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Chapter 7196DiscussionThe results of this first explorative study focusing on trauma in adults with 22q11.2DS support our hypothesis of an elevated risk of developing PTSD (8.0%) as compared with the general population (3.9%).2, 3There is growing evidence that intellectual disability and borderline intellectual functioning, both often seen in 22q11.2DS, increase the risk of exposure to traumatic events and the development of PTSD symptoms,5-7with direct negative effects on emotional, behavioural and adaptive functioning.8 Also, life events are more likely to be experienced as traumatic in people with intellectual disabilities, even though DSM-5 criteria are not always met.5 PTSD and traumatic experiences are however often not recognized in these populations.5,6 One reason may be that symptoms may be overshadowed by, or attributed to, other psychiatric disorders such as psychotic illness.6 Another reason may be that patients and/or their relatives themselves do not recognize trauma-related symptoms,6 or find it hard to ask for help for trauma-related symptoms. Also, professionals may hesitate to pay attention to past traumatic experiences, out of fear of aggravating symptoms and causing a crisis.6 Therefore, we presume under-recognition and/or under-reporting of PTSD and traumatic experiences in 22q11.2DS. Here, it should also be noted that adults and patients with intellectual disability were underrepresented in previous 22q11.2DS research.2Recognition of trauma and PTSD is important since it allows for treatment which may also have the potential of reducing psychosis risk in high-risk populations,9 such as 22q11.2DS. While we are not aware of any study reporting on the effectiveness of interventions for trauma in 22q11.2DS, an increasing number of studies have shown positive effects of EMDR and CBT in individuals with intellectual disability.10Strengths and limitationsThe strengths of this study include the relatively large adult 22q11.2DS sample and the fact that the focus on trauma was not limited to strict DSM5 criteria for PTSD. There were also several limitations, mostly related to the retrospective nature of the study. For example, data were limited to the