Role of Stress and Age in Resilience Among Parents of the Children with Intellectual Disability

Parents of children with intellectual disability face various stressful situations. However, many of them show resilience even in the midst of challenges and are able to meaningfully contribute to the life of the child. In the present study, the factors of stress that hinder resilience are assessed in a sample of 50 parents of intellectually disabled children. Stress scale for parents of mentally challenged (SPMC) developed by Rejitha, Biji, and Jayan was used to measure the stress of the parents. Resilience was measured using the Bharathiar University resilience scale, developed by Annalakshmi. Results showed extra-familial stress as a significant inverse predictor of resilience. Older parents are relatively more resilient when compared to the younger.

Sexuality, Sexual Abuse, Marriage, Partner Violence, and Parenting Skills Among Persons With Intellectual Disability

Sexuality begins from the moment of birth and has an active role in the development, evolution, emotional balance, and affective stability of the individual. It has a significant role in interpersonal and couple's relationships. The sexuality of people with intellectual disability is important from the view of medical, pedagogical, psychological, and ethical aspects. As intellectually disabled person approach puberty their control of behavior and expression of sexuality may manifest in unacceptable ways. They are also at increased risk for physical, sexual, and emotional abuse. The chapter focused on the sexuality, the risk of sexual abuse, marriage, partner violence among people with intellectual disability. The requirement of sex education and components of sex education for various age ranges were also explained and effectiveness of such programs were also discussed. The chapter also discussed the parenting and challenges involved in parenting among intellectually disabled individuals.

On patients who explode: surviving petrifying psychotherapeutic experiences

Although most of our patients will enter the consulting room quite quietly, often in a depressive state, having contained their sadistic impulses, a tiny fraction of those with whom we work will attack us in a variety of chilling ways. In this article, the author describes in detail two particularly terrifying clinical experiences in which a patient either threatened to kill him or actually sullied his consulting room with bodily fluids. Drawing upon his psychotherapeutic encounters not only with intellectually disabled patients and forensic patients but, also, with those who presented as ordinary “normal-neurotics”, the author considers the phenomenology of these “bomb”-like explosions and explains how he attempted to maintain a classical psychoanalytical focus of understanding, which consisted of a careful scrutiny of the countertransference and a firm commitment to the interpretation of unconscious material, whilst under attack. Furthermore, he examines the essential role of speaking with experienced colleagues who will provide essential supervision or assistance during these challenging chapters of clinical practice. The author also considers the many ways in which “bombs” can be hurled not only by the more obviously dangerous or disturbed individuals but, also, with surprising frequency, by those with no criminal history whatsoever, who, upon first encounter, often present as reasonably healthy.

Identification of three novel pathogenic mutations in cystathionine beta-synthase gene of Pakistani intellectually disabled patients

Background Classical homocystinuria (HCU) is an autosomal recessive inborn error of metabolism, which is caused by the cystathionine-β-synthase (CBS: encoded by CBS) deficiency. Symptoms of untreated classical HCU patients include intellectual disability (ID), ectopia lentis and long limbs, along with elevated plasma methionine, and homocysteine. Methods A total of 429 ID patients (age range: 1.6–23 years) were sampled from Northern areas of Punjab, Pakistan. Biochemical and genetic analyses were performed to find classical HCU disease in ID patients. Results Biochemically, nine patients from seven unrelated families were identified with high levels of plasma methionine and homocysteine. Targeted exonic analysis of CBS confirmed seven causative homozygous mutations; of which three were novel missense mutations (c.451G>T; p.Gly151Trp, c.975G>C; p.Lys325Asn and c.1039 + 1G>T splicing), and four were recurrent variants (c.451 + 1G>A; IVS4 + 1 splicing, c.770C>T; p.Thr257Met, c.808_810del GAG; p.Glu270del and c.752T>C; p.Leu251Pro). Treatment of patients was initiated without further delay with pyridoxine, folic acid, cobalamin, and betaine as well as dietary protein restriction. The immediate impact was noticed in behavioral improvement, decreased irritability, improved black hair color, and socialization. Overall, health outcomes in this disorder depend on the age and symptomatology at the time of treatment initiation. Conclusions With personalized treatment and care, such patients can reach their full potential of living as healthy a life as possible. This screening study is one of the pioneering initiatives in Pakistan which would help to minimize the burden of such treatable inborn errors of metabolism in the intellectually disabled patients.

Covid-19 Impact on Children with Autism Spectrum Disorder and Intellectual Disability: Study in Saudi Arabia

This study investigated the impact of COVID-19 on children with autism spectrum disorder and intellectually disabled children from a parent's point of view and statistically significant differences between the responses of parents of children with disabilities about the impacts of the COVID-19 attributed to the child’s sex (male/female), the type of the child’s disability (autism/intellectual disability), the parents’ education level (intermediate or lower/above intermediate). The study used the quantitative approach and used a questionnaire applied to a sample of (217) parents of children with autism spectrum disorder and intellectually disabled children in Jeddah who are registered in governmental and private centers and institutes of the Ministry of Education and the Ministry of Social Affairs. The results of the study showed that the impact of COVID-19 on children with autism spectrum disorder and intellectually disabled children had a high degree. Also, the results showed that there are no statistically significant differences between the responses of parents of children with disabilities about the impacts of the COVID-19 attributed to the child’s sex, the type of the child’s disability, the parents’ education level. The study recommends Involve parents of children with disabilities during rerehabilitation sessions for their children so that they can train their children in desired behaviors in light of some crises such as the Corona pandemic. Received: 4 August 2021 / Accepted: 23 September 2021 / Published: 5 November 2021

Sexual abuse leading to secondary syphilis in an intellectually disabled person: a case report

<p class="abstract">Syphilis is a sexual transmitted infection (STI) caused by a spirochete, <em>Treponema pallidum</em>. Condylomata lata is a characteristic lesion seen in secondary syphilis. Here we reported a case of 24 year old unmarried male with intellectual disability who presented with condyloma lata over the scrotum, prepuce and perianal region and with moth eaten alopecia over scalp since 1 month. Here the patients mother revealed he had promiscuous relationship with multiple friends, which is a sexual abuse since the patient is intellectually disabled. Clinically diagnosed as secondary syphilis. Venereal disease research laboratory (VDRL) test titre was reactive at 1:32 and <em>Treponema pallidum </em>hemagglutination test (TPHA) was positive. Biopsy was also done, which confirmed diagnosis. Single dose of injection benzathine penicillin G, 2.4 million units was administered intramuscularly. Patient did not develop a Jarisch-herxheimer reaction. On follow up his lesions healed and VDRL titres also came down and non-reactive at 3 months. Here in this case sexual abuse lead to secondary syphilis since patient was intellectually disabled so he couldn’t address his complaints clearly. Hence counselling was done to the patient and family members by dermatologist and psychiatrist.</p><p class="abstract"> </p>