Adolescents with Borderline Intellectual Functioning: Psychopathological Risk
Masi, Gabriele, Marcheschi, Mara, Pfanner, Pietro, Adolescence
This paper presents a qualitative analysis of cognitive and emotional functioning in intellectually borderline adolescents (IQ ranging from 71 to 84) and the consequences for personality and social development. Psychopathological risk, particularly in terms of mood disorders, conduct disorders, and intellectual deterioration, is analyzed, with the distinction made between "excited" and "inhibited" forms. Conceptualizations intellectually borderline adolescents have of their own mental functioning are described in light of the notion of cognitive self--the ability to understand and control internal and external reality. The implications for psychotherapy and rehabilitation are discussed.
In adolescence there is a close relationship between emotional development and cognitive development (Masi, Poli, & Marcheschi, 1994). Just as emotional disorders can interfere with intellectual functioning, cognitive difficulties can be a risk factor in personality development. Cognitive dysfunction can interfere with conceptualizations of reality, reduce the ability of adolescents to deal successfully with emotional tensions as well as pubertal transformations, and disrupt relations between the individual and the outside world. These developmental risks are also present in persons who are intellectually borderline according to the DSM-IV (American Psychiatric Association, 1994) and the ICD-10 (World Health Organization, 1992)--those having an IQ ranging from 71 to 84. They are more than one standard deviation below the average, but do not fall into the diagnostic category of mental retardation (IQ less than 70), which is more than two standard deviations below the average. The DSM-IV includes poor intellec tual functioning among "additional conditions that may be a focus of clinical attention."
A qualitative analysis of cognitive development in Piagetian terms reveals a delay for intellectually borderline adolescents: concrete operational thought is generally achieved after age 10-12; formal operational thought is seldom reached. They also display rigid cognitive functioning (e.g., the inability to modify conceptualizations and difficulty in considering problems from another point of view). Further, the ability to plan, analyze, and undertake tasks is often limited. There is poor awareness of their own thought processes, which therefore are not used to the fullest. Their approach to learning is passive, with a tendency to resort to memorizing, which becomes insufficient when the verbal load is excessive. Impairment is greater in the more original and creative areas of mental functioning, such as logical reasoning and metacognitive abilities (Masi, Marcheschi, & Pfanner, 1996). There is often low self-esteem, characterized by the conceptualization of a cognitively incompetent self: the youth does no t feel confident about the possibility of control over internal and external realities and over his or her own future. The difficulties tend to increase as scholastic demands become more complex. This tendency is not necessarily observed in the extrascholastic cognitive competencies that influence social interaction or job performance; in fact, many daily activities, including numerous work tasks, do not require logico-formal thought and can be carried out by the cognitively borderline. Consequently, when schooling ends, adaptation seems to depend less on cognitive factors and more on personality organization, relational attitudes, ability to control emotions and impulses, and self-confidence. For this reason, psychopathological assessment becomes particularly important.
The psychopathological risk of the mentally retarded has been pointed out--their cognitive deficit is a significant indicator of vulnerability (Bregman, 1991; Masi, Marcheschi, & Pfanner, 1996). However, less attention has been paid to those with borderline intellect. Cognitively borderline persons are not equipped with the mental abilities of those with normal intelligence, which ensure better potential for analyzing and working out internal and external conflicts. …