Frequency Of Self-injurious Behavior Research Articles

ЛИЧНОСТНЫЕ ОСОБЕННОСТИ ЮНОШЕЙ С САМОПОВРЕЖДАЮЩИМ ПОВЕДЕНИЕМ И С СУБКЛИНИЧЕСКОЙ ДЕПРЕССИЕЙ

The article presents the results of empirical research studying the personal characteristics of young men with self-injurious behavior and subclinical depression. Relevance of this topic is conditioned by the frequency of self-injurious behavior. A general hypothesis of the study was the statement that there are significant differences in the intensity of personality traits in young men with subclinical depression who have a history of self-injurious behavior as opposed to young men with subclinical depression but without self-injurious behavior, and also opposed to the test audience without the symptoms of depression and self-harm. The survey sample consisted of 169 young men aged from 18 to 22 years (average age — 19.2). We applied the methods of testing, polling, subjective scaling, statistical analysis. In the group with subclinical depression and self-harm were noted low self-esteem, high levels of situational anxiety, personal anxiety, proneness to conflict, neuroticism, spontaneous aggressiveness, irritability, and emotional lability. Young men from this group demonstrated lower rates of inherent worth, self-acceptance, self-attachment, mirror self, and sociability than those with subclinical depression but without self-harm. A positive correlation was revealed between the severity of self-harm and situational aggressiveness, proneness to conflict, self-accusation, neuroticism, spontaneous aggressiveness, depression, low self-esteem; a negative correlation was found between the severity of self-harm and inherent worth, self-acceptance, self-attachment and the mirror self. There is a positive correlation between depression and cynicism, hostility, aggressiveness, anxiety, proneness to conflict, irritability, and low self-esteem, and a negative correlation between depression and sociability and openness.

The evolution of self-injurious behaviors in people with intellectual disability and epilepsy: A follow-up study

PurposeLongitudinal studies of the evolution of Self-Injurious Behaviors (SIBs) in people with Intellectual Disability (ID) and epilepsy are not common. This study aimed to analyze the evolution (in terms of remission and persistence) and changes in the type, localization, frequency, and intensity of SIBs. MethodsSIBs were assessed in a sample of 52 people with ID and epilepsy, and re-evaluated after a seven-year interval, using the “Scale for the Assessment of Self-Injurious Behaviors”. The scale was administered to caregivers (parents or health professionals) through a semi-structured interview conducted by a specifically trained psychologist. ResultsThe most frequent types of SIBs identified were: self-biting, self-hitting with objects, self-hitting with hand, object-finger in cavities. The main localizations of SIBs were: hands, mouth, head and cheeks. SIBs were found to be maintained after seven years, for type, localization, frequency, and intensity, in 90.4% of the sample. SIB types were stable over time, as were the affected areas. Global SIB frequency and intensity scores were found to be unchanged. Finally, a positive correlation was found between the frequency of SIBs and levels of intellectual disability. SIBs (frequency and intensity) and seizure frequency showed no correlation. ConclusionGiven the negative impact of SIBs on the adaptation and quality of life of people with ID and epilepsy, we believe that further studies on biological, psychological and environmental aspects are needed in order to identify any potential factors that might explain the persistence of SIBs and to find effective interventions to reduce them.

The treatment of severe self-injurious behavior through sensory stimulation: A case report

Self-injurious behavior of an institutionalized man with profound intellectual disability was treated with a daily 15-min sensory stimulation program, which consisted of moving the arms and hands of the participant, swinging his body, and massage. The frequency of self-injurious behavior was measured in 10-min sessions. Using a reversal design, it was shown that sensory stimulation decreased the participant’s self-hitting behavior significantly, both in intensity and in frequency. Sensory stimulation is recommended for use in those cases in which functional analysis has shown that self-injury may be reinforced by its sensory consequences.

Risk factors for self-injurious, aggressive, and stereotypic behavior in children and youths with visual impairments

To increase the limited knowledge concerning the form and risk factors of self-injurious, aggressive, and stereotypic behavior in children and youths with visual impairments. Parents of 83 children and youths with visual impairments report on the characteristics of visual impairment, the social-communicative competence of their children, and the frequency and severity of self-injurious, aggressive, and stereotypic behaviors. Stereotypic behaviors are reported more often than the other behavioral abnormalities. The frequencies of stereotypic and self-injurious behaviors are correlated with each other. Children with higher social-communicative competence received lower scores in stereotypic and self-injurious behaviors (range of correlation coefficients between –.26 and –.48). Furthermore, the developmental delay of cognitive and adaptive competence is associated with the frequency and severity of these self-injurious behaviors (F = 4.65, p = .012/F > 5.65, p < 0.01). For blind children, the parents describe a higher frequency and severity of stereotypic and self-injurious behaviors. The frequency of self-injurious behavior is lower for children in an integrative setting. Frequency and severity of stereotypic and self-injurious behavior varies with characteristics of the child’s visual impairment and additional disabilities. This association is not supported for aggressive behaviors.

