Impulsividade e comportamento adaptativo em adultos com deficiência intelectual e múltipla

Abstract

Introduction: Intellectual and multiple disability (IMD) is characterized by limitations that affect a person's cognitive and adaptive capacity, and may be associated with limitations in communication skills, learning, self-care and social skills. In addition to hereditary and environmental factors, we know that impulsivity is one of the determinants of adaptive behavior in children and adolescents with IMD. However, the consequences of high levels of impulsivity on adaptive behavior in adults with IMD remain unknown. Objective: To investigate the influence of impulsivity on the adaptive behavior of adults with intellectual and multiple disabilities. Methods: This study involved 56 people with IMD who were divided into two groups according to the absence (IMD-IB, n=34) or absence of impulsive behavior (IMD+IB, n=22). The intellectual aspect of the sample was assessed using the abbreviated version of the Wescheler Intelligence Scale (WASI), which is made up of the subtests i) Cubes ii) Vocabulary iii) Similarities and iv) Matrix reasoning. The Barrat Impulsivity Scale (BIS-11) was used to measure the level of global impulsivity and the motor, attentional and lack of planning subdomains, and the Víneland-III Adaptive Behavior Scales were used as a measure of adaptive behavior. Differences with values of P≤ 0.05 were considered statistically significant. Results: No significant differences were observed in the global, verbal and execution intelligence quotients between the groups. And, as expected, the IMD+IB group showed significantly higher levels of global impulsivity (P<0.01), motor impulsivity (P<0.01), attentional impulsivity (P<0.01) and non-planning impulsivity (P<0.01) compared to the IMD-IB group. When analyzing the domains of adaptive behavior, we observed that adults with IMD+IB had lower levels of socialization, both reported by the volunteer (P=0.05) and the caregiver (P=0.02). Considering the sub-factors of the socialization domain, we found that the IMD+IB group had worse levels only in interpersonal relationships when compared to the IMD-IB group (P=0.05). The sub-factors play and leisure and coping skills were similar between the groups. Both global impulsivity and attentional impulsivity were inversely associated with the level of socialization (Rho= -0.36; P<0.01 and Rho= -0.30; P=0.01; respectively) and with interpersonal relationships (Rho= -0.23; P=0.04 and Rho= -0.22; P=0.05; respectively). Conclusion: Based on these findings, we can conclude that global impulsivity and attentional impulsivity negatively influence the adaptive behavior of adults with IMD due to impairment in both socialization and interpersonal relationships. These findings can provide support for the planning of therapeutic and educational interventions, helping in the development of individualized treatment and support strategies, especially in populations with complex and varied needs.