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Misattribution in the Detection of Alzheimers disease in persons with Downs syndrome Heidi Layton

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Title: Misattribution in the Detection of Alzheimers disease in persons with Downs syndrome Heidi Layton


1
Misattribution in the Detection of Alzheimers
disease in persons with Downs syndrome Heidi
Layton Sara Honn Qualls Department of Psychology
  • Method
  • Participants
  • 143 adults from 16 residential or home-based
    DD/ID service agencies in Colorado
  • 102 females (31 males)
  • Age M 39 (SD 12)
  • Education M 15 years (SD 1)
  • Years working w DD/ID M 3.5 (SD 1)
  • Position with agency
  • Direct Support Staff 10
  • Manager 16 (11.0)
  • Nurse/Health Provider 2 (1.4)
  • Supportive Living Staff 8 (5.5)
  • Host Home Provider 7 (4.8)
  • Procedure and Materials
  • Participants were randomly assigned to one of the
    nine vignette conditions
  • Vignette and Time 1 Ratings Each read the
    vignette and rated Appraisal, Action, and
    Attribution (only the peer and expert received
    the Cue ID at Time 1)

Downs Syndrome and Alzheimers Disease
Individuals with Downs Syndrome (DS) are at
increased risk for dementia of the Alzheimers
type. However, Alzheimers disease (AD) often is
undetected, likely due to a lack of knowledge
about age related diseases that leads to
misattribution (Janicki et al., 2002). No
previous research has been done on misattribution
in the detection of AD in individuals with DS.
Attributions and Controllability In persons
with DS, the detection and diagnosis of AD is
particularly difficult because of the already
existing cognitive impairment and other possible
explanations for behavioral changes. Carers of
persons with DS are believed to be at risk for
misattribution particularly in the early stages
of AD. Hyp 1 More intense AD symptoms are more
likely to generate attributions to uncontrollable
processes such as AD. Weiners theory of
helping behavior suggests that help is given to
others when they are faced with uncontrollable
factors that force them to fail at a task
(Weiner, 1980). A person who has failed due to
factors that were controllable will not receive
help. As applied to help-giving for persons
with behavior disorders, previous research shows
that participants are more willing to help an
actor in a vignette if that person is given a
label of AD (an uncontrollable disease process)
vs. Major Depressive Disorder (controllable
disease process). Carers for persons with DS who
misattribute symptoms of AD to other causes can
show reduced or ineffective help-giving and
seeking. Hyp 2 Attributions to uncontrollable
processes will lead to increased help-seeking
compared with attributions to controllable
processes. Social Validation Source Effects
Staff likely rely on input from other people to
clarify the cause of problem behavior. The social
nature of staff roles suggests that social
validation for staff may influence their
decisions about help-seeking, thus directly and
indirectly impacting AD recognition and response.
Two likely sources of social validation of
observed symptoms include health professionals
and peer staff. This study investigates the
effects of social validation, and whether the
source of validation matters. Hyp 3 Social
validation will increase attributions to
uncontrollable processes.
  • Figures

Figure 1
Figure 2

Figure 3

Controllable
Uncontrollable
Conclusion Attributions to disease processes
impact multiple decisions. This includes whether
symptoms are intense, whether the resident should
be pushed to do things he/she may not be able to
do, or whether medical help should be sought.
Residential facilities are highly social
environments, and these data show that the social
nature of decision-making is a powerful influence
over the conceptual framework/attributions which
shapes help-seeking. Continued staff training on
prevalent medical conditions and appropriate
help-seeking interventions are necessary for
early detection and better resident care.
References Janicki, M. P., Dalton, A. J.
(1999). Dementia, aging, and intellectual
disabilities. Castleton, NY Taylor
Francis. Weiner, B. (1980). A cognitive
(attribution)-emotion-action model of motivated
behavior An analysis of judgments of
help-giving. Journal of Personality and Social
Psychology, 39, 186-200. Tarrier, N.,
Barrowclough, C., Ward, J., Donaldson, C., Burns,
A., Gregg, L. (2002). Expressed emotion and
attributions in the carers of patients
Alzheimers disease The effect on carer burden.
Journal of Abnormal Psychology, 111, 340-349.
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