DOI QR코드

DOI QR Code

Exploring the Clinical Characteristics and Comorbid Disorders of Borderline Intellectual Functioning

  • Minae Kim (Department of Psychiatry, International St. Mary's Hospital, Catholic Kwandong University) ;
  • Keun-Ah Cheon (Department of Child and Adolescent Psychiatry, Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2024.04.08
  • Accepted : 2024.06.17
  • Published : 2024.07.01

Abstract

Borderline intellectual functioning (BIF) is characterized by cognitive impairment and deficits in adaptive functioning. Despite affecting a significant proportion of the population, BIF still remains underdiagnosed and poorly understood. In addition to cognitive impairments across a range of domains, individuals with BIF face a greater risk of academic failure and often require special educational support. They suffer from emotional problems, such as difficulties with emotional awareness, anxiety, depressed mood, and unhappiness. Individuals with BIF are more likely to have an impairment of social and adaptive functioning. Furthermore, individuals with BIF are at higher risk of physical and mental health problems, often receive inadequate treatment, and have a poorer prognosis. This review aims to enhance the understanding of clinicians, educators, and policymakers by providing an overview of the characteristics of BIF and its associated challenges, ultimately contributing to the improvement of support systems for individuals with BIF.

Keywords

References

  1. Peltopuro M, Ahonen T, Kaartinen J, Seppala H, Narhi V. Borderline intellectual functioning: a systematic literature review. Intellect Dev Disabil 2014;52:419-443. https://doi.org/10.1352/1934-9556-52.6.419
  2. Salvador-Carulla L, Garcia-Gutierrez JC, Ruiz Gutierrez-Colosia M, Artigas-Pallares J, Garcia Ibanez J, Gonzalez Perez J, et al. Borderline intellectual functioning: consensus and good practice guidelines. Rev Psiquiatr Salud Ment 2013;6:109-120. https://doi.org/10.1016/j.rpsm.2012.12.001
  3. Gigi K, Werbeloff N, Goldberg S, Portuguese S, Reichenberg A, Fruchter E, et al. Borderline intellectual functioning is associated with poor social functioning, increased rates of psychiatric diagnosis and drug use--a cross sectional population based study. Eur Neuropsychopharmacol 2014;24:1793-1797. https://doi.org/10.1016/j.euroneuro.2014.07.016
  4. Hassiotis A, Strydom A, Hall I, Ali A, Lawrence-Smith G, Meltzer H, et al. Psychiatric morbidity and social functioning among adults with borderline intelligence living in private households. J Intellect Disabil Res 2008;52(Pt 2):95-106. https://doi.org/10.1111/j.1365-2788.2007.01001.x
  5. Cooter KS, Cooter Jr RB. One size doesn't fit all: slow learners in the reading classroom. Read Teach 2004;57:680.
  6. Martinez-Leal R, Folch A, Munir K, Novell R, Salvador-Carulla L; Borderline Intellectual Functioning Consensus Group. The Girona declaration on borderline intellectual functioning. Lancet Psychiatry 2020;7:e8.
  7. Peltopuro M, Vesala HT, Ahonen T, Narhi VM. Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work. J Intellect Disabil Res 2020;64:923-933. https://doi.org/10.1111/jir.12783
  8. Fenning RM, Baker JK, Baker BL, Crnic KA. Parenting children with borderline intellectual functioning: a unique risk population. Am J Ment Retard 2007;112:107-121. https://doi.org/10.1352/0895-8017(2007)112[107:PCWBIF]2.0.CO;2
  9. Pulina F, Lanfranchi S, Henry L, Vianello R. Intellectual profile in school-aged children with borderline intellectual functioning. Res Dev Disabil 2019;95:103498.
  10. Satila H, Jolma LM, Merilainen-Nipuli M, Koivu-Jolma M. Challenges and neuropsychological functioning in children and adolescents with borderline intellectual functioning. Children (Basel) 2022;9:1847.
  11. Galletta D, Califano AI, Micanti F, Santangelo G, Santoriello C, de Bartolomeis A. Cognitive correlates of borderline intellectual functioning in borderline personality disorder. J Psychiatr Res 2020;130:372-380. https://doi.org/10.1016/j.jpsychires.2020.06.016
  12. Alloway TP. Working memory and executive function profiles of individuals with borderline intellectual functioning. J Intellect Disabil Res 2010;54:448-456. https://doi.org/10.1111/j.1365-2788.2010.01281.x