Nonsuicidal Self-Injury and Suicidal Self-Injury: A Taxometric Investigation

The present research examined the latent structure of self-injurious behavior (SIB) to determine whether suicidal self-injury (SSI) and nonsuicidal self-injury (NSSI) reflect categorically distinct types of SIB or dimensional variations of the same construct. Participants consisted of 1,525 female undergraduates across several universities in the United States who completed the Survey of College Mental Health and Well Being and endorsed a history of SIB. Empirically derived indicators representing intent to die, suicidal history, frequency of SIB, severity of SIB, and number of methods of SIB were submitted to three mathematically independent taxometric procedures. Results of multiple consistency tests converged to indicate that the latent structure of SIB is continuous, with individuals who engage in SSI and NSSI differing in degree rather than kind. The implications of these dimensional findings for the theoretical conceptualization, assessment, and treatment of SIB are discussed.

Are opioid antagonists effective in reducing self‐injury in adults with intellectual disability? A systematic review

Self-injury in people with intellectual disability (ID) may be due to variety of factors both environmental and biological. As the drive in UK is to manage people with ID and problem behaviours in the community, it is important to critically examine all treatment options available. As abnormalities in the endogenous opioid system may be a factor in some people with ID, we undertook a systematic review to evaluate the evidence for the effectiveness of opioid antagonists. Four electronic databases were searched for relevant journal articles. In addition, cross-referencing of pertinent reviews and a hand search for articles in major international ID journals between the years 2010 and 2012 was carried out to ensure that all relevant articles were identified. We also searched databases for unpublished clinical trials to overcome publication bias. Each database was searched up to present (February 2013) with no restrictions on the date of publication. The search terms consisted of broad expressions used to describe ID and autistic spectrum disorder as well as terms relating to opioid antagonists and specific drugs. All studies identified by the electronic database search and hand search were examined on the basis of title alone for relevance and duplication. The abstracts of the remaining papers were then scrutinised against the inclusion criteria. Where abstracts failed to provide adequate information, the full texts for these papers were obtained. All the full texts were then evaluated against the inclusion proforma. Two reviewers carried out all the stages of the process independently. The reviewers met to discuss their selections and where disagreements arose, these were settled by discussion with a member of the study group. Data from each study meeting the inclusion criteria was extracted on a pre-piloted data extraction form. The quality of each study was further assessed using the Jadad scale, a tool developed to assess the quality of randomised controlled trials. Out of 10 randomised control trials eight reported a reduction in the frequency of self-injurious behaviour. This meant that 62 participants out of 124 (50%) showed an improvement of which 61 were statistically significant. Forty-nine participants had autism. Eleven (9%) had minor side-effects. The improvement was more marked in people with severe and profound ID and was not affected by the coexistence of autism. This review suggests that some people respond to opioid antagonists with a reduction in self-injury but the trials do not predict who they may be. Future research may identify this sub-group when opioid antagonists may prove to be a useful addition in the pharmacotherapy of self-injury.

Association between regression and self injury among children with autism

Self injurious behaviors (SIBs) are challenging clinical problems in individuals with autism spectrum disorders (ASDs). This study is one of the first and largest to utilize inpatient data to examine the associations between autism, developmental regression, and SIBs. Medical records of 125 neurobehavioral hospitalized patients with diagnoses of ASDs and SIBs between 4 and 17 years of age were reviewed. Data were collected from medical records on the type and frequency of SIBs and a history of language, social, or behavioral regression during development. The children with a history of any type of developmental regression (social, behavioral, or language) were more likely to have a diagnosis of autistic disorder than other ASD diagnoses. There were no significant differences in the occurrence of self injurious or other problem behaviors (such as aggression or disruption) between children with and without regression. Regression may influence the diagnostic considerations in ASDs but does not seem to influence the clinical phenotype with regard to behavioral issues. Additional data analyses explored the frequencies and subtypes of SIBs and other medical diagnoses in ASDs, with intellectual disability and disruptive behavior disorder found most commonly.

