|dc.description.abstract||Background: Individuals with learning disabilities (LDs) have an increased risk for mental illness. The association between LDs and mental illness varies across sex, age, and among those with co-morbidities. While LDs and the emerging adult developmental period are independent risk factors for mental illness, the association between LDs and mental illness in emerging adults is unclear. Therefore, the mental health of emerging adults with LDs is a public health concern worth further consideration.
Objectives: The purpose of this study was to 1) investigate psychological distress in emerging adults with LDs, 2) explore the clinical importance of the association between LDs and mental illness in emerging adults, and 3) examine the modification of age, sex, attention-deficit/hyperactivity disorder (ADHD), and disability impairment on the association between LDs and mental illness.
Methods: The current study utilized the 2012 Canadian Community Health Survey – Mental Health (n=25,113), which was a cross-sectional investigation of Canadians ≥15 years from the ten Canadian provinces. The study sample was composed of individuals aged 15-29 years (n =5630), with similar age and sex distributions. The exposure was self-reported diagnosis of an LD, and the outcome was Kessler Psychological Distress (K6) Scale scores. Multiple linear regression was used to examine the association between learning disabilities and continuous psychological distress scores, and logistic regression was used to examine the association between learning disabilities and binary K6 scores (scores <13 or ≥13). Moderation by age, sex, ADHD, and World Health Organization Disability Assessment Schedule (WHODAS) 2.0 scores was determined. Multicollinearity and model fit were evaluated. All analyses utilized survey weights.
Results: The weighted frequency of those with LDs was approximately 421 (7.5%). Emerging adults with LDs displayed a higher mean score (1.6 vs. 1.3) and had a greater proportion with scores greater than or equal to the cut-point of 13 (7.0% vs. 2.5%) compared to those without LDs. There was no concern for multicollinearity. After controlling for demographic, psychosocial, and health covariates, emerging adults with LDs (1) displayed higher log-transformed K6 scores (β=0.10, p=0.149, adjusted R2=0.26), and (2) had a higher odds of K6 scores ≥13 [Odds Ratio (OR)=1.17, 95% CI=0.60-2.27] compared to those without LDs. However, the full linear and logistic regression models did not demonstrate statistical significance. Additionally, there was no statistically significant moderation in the adjusted linear regression between LDs and continuous K6 scores. However, males (OR=2.39, 95% CI=1.01-5.67) and those aged 15-19 years (OR=0.18, 95% CI=0.04-0.78) or 25-29 years (OR=3.87, 95% CI=1.05-14.30) had higher odds of K6 scores above the clinical cut-point. Stratification by ADHD-status and WHODAS 2.0 scores was not statistically significant.
Conclusion: The current epidemiological study confirmed that emerging adults with LDs had clinically important higher K6 scores and were more likely to have K6 scores at or above the cut-point compared to emerging adults without LDs. Additionally, age and sex were significant moderators in the association. The study findings suggest a need for improved awareness and resources in higher education and the workplace for emerging adults with learning disabilities.||en