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CHALLENGING BEHAVIOR
المؤلف:
PAUL MALORET
المصدر:
Caring for People with Learning Disabilities
الجزء والصفحة:
P78-C5
2025-10-11
61
CHALLENGING BEHAVIOR
Moss et al. (2000) found that there was a strong relationship between mental illness and people with learning disabilities who present ‘challenging behaviors’. Their study showed that mental illness was twice as prevalent in those with challenging behaviors as those without. Depression and anxiety were the most prevalent with those described as having challenging behavior.
Confusion and fear can often turn into anger and physical aggression. Often, people with a learning disability struggle to cope with events in their lives because they may not possess the insight to realize that situations may, in time, improve. Depression is essentially an over-reaction to loss, whereas anxiety is an over-reaction to the threat of loss. For example, people with learning disabilities may not understand that grieving is a feeling that, given time, may become less overwhelming and they can expect to feel better (Reiss 1992). John’s experience helps to demonstrate this.
Case study
John has a mild learning disability and has lived with his mother all his life. When his mother died of cancer John’s family felt that he could continue to live in his mother’s house, which had been left to him in his mother’s will. John continued his life in the house and with his job but, some months later, he started to demonstrate some behavioral changes. His employer said he was notably more irritable and ‘moody’; when asked what was wrong, he simply answered ‘My mum’. The situation became worse and John stopped turning up for work. His employers called social services and expressed their concerns.
A social worker visited John and reported that the house was in a poor condition, as was John’s personal hygiene, i.e. he had not washed or shaved for some weeks. John appeared very anxious and low in mood; the social worker made an urgent referral to the local psychiatric team. John was admitted to hospital and treated on anti-depressant medication; he also received bereavement counselling to help him deal with the loss of his mother.
His counsellor discovered that John had not realized his mother was dead and would not return; he had been told that his mother had gone to heaven; John didn’t know where this was and assumed it was a hospital. When she didn’t return, he assumed she had left him; he said he felt ‘unwanted’ and ‘missed his mum’. John was diagnosed with depression; his treatment continued over several months, after which time he was dis charged and went home. A learning disability nurse was given the responsibility of monitoring John’s progress and to observe for any signs of deterioration in his mental health.
John’s psychiatrist believed his condition was caused by a number of contributing factors. John’s initial reaction to his mother’s death was normal but this became abnormal when he was told his mother had ‘gone to heaven’; this had given him hope that his mother was coming back. When she did not return, he felt rejected by her; this caused greater sadness and further confusion. Despite this, John attempted to continue with his life, but failed, as he did not possess the coping skills or the practical skills, e.g. housekeeping skills; his previous dependence on his mother and his learning disability had prevented these skills from developing. This frustrated John and made him feel ‘helpless’ and ‘worthless’. John felt he would be a very sad person forever.
It is important to note that people with learning disabilities can suffer from the same mental health problems as anyone else. The four areas chosen here for their high prevalence rates present a higher risk, but people with learning disabilities are certainly represented in other areas, such as mood disorders and personality disorders.
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