Challenging behaviors should not be considered depressive equivalents in individuals with intellectual disabilities....

Previous research has proposed behavioral equivalents for depression, but evidence for behavioral equivalents has been contradictory. The relationship between a measure of depression and several proposed behavioral equivalents of depression was assessed in 693 adults living in a large residential setting. Most were adults with severe or profound intellectual disability. The frequency of language-based measures of depression was very low. A scale to assess depression was constructed based on an item analysis of a larger pool of items. Both item and factor analysis and correlations between scores on the depression scale and individual maladaptive behavior items showed little or no relationship between proposed behavioral equivalents and depression. No support was found for behavioral equivalents of depression. This replicated the findings of Tsiouris, Mann, Patti, and Sturmey (2003). Practitioners are cautioned against using maladaptive behaviors as evidence of depression in people with severe or profound intellectual disabilities.