Posttraumatic stress disorder in people with developmental disability
People with developmental disability have an increased risk of experiencing traumatic life events compared to the general population (see Abuse, trauma and supporting people with developmental disability), and may be more vulnerable to developing posttraumatic stress disorder (PTSD). This may be due to reduced capacity to adaptively process information, emotions and memories related to the traumatic event.
Research into how PTSD presents in people with developmental disability is limited. Commonly reported symptoms include irritability, aggression, depression, nightmares and frequent retelling of the experience. It may also present as the person acting out the traumatic experience, self-injurious behaviour, disorganisation, increasing resistance and isolation.
There is strong evidence for trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) for treatment of PTSD in the neurotypical population1. Emerging research is ongoing in the use of EMDR in the intellectual disability population. The benefits of this modality are that it has less reliance on communication and does not require homework. Early case evidence shows that EMDR is well tolerated and potentially efficacious in people with intellectual disability, though there is variability in the number of sessions required for an individual, which may be linked with their disability level.
Refer people with developmental disability and suspected PTSD to a specialist service for diagnostic clarification. In the absence of more robust evidence, treatment as per the neurotypical population is recommended; see Mental health disorders following trauma exposure. The recognition of trauma and practice of trauma-informed care are essential to minimise contributing factors and improve outcomes for people with developmental disability.
For general principles of assessment of psychiatric disorders in people with developmental disability, see here. For general principles of management, see here.