Depression and anxiety symptoms during the transition to early adulthood for people with intellectual disabilities

Scope: Young adults are at especially high risk of developing mental health disorders with disorders like depression having prevalence rates of 10.8% (Goldney, Eckert, Hawthorne & Taylor, 2010). In people with an Intellectual Disability (ID) however, these rates are even higher and are estimated to be three to four times greater than the population estimates of 4.2% (anxiety) and 4.4% (depression) (Baxter, Scott, Vos & Whiteford, 2012; Ferrari et al., 2013; Einfeld et al., 2006). Despite these disorders exacerbating the social and adaptive functioning deficits already experienced, the factors that contribute to the increased risk of mental health disorders in young adults with IDs remain unknown. Purpose: The study aimed to assess the generalizability of the risk factors from typically developing young adults and adults with an ID to determine if these same factors may be contributing to the higher risk of mental health disorders in young adults with IDs. The study also considered the relative importance of each factor assessed (demographic variables, coping styles, hopelessness, discrepancies between expected and achieved adulthood milestones, and self-reflection and insight) by comparing them against one another and seeing which factors were most closely linked with depressive and anxiety symptoms. Methodology: A sample of 114 young adults: 55 with IDs and 82 who were recruited as aged-matched controls. Participants completed an emerging adulthood and mental health survey battery before their cognitive abilities were assessed. Data was first analysed for between-groups differences and the overall impact of the factors on anxiety and depression. Separate regression models were then undertaken for the ID and control groups for both anxiety and depression. Results: Insight was the strongest predictor of anxiety (with gender in the controls) for young adults with and without an ID with increased insight associated with fewer symptoms of anxiety. Significant between-group differences were found with young adults with IDs having less insight than their aged-matched counterparts and significantly more anxiety. They were also less likely to have achieved traditional adulthood milestones and maladaptive coping was the strongest predictor of depression for this group. For depression, maladaptive coping predicted more symptoms in young adults with an ID whereas both maladaptive coping and insight predicted symptoms in controls. Conclusions: The present study highlights the need to develop specifically targeted treatment programs that focus on increasing insight and reducing maladaptive coping for young adults with IDs and depression or anxiety. This is imperative if their responsiveness to treatment and their adaptive functioning capacities following the comorbid diagnosis are to improve. This is also likely to reduce the disproportionately high prevalence rates seen in this population. Future longitudinal studies would be beneficial to identify the factors that contribute to the onset of the disorders.