Risk markers associated with challenging behaviours in people with intellectual disabilities: a meta-analytic study

J Intellect Disabil Res. 2003 Sep;47(Pt 6):405-16. doi: 10.1046/j.1365-2788.2003.00517.x.


A meta-analysis of prevalence and cohort studies conducted over the last 30 years was carried out to identify risk markers for challenging behaviour shown by individuals with intellectual disabilities (IDs). A total of 86 potential studies was identified from the review, with 22 (25.6%) containing sufficient data to enable a statistical analysis to be conducted. Results indicated that males were significantly more likely to show aggression than females, and that individuals with a severe/profound degree of ID were significantly more likely to show self-injury and stereotypy than individuals with a mild/moderate degree of ID. Individuals with a diagnosis of autism were significantly more likely to show self-injury, aggression and disruption to the environment whilst individuals with deficits in receptive and expressive communication were significantly more likely to show self-injury. In most cases, tests for heterogeneity were statistically significant, as expected. The meta-analysis highlighted the paucity of methodologically robust studies of risk markers for challenging behaviours and the lack of data on incidence, prevalence and chronicity of challenging behaviour in this population.

Publication types

  • Meta-Analysis

MeSH terms

  • Adolescent
  • Adult
  • Aggression / psychology*
  • Child
  • Humans
  • Intellectual Disability / psychology*
  • Risk Factors
  • Self-Injurious Behavior / psychology
  • Social Behavior*