Sex and genes, part 2: A biopsychosocial approach to assess and treat challenging sexual behavior in persons with intellectual disabilities including fragile X syndrome and 22q11.2 deletion syndrome.

Individuals with intellectual disabilities (IDs) - and specifically those with genetic disorders - are more prone to medical and psychological challenges that affect their sexual development, experiences, and fertility. In this review paper we first provide an overview of the biopsychosocial (BPS) model and then explain how the model can guide and improve the assessment and treatment of challenging sexual behaviors by persons with IDs. We discuss two genetic conditions - fragile X syndrome and 22q11.2 deletion syndrome - in case studies, showing how the BPS model can be used to assess and treat the sexual problems of individuals with various types of ID. We conclude with BPS-formulated treatment considerations in three key domains: biomedical treatment (e.g., medication side effects; stopping or changing medications), psychological treatment (e.g., providing psychological therapies), and socio-environmental interventions (e.g., providing socio-sexual education and staff training). Together, these treatment interventions can aid clinicians to prevent and/or treat problematic sexual behaviors of people with IDs.

"In Medical School, You Get Far More Training on Medical Stuff than Developmental Stuff": Perspectives on ASD from Ontario Physicians.

This study investigated the knowledge and perceived competence of Ontario physicians regarding the diagnosis and treatment of ASDs. Previous research demonstrates that many physicians would like more education regarding diagnosis and treatment of autism spectrum disorders (ASDs). Twenty-seven Ontario physicians filled out a questionnaire and participated in a semi-structured interview. Findings revealed that despite participants' high perceived knowledge regarding diagnosis and treatment of ASDs, they feel uncomfortable in providing care for this population. Furthermore, many participants stated diagnosing and treating ASDs is not within their scope of practice. Findings have implications for increasing physicians' knowledge of diagnosis and treatment of ASDs as well as what is required to enhance healthcare for individuals with ASDs and their families.

Health Care Students' Attitudes About Alcohol Consumption During Pregnancy: Responses to Narrative Vignettes.

This article explores medical, midwifery, and nurse practitioner students' attitudes about women who may consume alcohol throughout their pregnancies. Twenty-one health care students responded to a scenario-based vignette addressing alcohol consumption during pregnancy, as well as a semistructured interview, which were analyzed using Braun and Clarke's thematic analysis approach. Two primary themes related to students' attitudes concerning alcohol consumption during pregnancy were identified: (a) divergent recommendations for different women, based on perceptions of their level of education, culture/ethnicity, and ability to stop drinking; and (b) understanding the social determinants of health, including the normalization of women's alcohol consumption and potential partner violence. Health care professionals in training need further education about the risks of alcohol consumption during pregnancy and fetal alcohol spectrum disorder (FASD). In addition, health care students need training in how to engage in reflective practice to identify their own stereotypical beliefs and attitudes and how these attitudes may affect their practice.

"No Alcohol Is Recommended, But . . .": Health Care Students' Attitudes About Alcohol Consumption During Pregnancy.

Canadian findings suggest that health care providers require further training and education to support their work preventing fetal alcohol spectrum disorder (FASD). However, the knowledge and training of health care students in relation to FASD remains largely unexplored. The purpose of this study was to understand the attitudes and beliefs of health care students about alcohol use during pregnancy. Twenty-one health care students participated in a scenario-based vignette about alcohol consumption during pregnancy. Although almost all students recognized that no alcohol consumption during pregnancy is the safest recommendation, many students recounted that this advice is not always conveyed during encounters with their pregnant patients. Three primary themes related to students' attitudes concerning alcohol use during pregnancy were identified. Health care professionals in training need further education about the risks of alcohol consumption during pregnancy and the potential health outcomes associated with prenatal alcohol exposure.

Autism spectrum disorder and fetal alcohol spectrum disorder. Part I: a comparison of parenting stress.

