{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:26:04Z","timestamp":1791329164845,"version":"4.3.1"},"reference-count":42,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,23]],"date-time":"2016-11-23T00:00:00Z","timestamp":1479859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"States of Jersey Health and Social Services Department"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["British J Clinic Psychol"],"published-print":{"date-parts":[[2017,3]]},"abstract":"\n Objectives<\/jats:title>\n \n Considerable variation has been reported in the prevalence and correlates of challenging behaviour (CB) in adults with intellectual disabilities (ID). To provide a robust estimate of prevalence, we identified the entire administrative population of adults with\n ID<\/jats:styled-content>\n in a defined geographical area and used a behaviour assessment tool with good psychometric properties.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Data from 265 adults who were known to services were collected using a demographic survey tool and the Behavior Problems Inventory \u2013 Short Form. The prevalence of self\u2010injurious, aggressive\/destructive, stereotyped, and overall CB was evaluated. We explored the potential of developing cumulative risk indices (\n CRI<\/jats:styled-content>\n ) to inform longitudinal research and clinical practice.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The prevalence of overall CB was 18.1% (95%\n CI<\/jats:styled-content>\n : 13.94\u201323.19%). The prevalence of self\u2010injurious behaviour was 7.5% (95%\n CI<\/jats:styled-content>\n : 4.94\u201311.37%), aggressive\u2013destructive behaviour 8.3% (95%\n CI<\/jats:styled-content>\n : 5.54\u201312.25%), and stereotyped behaviour 10.9% (95%\n CI<\/jats:styled-content>\n : 7.73\u201315.27%). Communication problems and severity of\n ID<\/jats:styled-content>\n were consistently associated with higher risk of CBs.\n CRI<\/jats:styled-content>\n s were significantly associated with CBs, and the five methods of\n CRI<\/jats:styled-content>\n development produced similar results.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Findings suggest a multi\u2010element response to CB is likely to be required that includes interventions for communication and daytime activity. Exploratory analyses of\n CRI<\/jats:styled-content>\n s suggested these show promise as simple ways to capture cumulative risk in this population. Subject to longitudinal replication, such a tool may be especially useful in clinical practice to identify adults who are priority for interventions and predict future demand on services.\n <\/jats:p>\n <\/jats:sec>\n \n Practitioner points<\/jats:title>\n \n \n \n The prevalence of challenging behaviour (CB) was 18.1% in this total population study. Stereotypy was the most frequent type of CB.<\/jats:p>\n <\/jats:list-item>\n \n Communication difficulties and severe\u2010profound intellectual disabilities were most systematically related to the presence of CB.<\/jats:p>\n <\/jats:list-item>\n \n Establishing the effect of multiple risk factors is likely to identify people who are priority for interventions. Addressing multiple, rather than singular risks, is likely to be more efficacious.<\/jats:p>\n <\/jats:list-item>\n \n We tested five different methods of putting together a multiple risk index.<\/jats:p>\n <\/jats:list-item>\n \n \n All methods provided a reasonable association with CB. The most user\u2010friendly method was the additive cumulative risk index (\n CRI<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n \n \n Limitations<\/jats:bold>\n <\/jats:italic>\n <\/jats:p>\n \n \n \n This is a cross\u2010sectional design which enabled factors currently associated with CB to be identified for the whole cohort, but these variables may not be those conferring risk for the development or maintenance of CB over time.<\/jats:p>\n <\/jats:list-item>\n \n \n Future longitudinal research is required to replicate these\n CRI<\/jats:styled-content>\n analyses before concluding about the\n CRI<\/jats:styled-content>\n method with the highest predictive validity.\n <\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bjc.12118","type":"journal-article","created":{"date-parts":[[2016,11,23]],"date-time":"2016-11-23T01:57:00Z","timestamp":1479866220000},"page":"16-32","source":"Crossref","is-referenced-by-count":200,"title":["Challenging behaviours in adults with an intellectual disability: A total population study and exploration of risk indices"],"prefix":"10.1111","volume":"56","author":[{"given":"Darren L.","family":"Bowring","sequence":"first","affiliation":[{"name":"School of Psychology University of Bangor UK"},{"name":"Health and Social Services Jersey UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Totsika","sequence":"additional","affiliation":[{"name":"CEDAR University of Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard P.","family":"Hastings","sequence":"additional","affiliation":[{"name":"CEDAR University of Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"Toogood","sequence":"additional","affiliation":[{"name":"School of Psychology University of Bangor UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma M.","family":"Griffith","sequence":"additional","affiliation":[{"name":"School of Psychology University of Bangor UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,23]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Challenging behaviour survey: Individual schedule","author":"Alborz A.","year":"1994"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7441.702"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469\u20107610.2004.00351.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954579400003114"},{"key":"e_1_2_6_6_1","volume-title":"Applied multiple regression\/correlation analysis for the behavioral sciences","author":"Cohen J.","year":"2003"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.170.4.375"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102788.2008.01127.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102788.2008.01060.x"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102788.2001.00373.x"},{"key":"e_1_2_6_11_1","unstructured":"Department of Work and Pensions(2012).Medical guidance for DLA and AA decision makers (adult cases): Staff guide. 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