Aggressive and destructive behaviour in a group of patients with intellectual disability

Abstract

Aggressive and destructive behaviour is seen as a risk factor in institutions caring for patients with intellectual disability. Certain situations may lead to or trigger aggressive and destructive behaviour. A study of the full extent of aggressive and destructive behaviour, including types of behaviour and situations in which they occur, was needed. This knowledge could help in understanding such behaviour better and help establish guidelines and intervention programs for reducing aggressive and destructive behaviour in a group of people with intellectual disability. semi-structured interview was conducted with both patients and staff. consisting three questions. To patients: What makes you angry or upset? 2. What do you do when you get angry or upset? 3. What do you do to feel calm and relaxed? To Staff: 1. at makes the patient angry or upset? . What does the patient do when he/she gets angry or upset? 3. What does the patient do to feel calm and relaxed? The data received were then analysed, placed into categories and weighted by percentage. Categories of responses were reported for both men and women. The most frequent categories reported by patients and staff to all questions were: conflict with patients, conflict with staff, aggressive behaviour, destructive behaviour, isolation, recreational and leisure activities, and socialization. Isolation and destructive behaviour in response to the question, what do you do when you are angry or upset?, were categories identified in the patient population which were not noted by the staff. Staff and patients generally identified the same categories, but with different emphasis on weight and significance to both. These categories evolved from incidents annotated of verbal aggression, swearing, teasing and threats, as well as physical aggression like hitting and biting. Incidents of destructive behaviour like breaking windows, slamming doors, invasion of privacy and theft were annotated. Physical needs identified included food, confectionery and clothes. Psychological needs identified ranged from socialization to isolation, rest or sleep, social interaction and the use of recreational facilities. The self-reports proved useful in establishing the needs of both patients and staff, establishing staff insight as well as identifying situations and types of behaviour which manifest in patients with intellectual disability. It is suggested that these areas be focussed on in the understanding, training and planning of intervention strategies to handle problem areas such as aggressive and destructive behaviour in institutions for people with intellectual disability. The results indicate reduced staff awareness to some dimensions of patient behaviour. A thorough knowledge of patients' needs, of the environment in which they live and their behaviour is necessary for effective management of problem behaviours and situations. Through training this knowledge should allow for a better understanding of patients, their

reactions and behaviour, which may lead to reducing aggressive and destructive behaviour.