Risk-taking in adolescents with mild-to-borderline intellectual disability and/or behavior disorder: An experimental study of cognitive and affective processes

Epidemiological studies indicate that real-life risk taking, such as sexual risk-taking, substance abuse and delinquency, is increased in adolescents with Mild-to-Borderline Intellectual Disability (MBID) compared to the general population. MBID is defined by an IQ between 50 and 85 in addition to (social) adaptive problems. Prevalence of childhood Behavior Disorder (BD) such as attention deficit hyperactivity disorder or disruptive behavior disorder is quite high in this population (i.e., estimated at 25%). In this thesis we aimed to study the factors underlying such risk-taking in adolescents with MBID and Behavior Disorders (BD). We did this in a factorial design that included adolescents with neither MBID nor BD (typically developing), BO-only, MBID-only and both MBID+BD. The factors that were studied in this thesis were cognitive control, cognitive decision-making, affective decision-making and susceptibility to peer-influence. Adolescents with MBID-only were characterized by deficits in cognitive control and cognitive decision-making and by an increased susceptibility to peer-influence. Adolescents with MBID+BD were characterized by a deficit in cognitive decision-making and an increased susceptibility to peer-influence. These deficits in cognitive control and cognitive decision-making together with an increased susceptibility to peer-influence may well explain increased real-life risk-taking in the MBID population. The findings presented in this thesis stress the importance of adequate long-term support and care for adolescents with MBID. Adequate preventive interventions that reduce the impact of deficits in cognitive control, cognitive decision-making and susceptibility to peer-influence may prevent the potential devastating consequences of sexual risk-taking behavior, substance abuse and delinquency in the MBID population.