BACKGROUND: There is a long history of research on parents of children with disabilities, but to the authors' knowledge, no study has compared the stress of parents of children with fetal alcohol spectrum disorder (FASD) to parents of children with autism spectrum disorder (ASD). METHOD: Twenty-five parents of children with ASD and 25 parents of children with FASD completed the Parenting Stress Index - Short Form (PSI-SF) and the Questionnaire on Resources and Stress - Friedrich's Version (QRS-F). RESULTS: Although both parent groups reported elevated stress, PSI-SF results indicated that parents of children with FASD were experiencing significantly more stress compared to parents of children with ASD. No significant differences were found between groups on the total QRS-F, but parents of children with FASD had higher scores on the Pessimism subscale. CONCLUSIONS: The authors call for measures grounded in theory as well as mixed methods research that includes the subjective experience of parents' stress.

Autism spectrum disorder and fetal alcohol spectrum disorder. Part II: a qualitative comparison of parenting stress.

BACKGROUND: Researchers investigating the impact of parenting children with disabilities suggest that regardless of the specific diagnosis, parents experience increased levels of stress. However, particular disabilities may be associated with distinct stressors and strains. METHOD: Parents of children with autism spectrum disorder (ASD) and parents of children with fetal alcohol spectrum disorder (FASD) participated in in-depth qualitative interviews employing a basic interpretative approach. RESULTS: Both groups described some similar stressors, such as multi-tasking, the diagnostic process, and dealing with behavioural issues, but there are distinct differences between families of children with FASD and families of children with ASD. Whereas parents of children with FASD focused on their children's illegal behaviours, parents of children with ASD struggled with their children's tantrums and anxieties. CONCLUSIONS: Supports must be tailored to meet the specific needs of parents of children with different types of disabilities.

The relationship between burnout and coping in adult and young offender center correctional officers: an exploratory investigation.

High levels of occupational stress and burnout are costly for correctional services and their employees. Correctional officers report high levels of burnout, absenteeism, turnover, and poor physical health. The purpose of this study was to investigate the prevalence of burnout and the coping mechanisms used to buffer the effects of burnout within correctional centers. In the current study, 208 correctional officers from adult and young offender centers completed an online survey measuring burnout and coping strategies. Results from the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Brief Coping Orientation to Problems Experienced (COPE) Scale indicated that even though correctional center officers mostly used adaptive coping strategies, they still reported high levels of burnout. The results of this study suggest that there are variables other than coping strategies, such as gender and length of experience, that lead to the level of burnout as observed in correctional officers.

The impact of parenting stress: a meta-analysis of studies comparing the experience of parenting stress in parents of children with and without autism spectrum disorder.

Researchers commonly report that families of children with autism spectrum disorder (ASD) experience more parenting stress than families of typically developing (TD) children or those diagnosed with other disabilities [e.g., Down syndrome (DS), cerebral palsy, intellectual disability]. The authors reexamined the research using comparison groups to investigate parenting stress and conducted a meta-analysis to pool results across studies. The experience of stress in families of children with ASD versus families of TD children resulted in a large effect size. Comparisons between families of children of ASD and families with other disabilities also generated a large effect size however, this result should be interpreted with caution as it may be associated with the specific experience of parenting a child with DS.

Sexual knowledge and attitudes of men with intellectual disability who sexually offend.

BACKGROUND: Various explanations of sexual offending in men with intellectual disability (ID) have stressed sexual deviance and a lack of developmental socio-sexual knowledge. METHOD: Using the normative dataset of people with ID from the development of the Socio-Sexual Knowledge and Attitudes Assessment Tool - Revised (SSKAAT-R: Griffiths & Lunsky, 2003), two samples of individuals with ID and a history of sexual offence were compared on sexual knowledge to matched samples of individuals with ID and no known sexual offences. RESULTS: Offenders with ID who were identified as having engaged in sexually inappropriate behaviour, such as public masturbation or touching someone inappropriately, did not differ in terms of sexual knowledge from their matched sample of individuals with ID with no sexual offence history, whereas offenders who had committed more serious offences demonstrated greater sexual knowledge than matched non-offenders. When only those individuals who had received prior sex education were compared in terms of sexual knowledge, there were no differences between groups. However, sex offenders (serious offences) expressed more liberal attitudes than sex offenders (inappropriate behaviour) and non-offenders towards same-sex activities. CONCLUSIONS: The study points to the dynamic effect of socio-sexual education on offenders' knowledge and attitudes, and highlights potential differences in the knowledge and attitudes of different subtypes of offenders.