  13. Van der Molen MJ, Van Luit JE, Jongmans MJ, Van der Molen MW. Verbal working memory in children with mild intellectual disabilities. J Intellect Disabil Res 2007;51(Pt 2):162-169. https://doi.org/10.1111/j.1365-2788.2006.00863.x
  14. Agua Dias AB, Albuquerque CP, Simoes MR. Memory and linguistic/executive functions of children with borderline intellectual functioning. Appl Neuropsychol Child 2019;8:76-87. https://doi.org/10.1080/21622965.2017.1384924
  15. Smirni D, Smirni P, Di Martino G, Operto FF, Carotenuto M. Emotional awareness and cognitive performance in borderline intellectual functioning young adolescents. J Nerv Ment Dis 2019; 207:365-370. https://doi.org/10.1097/NMD.0000000000000972
  16. Stathopoulou A, Papaioannou GL, Driga AM. Borderline intelligence, academic and social emotional development: the role of ICTs. World J Adv Res Rev 2023;18:889-900. https://doi.org/10.30574/wjarr.2023.18.3.1145
  17. Kaznowski K. Slow learners: are educators leaving them behind? NASSP Bull 2004;88:31-45. https://doi.org/10.1177/019263650408864103
  18. Karande S, Kanchan S, Kulkarni M. Clinical and psychoeducational profile of children with borderline intellectual functioning. Indian J Pediatr 2008;75:795-800. https://doi.org/10.1007/s12098-008-0101-y
  19. Claypool T, Marusiak C, Janzen HL. Ability and achievement variables in average, low average, and borderline students and the roles of the school psychologist. Alberta J Educ Res 2008;54:432-447. https://doi.org/10.55016/ojs/ajer.v54i4.55249
  20. Kortteinen H, Narhi V, Ahonen T. Does IQ matter in adolescents' reading disability? Learn Individ Differ 2009;19:257-261. https://doi.org/10.1016/j.lindif.2009.01.003
  21. Fernell E, Ek U. Borderline intellectual functioning in children and adolescents - insufficiently recognized difficulties. Acta Paediatr 2010;99:748-753. https://doi.org/10.1111/j.1651-2227.2010.01707.x
  22. Luyten P, Fonagy P. The neurobiology of mentalizing. Personal Disord 2015;6:366-379. https://doi.org/10.1037/per0000117
  23. Alesi M, Rappo G, Pepi A. Emotional profile and intellectual functioning: a comparison among children with borderline intellectual functioning, average intellectual functioning, and gifted intellectual functioning. SAGE Open 2015;5:2158244015589995.
  24. Emerson E, Einfeld S, Stancliffe RJ. The mental health of young children with intellectual disabilities or borderline intellectual functioning. Soc Psychiatry Psychiatr Epidemiol 2010;45:579-587. https://doi.org/10.1007/s00127-009-0100-y
  25. Byrd RS, Weitzman M, Auinger P. Increased behavior problems associated with delayed school entry and delayed school progress. Pediatrics 1997;100:654-661. https://doi.org/10.1542/peds.100.4.654
  26. Ali A, Ambler G, Strydom A, Rai D, Cooper C, McManus S, et al. The relationship between happiness and intelligent quotient: the contribution of socio-economic and clinical factors. Psychol Med 2013;43:1303-1312. https://doi.org/10.1017/S0033291712002139
  27. Hetzroni O, Oren B. Effects of intelligence level and place of residence on the ability of individuals with mental retardation to identify facial expressions. Res Dev Disabil 2002;23:369-378. https://doi.org/10.1016/S0891-4222(02)00139-7
  28. McAlpine C, Kendall KA, Singh NN. Recognition of facial expressions of emotion by persons with mental retardation. Am J Ment Retard 1991;96:29-36.
  29. van Nieuwenhuijzen M, Vriens A, Scheepmaker M, Smit M, Porton E. The development of a diagnostic instrument to measure social information processing in children with mild to borderline intellectual disabilities. Res Dev Disabil 2011;32:358-370. https://doi.org/10.1016/j.ridd.2010.10.012
  30. Lemerise EA, Gregory DS, Fredstrom BK. The influence of provocateurs' emotion displays on the social information processing of children varying in social adjustment and age. J Exp Child Psychol 2005;90:344-366. https://doi.org/10.1016/j.jecp.2004.12.003
  31. Baglio G, Blasi V, Sangiuliano Intra F, Castelli I, Massaro D, Baglio F, et al. Social competence in children with borderline intellectual functioning: delayed development of theory of mind across all complexity levels. Front Psychol 2016;7:1604.
