Behavioural and cognitive‐behavioural interventions: can they reduce aggressive behaviour in people with intellectual disabilities?

Prior D, Win S, Hassiotis A, Hall I, Martiello MA, Ali AK. Behavioural and cognitive-behavioural interventions for outwardly directed aggressive behaviour in people with intellectual disabilities. Cochrane Database of Systematic Reviews 2023, Issue 2. Art. No.: CD003406. DOI: 10.1002/14651858.CD003406.pub5.¹

People with intellectual disabilities may demonstrate challenging behaviour to carers, family members and when they interact with service providers. These behaviours can include aggression, self-injury, stereotypic behaviour, withdrawal and disruptive or destructive behaviour.² Behavioural therapy (BT) aims to reduce or eliminate unwanted behaviours whilst encouraging desirable behaviours. Positive behavioural support (PBS) includes a range strategies that are employed to improve perceived behaviour.³ Cognitive behavioural therapy is also a well-established tool for the treatment of anger.⁴ This review aimed to determine if both BT and CBT can reduce aggressive behaviours in people with intellectual disabilities.¹

Both BT and CBT reduced aggressive behaviour in people with intellectual disability in the short term. However, there was very little evidence to determine if these effects are maintained over time.¹ These findings support current recommendations that psychological treatments should be used as first line treatments (Table 1).²

Table 1.  Safety and effect of Behavioural and cognitive-behavioural interventions for reducing aggressive behaviour in people with intellectual disabilities.