Page 48 - Post-traumatic stress disorder in adults with mild intellectual disability: Screening, assessment, and brief intensive EMDR therapy

Chapter 2
symptoms may be incorrectly attributed to other mental disorders (Kildahl
& Helverschou, 2023). For example, intrusion symptoms (PTSD criterion B)
can incorrectly be interpreted as hallucinations belonging to a psychotic
disorder, and alterations in arousal and reactivity (PTSD criterion E) may
appear to be manifestations of ADHD. Finally, the difficulty to recognize
PTSD in this target group could be explained by the fact that caregivers are
often insufficiently aware of the trauma history (Hoogstad et al., 2023) and
PTSD symptoms (Versluis et al., 2025) of the individuals they work with.
As stated in the Introduction, undetected and untreated PTSD is related
to serious problems in daily life, which may specifically hold true for
individuals with MID-BIF (McNally et al., 2021). It is important that PTSD
is better recognized in people with MID-BIF so that they can receive proper
treatment. In recent years, an increasing number of studies have shown
that trauma treatments, such as EMDR therapy, are suitable, safe, and
potentially effective for adults with MID-BIF who have been diagnosed with
PTSD (e.g., Penninx Quevedo et al., 2021; Unwin et al., 2018).
Limitations of the Study
The present study has limitations. First, since the introduction of DSM,
MID and BIF should no longer be diagnosed by an IQ-score alone. When
determining a MID or BIF, adaptive functioning should be considered
in addition to the IQ score. All participants in this study were previously
classified with MID or BIF as mentioned in their client file, but often the
classification was based only on an IQ score and not on their adaptive
skills. The latter is due to the lack of an up-to-date Dutch language and
standardized instruments for measuring adaptive skills in people with MID-
BIF. Consequently, it remains uncertain whether all participants would fulfill
all DSM-5-TR criteria for MID or BIF. Second, we investigated a specific
sample of adults with MID-BIF all living in supported housing in two ID care
services, which implies these findings may not be generalizable to the MID-
BIF population in general.
Recommendation for future Research
The DITS-ID-adults contains a follow-up measurement, with which a
clinician can assess whether there is still a PTSD classification and/or
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