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Evidence summaries

Behavioural and Cognitive-Behavioural Interventions for Outwardly-Directed Aggressive Behaviour in People with Intellectual Disabilities

Cognitive behavioural treatments may be effective in the short-term management of outwardly-directed aggression in people with intellectual disabilities. Level of evidence: "C"

The quality of evidence is downgraded by inconsistency (heterogeneity in participant, interventions and outcomes), and by imprecise results (few patients, wide CIs).

Summary

A Cochrane review [Abstract] 1 included 15 studies on people with intellectual disabilities with a total of 921 subjects (adults, adolescents and children). Most participants had mild-to-moderate ID. These studies examined a range of behavioural (positive behaviour support, reciprocal imitation training, parent training) and cognitive-behavioural therapy approaches (individual- and group-based anger management, relaxation, mindfulness-based meditation, mindfulness-based positive behaviour support, adapted dialectal behavioural therapy) for outwardly aggressive behaviour in people with IDs.

One study showed some benefit of the anger management on improving severity of aggressive behaviour post-treatment (MD 3.50, 95 % CI 6.21 to 0.79; n=158). Two studies showed some benefit of positive behaviour support on reducing aggressive behaviour posttreatment (MD 7.78, 95 % CI 15.23 to 0.32; n=275) but suggested it probably does not reduce aggressive behaviour at 12 months (MD 5.20, 95 % CI 13.27 to 2.87; n=225). In 1 study mindfulness reduced incidents of physical aggression (MD 2.80, 95 % CI 4.37 to 1.23; n=34) and in 2 studies mindfulnessbased positive behaviour support reduced incidents of aggression posttreatment (MD 10.27, 95 % CI 14.86 to 5.67, I2 = 87 %; n=128).

References

  • Prior D, Win S, Hassiotis A, et al. Behavioural and cognitive-behavioural interventions for outwardly directed aggressive behaviour in people with intellectual disabilities. Cochrane Database Syst Rev 2023;2(2):CD003406[PubMed]

Primary/Secondary Keywords