, Italian DABS Areas Under the ROC Curves were excellent (or good, practical skill domain), and comparable to the results reported for the Vineland-II. CONCLUSIONS: The Italian DABS is an excellent measure to evaluate the adaptive behavior for ID diagnosis; it is comparable to the Vineland-II but being shorter, the Italian DABS requires less time to administer.

Psychometric properties of the short UPPS-P scale in adolescents: Gender, age invariance, and validity among italian youth.

Impulsivity is a multifaceted construct associated with poor planning skills, difficulty in maintaining attention, and behavioral disinhibition-especially in conditions of highly activated affective states. Impulsivity plays a prominent role in adolescents, in whom high levels of impulsivity expose them to a greater risk of exhibiting risky behaviors or developing pathological conditions. Currently, one of the most popular frameworks to explain and assess impulsivity is the UPPS-P, which distinguishes between five impulsivity components, and from which the UPPS-P Scale and its short form are derived. In light of the relatively low number of psychometric analyses of the scale in adolescents, this study aimed to verify the psychometric properties of the Short UPPS-P Scale among Italian adolescents. The participants were 647 adolescents (68% males, mean age = 16.9, SD = 1.1 years). Confirmatory factor analysis supported the five-factor model of the scale, which was found to be invariant across gender and age and to have had good internal consistency values. Gender and age differences were also investigated. Evidence for validity was provided by supporting relationships between specific UPPS dimensions, gambling frequency, problem gambling, and problematic use of social networks. Overall, the findings showed that the Short UPPS-P Scale is a promising instrument to assess the multidimensional construct of impulsivity in adolescents in both research and clinical practice.

Behavioral and emotional problems of toddlers with autism spectrum disorder: Effects of parents' sociocultural level and individual factors.

BACKGROUND: Toddlers with autism spectrum disorder (ASD) show higher prevalence and severity of Behavioral and Emotional Problems (BEP) than their peers without ASD. AIMS: Investigating the effects of parental factors, i.e., mothers' and fathers' age and Sociocultural Level (Socioeconomic Status, Cultural Capital, and Social Capital), and individual factors, i.e., toddles' age, birth order, general development, autism symptom severity, and adaptive behavior, on the expression of BEP in toddlers with ASD. METHODS: Participants were 148 toddlers with ASD (aged 18-37 months) and both their parents. BEP were measured with the Child Behavior Checklist 1½-5 (CBCL) Syndrome and Pervasive developmental problems (PDD) DSM-oriented scales, general development with the Griffiths Mental Development Scales (GMDS), autism symptom severity with the Autism Diagnostic Observation Schedule-2 (ADOS-2), and adaptive behavior with the Vineland-II Adaptive behavior composite. RESULTS: Vineland-IIAdaptive behavior composite was negatively associated with the majority of the CBCL scales. In contrast, the ADOS-2 Restrictive and repetitive behavior was negatively and the ADOS-2 Social affect, toddlers' age, and birth order were positively associated with only a few of the CBCL scales (e.g., PDD). GMDS scores were not associated with any CBCL scales. Mothers' age and fathers' Cultural Capital and Social Capital dimensions were negatively associated with specific CBCL scales, even when considered in addition to individuals' factors. CONCLUSIONS: Individual and parental factors simultaneously affect the expression of BEP and should be considered for clinical decisions.

Individual and Environmental Factors Affecting Adaptive Behavior of Toddlers with Autism Spectrum Disorder: Role of Parents' Socio-cultural Level.

The effects of environmental factors [including Socio-Economic Status, Cultural Capital, and Social Capital (Socio-Cultural Level) of both parents] on the Vineland-II adaptive behavior dimensions of toddlers with autism spectrum disorder (ASD), in addition to individual factors, was investigated in 148 Italian toddlers (82% males), aged 18 to 37 months with ASD. Toddlers' age and Griffiths Mental Development Scales general development affected all of the adaptive behavior dimensions, with negative and positive associations, respectively. The Child Behavior Checklist comorbid conditions were negatively associated with some adaptive behavior dimensions while the ADOS-2 Social affect only with the communication dimension. Mothers' and fathers' specific Socio-Cultural Level dimensions were positively associated with toddlers' specific adaptive behavior dimensions with the same magnitude as comorbid conditions.

Attitudes of Mainstream and Special-Education Teachers toward Intellectual Disability in Italy: The Relevance of Being Teachers.

The attitudes of teachers toward intellectual disability (ID) contribute to an effective school inclusion of students with ID, thereby enhancing their quality of life. The present study was aimed at investigating the attitude differences toward ID of mainstream and special-education teachers in Italy and the general and specific teachers' characteristics most related to these attitudes. An online version of the Attitudes toward Intellectual Disability (ATTID) questionnaire was filled by 307 mainstream teachers and 237 special-education teachers. The findings show that special-education teachers held more positive attitudes. Specific ATTID dimensions were positively affected for both types of teachers by previous training in special education/ID, perceived support, and promotion of positive attitudes toward ID, in addition to the quality of relationships with individuals with ID, while they were positively affected for special-education teachers by perceived efficacy of ID knowledge. No or very limited effects were observed for previous experience in teaching students with typical development or ID (even with severe/profound ID). Fostering resources to provide teachers with high-quality training, support, and resources and strategies to promote positive attitudes toward ID seems a relevant approach leading to favorable attitudes, thereby improving the quality of life of students with ID.