Exploring Trauma Related Changes and the Feasibility of Post Traumatic Growth in People with Intellectual Disabilities

Introduction: Adults with intellectual disabilities (ID) are more likely to experience traumatic events, such as abuse and discrimination, than the general population. Subsequently, considerable research has explored the negative impact of trauma in this clinical group, such as rates and symptoms of post-traumatic stress disorder. Within the wider literature, there has been increased acknowledgment that positive changes can also result from trauma, which has been termed post-traumatic growth (PTG). This thesis aims to explore this phenomenon in people with ID.

Method: Firstly, a scoping review of qualitative studies looking at how trauma impacts on people with ID was conducted, to examine evidence relating to PTG. This was followed by a critical realist thematic analysis of ten semi-structured interviews with people with ID. These interviews explored how people with ID changed following a traumatic event.

Results: In the scoping review, data from 20 papers supported the theoretical feasibility of PTG occurring in people with ID. The empirical study revealed four interconnected themes in how participants changed following trauma: 1) The importance of others listening and helping; 2) The impact of pain and suffering; 3) The power of connecting with others and the need for improved services; 4) Trauma can be a life changing force. Two causal mechanisms were hypothesised to underpin these themes: 1) Participants having a need to seek safety and containment during the trauma and 2) Beliefs and schemas being disrupted and re-formed.

Discussion: These results are consistent with the possibility that people with ID could experience PTG, in addition to trauma related distress. Emphasis was placed on the role of others facilitating PTG in people with ID by providing emotional and practical support. The clinical and research implication of these results are discussed along with the strengths and limitations of the thesis.