How service-users with intellectual disabilities understand challenging behaviour and approaches to managing it.

BACKGROUND: This study explored understandings that service-users with intellectual disabilities and challenging behaviour held around their behaviour, what shaped these understandings, and the relationship between how behaviours are managed and well-being. METHODS: Eight participants (three female, five male) partook in individual semi-structured qualitative interviews. Interviews were transcribed and analysed using interpretative phenomenological analysis. RESULTS: Three master themes emerged from this analysis: (a) challenging behaviour can be explained via an internal or external frame of reference, with each framework having different implications for how participants attempted to manage behaviour. (b) Positive relationships provide a long-term buffer to challenging behaviour, with positive relationships with family, staff and peers operating through different mechanisms to achieve this. (c) A greater ability to exert power and control in day-to-day life was perceived to reduce challenging behaviour in the long term. CONCLUSIONS: Implications for practice are discussed.

A systematic review of the clinical utility of the concept of self-disgust.

This systematic literature review examined the clinical utility of the construct of self-disgust in understanding mental distress. Specifically, the review assessed whether there is a shared conceptual definition of self-disgust, the face and construct validity of the quantitative assessment measures of self-disgust, and the predictive validity of self-disgust in formulating the development of a range of psychological difficulties. A systematic database search supplemented by manual searches of references and citations identified 31 relevant papers (27 quantitative, 3 qualitative, and 1 mixed). Analysis of qualitative papers indicated a number of shared features in the definition of self-disgust, including a visceral sense of self-elicited nausea accompanied by social withdrawal and attempts at cleansing or suppressing aspects of the self. Quantitative assessment measures appeared to capture these dimensions and evidenced good psychometric properties, although some measures may have only partially captured the full self-disgust construct. Strong relationships were observed between self-disgust and a range of mental health presentations, in particular, depression, body-image difficulties, and trauma-related difficulties. However, these relationships are smaller when the effects of other negative self-referential emotions were controlled, and stronger conclusions about the predictive validity of self-disgust are limited by the cross-sectional nature of many of the studies.