  32. Roberts C, Pratt C, Leach D. Classroom and playground interaction of students with and without disabilities. Except Child 1990;57:212-224. https://doi.org/10.1177/001440299105700304
  33. Leffert JS, Siperstein GN, Widaman KF. Social perception in children with intellectual disabilities: the interpretation of benign and hostile intentions. J Intellect Disabil Res 2010;54:168-180. https://doi.org/10.1111/j.1365-2788.2009.01240.x
  34. Snell ME, Luckasson R, Borthwick-Duffy WS, Bradley V, Buntinx WH, Coulter DL, et al. Characteristics and needs of people with intellectual disability who have higher IQs. Intellect Dev Disabil 2009;47:220-233. https://doi.org/10.1352/1934-9556-47.3.220
  35. Vuijk PJ, Hartman E, Scherder E, Visscher C. Motor performance of children with mild intellectual disability and borderline intellectual functioning. J Intellect Disabil Res 2010;54:955-965. https://doi.org/10.1111/j.1365-2788.2010.01318.x
  36. Westendorp M, Houwen S, Hartman E, Visscher C. Are gross motor skills and sports participation related in children with intellectual disabilities? Res Dev Disabil 2011;32:1147-1153. https://doi.org/10.1016/j.ridd.2011.01.009
  37. Hartman E, Houwen S, Scherder E, Visscher C. On the relationship between motor performance and executive functioning in children with intellectual disabilities. J Intellect Disabil Res 2010;54:468-477. https://doi.org/10.1111/j.1365-2788.2010.01284.x
  38. Dekker MC, Koot HM. DSM-IV disorders in children with borderline to moderate intellectual disability. I: prevalence and impact. J Am Acad Child Adolesc Psychiatry 2003;42:915-922. https://doi.org/10.1097/01.CHI.0000046892.27264.1A
  39. Chen CY, Lawlor JP, Duggan AK, Hardy JB, Eaton WW. Mild cognitive impairment in early life and mental health problems in adulthood. Am J Public Health 2006;96:1772-1778. https://doi.org/10.2105/AJPH.2004.057075
  40. Handen BL, Janosky J, McAuliffe S. Long-term follow-up of children with mental retardation/borderline intellectual functioning and ADHD. J Abnorm Child Psychol 1997;25:287-295. https://doi.org/10.1023/A:1025760302598
  41. Greenspan S. Borderline intellectual functioning: an update. Curr Opin Psychiatry 2017;30:113-122. https://doi.org/10.1097/YCO.0000000000000317
  42. Xenitidis K, Paliokosta E, Rose E, Maltezos S, Bramham J. ADHD symptom presentation and trajectory in adults with borderline and mild intellectual disability. J Intellect Disabil Res 2010;54:668-677. https://doi.org/10.1111/j.1365-2788.2010.01270.x
  43. Simonoff E, Pickles A, Wood N, Gringras P, Chadwick O. ADHD symptoms in children with mild intellectual disability. J Am Acad Child Adolesc Psychiatry 2007;46:591-600. https://doi.org/10.1097/chi.0b013e3180323330
  44. Peterson BS, Pine DS, Cohen P, Brook JS. Prospective, longitudinal study of tic, obsessive-compulsive, and attention-deficit/hyperactivity disorders in an epidemiological sample. J Am Acad Child Adolesc Psychiatry 2001;40:685-695. https://doi.org/10.1097/00004583-200106000-00014
  45. Aman MG, Buican B, Arnold LE. Methylphenidate treatment in children with borderline IQ and mental retardation: analysis of three aggregated studies. J Child Adolesc Psychopharmacol 2003;13:29-40. https://doi.org/10.1089/104454603321666171
  46. Barnevik Olsson M, Holm A, Westerlund J, Lundholm Hedvall A, Gillberg C, Fernell E. Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age. Neuropsychiatr Dis Treat 2017;13:2519-2526. https://doi.org/10.2147/NDT.S143234
  47. Zetlin A, Murtaugh M. Whatever happened to those with borderline IQs? Am J Ment Retard 1990;94:463-469.
  48. Farrington DP. Psychosocial predictors of adult antisocial personality and adult convictions. Behav Sci Law 2000;18:605-622. https://doi.org/10.1002/1099-0798(200010)18:5<605::AID-BSL406>3.0.CO;2-0
  49. van der Meere JJ, van der Meer DJ, Kunert HJ, Borger N, Pirila S. Impulsive responses in children with conduct disorder and borderline intellectual functioning. Child Neuropsychol 2008;14:187-194. https://doi.org/10.1080/09297040701660283
  50. Emerson E, Robertson J. Obesity in young children with intellectual disabilities or borderline intellectual functioning. Int J Pediatr Obes 2010;5:320-326. https://doi.org/10.3109/17477160903473713