Page 13 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

General introduction
Hilda is a 32-year-old woman with a mild intellectual disability.
Her parents were no longer able to provide the care she needed
when she was 12 years old. At that time, she started behaving
differently and showed much more aggression than before.
She was placed out of home and subsequently lived in various
care institutions for individuals with intellectual disabilities.
Hilda has been living in her current home for several months.
She receives intensive support from professional caregivers 24
hours a day. Since moving into her current home, the complexity
of her care needs has increased significantly. She frequently
exhibits physical and verbal aggression towards other residents
and professional caregivers. She often has trouble sleeping and
tends to isolate herself, particularly when she is with others.
According to her file, she has autism spectrum disorder in
addition to mild intellectual disability. During a meeting that was
held because the professional caregivers were concerned about
Hilda, one of them noted that her behaviour was very different
from what the team at her previous home had reported. While
her professional caregiver suspected that this might be related
to her autism spectrum disorder and her move to her current
home, he wondered if something else had happened. Given that
Hilda’s file also described a significant behavioural change at the
age of 12, the team decided to conduct a diagnostic interview for
trauma and stressor-related disorders. During the assessment,
Hilda revealed that she had been sexually abused several times
by someone when she was 12 and by a neighbour from her
current home several months ago. Following the diagnostic
assessment, Hilda was diagnosed with post-traumatic stress
disorder (PTSD). When the results were shared with her
parents and one of her professional caregivers, they were all
surprised to learn that she had experienced sexual abuse. This
was not documented anywhere in her file, and she had never
mentioned it. However, they also admitted that no one had ever
asked her about it. They agreed that PTSD symptoms should
be treated. Hilda decided to try eye movement desensitisation
and reprocessing (EMDR) therapy and was scheduled to see the
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