Chapter 15: Supporting people with learning disabilities on general psychiatric wards, PICUs and LSUs Patients with mild learning disability may experience problems with understanding due to which of the following? Difficulties in working memory No speech Difficulties with abstract thinking Difficulties in sustained attention Lack of interest in people Dacey et al (1999) found a high correlation between IQ and which domain subscale of the Vineland Adaptive Behaviour Scale in people with mild and moderate learning disability? Communication skills Daily living skills Socialisation skills Skills of adaptation Motor skills Prevalence rates of severe challenging behaviour are most frequent in … Females Those aged 15-35 Those with less severe intellectual impairment Those with a sensory disability In those with epilepsy What is the ICD-10 definition of learning disability? Learning impairment An autistic spectrum condition Developmental retardation Mental retardation Complex needs Mild learning disability is associated with a measured IQ of … 40-60 50-70 60-80 70-90 Randomised controlled trials in children and adults with autism and learning disability with significant behavioural problems found low-dose fluvoxamine was … Associated with aggression in children Helpful in both adults and children Helpful in only children Associated with agitation in adults Which of the following are characteristic impairments of communication in individuals with autism? Excellent turn-taking skills Echolalia Engaging in social activities Repetitiveness Use of facial gestures to communicate Which of the following are the core features of autism? Disturbed mutual contact An inability to maintain routine Communication difficulties Memory impairments Limited imagination In Flynn et al’s (2002) survey of patients in low and medium secure inpatient facilities specialising in learning disability what was the approximate prevalence of severe personality disorder? 9% 19% 39% 59% 79% Depression in people with learning disability can … Only be diagnosed with an IQ above 50 Present as loss of interest in usual activities Be monitored by changes in activity level Commonly produce suicidal ideation Cause weight gain Which of the following drugs are commonly used outside their normal licensed indications? Lithium Anti-depressants Neuroleptics Anticholinergics Anticonvulsants Which of the following are essential features of learning disability? Features of brain damage in adults Significant intellectual impairment Evidence of an autistic spectrum condition Significant difficulties in adaptive function Impairment arising in the developmental period Epilepsy treatment in learning disability may involve which of the following psychiatric adverse effects? Psychosis with vigabatrin Paradoxical over-arousal with phenobarbitone Sedation and confusion with valproate Hallucinations with midazolam Sedation with clonidine Which of the following statements are correct with regard to using psychotropic drugs in adults with learning disability? Neuroleptics may be efficacious at lower doses than are used in general psychiatry Psychotropic drugs are rarely used They show fewer side effects than the general population Psychotropic drugs should be used with caution due to the propensity to reduce seizure threshold Anticholinergic drugs are effective and do not affect cognitive function What percentage of people with mild learning disability also have autism? 2% 17% 32% 56% 84% Which of the following are examples of challenging behaviour? Non-concordance Social withdrawal Obsessions or rituals Apathy Self-neglect Which of the following are explanations for delusional thinking in learning disabled patients? Wish-fulfilment Hallucinations Sleep disturbance Disclosure of abuse Psychotic perceptual disturbance The process of identifying the motivation for behaviour as an attempt at communication is also called what? Behavioural analysis Motivational interviewing Procedural analysis Functional analysis Cognitive behavioural therapy When planning for a clinical interview with an individual with learning disability which of the following should be kept in mind? That any informant has no relationship with the individual Consider a structured and prolonged approach Use leading questions Avoid jargon Use an active voice There is a particular risk of acquiescence and suggestibility when a vulnerable individual is … Confronted by a person they know Tired Feeling guilt In pain Hungry Which of the following drugs are an effective treatment of severe impulsive aggression in patients with learning disability where other treatments have failed? Sodium valproate Lithium Carbamazepine Naltrexone Loading …
