Tuesday, January 13, 2015

Comorbid Cognitive Disorders in Adolescent Males in Residential Treatment: Prevalence Rates and Treatment Recommendations

Keith D. McGoldrick, Student, Psychology; Ashlee Oroczo, Student, Psychology; Kimberly S. Hutchinson, Alumna; Lawrence Dilks; Sandra Viggiani; Chelsi King; Adrian Julian; Kelly DeRoche

Objective: Adolescent males in residential treatment facilities often present with a combination of psychiatric and cognitive problems. When the presence of a psychiatric disorder is combined with a cognitive disorder treatment can be far more challenging, result in poor prognoses, and require continual need for treatment and services. Furthermore, psychotherapeutic approaches may require adaptation to attend to cognitive impairments. This combination of a psychiatric disorder and a cognitive disorder is defined as a comorbid cognitive disorder (CCD) (Bogacki & McGoldrick, 2014). This poster presents results from a pilot study to assess the CCD prevalence in a residential treatment facility and provide treatment recommendations.

Methods: Chart reviews of 25 adolescent males admitted to a residential treatment facility were reviewed for cognitive and educational functioning. All residents were court ordered for treatment, had at least one previous residential treatment facility admission, and diagnosed with a psychiatric disorder. Wechsler Adult Inelegance Tests, Fourth Edition (WAIS-IV) and Wide Range Achievement Test, Fourth Edition (WRAT-4) scores were analyzed for CCD Criteria.

Results: The age range of males admitted to the locked residential unit ranged from 16 to 19 years old. Mean standard scores for the WAIS-IV were: FSIQ = 77, VCI = 80.4, PRI = 84.2, WMI = 78.9, and PSI = 77.9. WRAT-4 mean scores were: Word Reading = 87.5, Sentence Comprehension = 77.1, Spelling = 87.9, Math Computation = 78.4, and Reading Composite = 81.4.

Conclusions: Often treatment in residential facilities focuses on the psychiatric and behavioral disorders with little focus on the cognitive functioning. The results of this study suggest the prevalence of CCD in adolescent males in a residential treatment facility is high with 72% falling in the borderline range on the WAIS-IV FSIQ. Educationally, the majority held broad academic abilities at or below the fifth grade level: Word Reading = 55%, Sentence Comprehension = 55%, Spelling – 55%, and Math Computation = 70%. These results indicate that these adolescents in residential facilities need to have these comorbid conditions must be treated in unison. Treatment considerations will be discussed.

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