Behavior Problems in Individuals with Cornelia de Lange Syndrome: Population-Specific Validation of the Behavior Problem Inventory-01

The purpose of this study was to validate the Behavior Problem Inventory-01 (BPI-01; Rojahn J Autism Dev Disord 31:577–588, 2001) in a population of 179 individuals with Cornelia de Lange Syndrome (CdLS) and to extend the literature on the behavioral phenotype of individuals with CdLS. We also set out to determine the relationship between the frequency of self-injurious behavior (SIB), stereotyped behavior, and aggressive/destructive behavior topographies with the level of intellectual disability (ID). The BPI-01 among the individuals with CdLS showed a sufficient factor structure and internal consistency of each of the three assessed construct (SIB, stereotyped behavior, and aggressive/destructive behaviors). Similar to the findings in other populations with intellectual disabilities, those with severe/profound intellectual impairment exhibited significantly more frequent SIB and stereotypic behavior than those with moderate or mild intellectual impairment or average intellectual abilities while no statistically a differences were noted for aggressive behavior across levels of intellectual impairment. There is a need for uniformity of assessment tools across different study to improve our ability to compare results across different prevalence studies.

Explanations of Firesetting in Mentally Disordered Offenders: A Review of the Literature

This paper reviews current explanations of firesetting in adult mentally disordered offenders. In particular, attention is given to contemporary research that has examined developmental and background characteristics, personality and associated traits, motivation for firesetting, neurobiological explanations, psychiatric diagnoses, and frequency of self-injurious behavior, including suicide. The likelihood of recidivism and associated risk factors is also considered. Evaluation of the existing research has highlighted that even though a significant proportion has been conducted with psychiatric populations, little is understood about firesetting by mentally disordered offenders. In addition, little research has been conducted that compares mentally disordered firesetters to both other mentally disordered offenders and non-mentally disordered offenders. Recommendations are made for future research to further develop knowledge of this behavior.

Investigating the Relationship between Self-Injurious Behavior, Social Deficits, and Cooccurring Behaviors in Children and Adolescents with Autism Spectrum Disorder.

Research suggests that self-injurious behavior (SIB) is related to social deficits and cooccurring problem behaviors in children and adolescents with autism spectrum disorder. A sample of 95 participants with ASD was assessed on presence and frequency of SIB (Behavior Problems Inventory), social deficits (the Matson Evaluation of Social Skills with Youngsters-II) and cooccurring problem behaviors (ASD-Comorbidity-Child version). A model was created and tested to explain the relationship between these variables. Results showed that the model was acceptable in presenting the relationships between these variables. This information could be used to help predict which individuals are at risk of developing further cooccurring behavioral problems and determine risk markers for the development of social deficits.

Behavioural interventions for self injurious behaviour: a review of recent evidence (1998–2008)

Accessible summary One in four people with a severe learning disability harm themselves. This affects their health and quality of life. This study looks at research on helping people who harm themselves. More research needs to be done to find better ways of helping people who harm themselves. SummaryEstimates suggest that up to one quarter of people who have a severe learning disability engage in self injurious behaviour (SIB). SIB poses serious risks, both to the person’s physical health and their quality of life. Behavioural approaches have made a contribution to supporting people who engage in SIB, although the last review of these approaches was completed in 2001. The current study provides an update to this review, and has considered papers published over the last 10 years. A systematic search of peer reviewed journals and the ‘grey’ literature identified 34 relevant documents, the majority of which were single case studies. These papers tended to report only on changes in the frequency of SIB during the intervention; one cannot conclude, therefore, about the long term efficacy and generalisability of these approaches. Reductions in SIB were highly variable, often produced in controlled environments and with the use of aversive interventions. The current study presents implications for research and clinical practice and highlights the need for more research reporting on the effectiveness of new interventions such as positive behavioural support.

Predicting Self-Injury in BPD: An Investigation of the Experiential Avoidance Model

This study investigated the contribution of indices of experiential avoidance to prediction of frequency and lethality of self-injurious behaviour (SIB) in a female BPD sample (N = 71) with high levels of SIB and histories of poor treatment outcomes. The experiential avoidance model (EAM) tested included motivations for SIB, coping style and DSM-IV Avoidant PD criteria. Distinct findings for suicidal and non-suicidal SIB were noted. In partial support of the model, motivations related to relief from negative emotions positively predicted frequency of non-suicidal, but not suicidal, SIB. Avoidant PD traits predicted a pattern of more frequent, less risky non-suicidal SIB. However, reliance on avoidant coping strategies predicted lethality but not frequency of SIB, while self-blaming coping and SIB motivations related to a desire to influence others predicted frequency of non-suicidal SIB. Results suggest the need for investigation of a more complex model of the antecedents and functions of SIB that includes the contribution of Avoidant PD traits.

Self-injurious behavior and tuberous sclerosis complex: Frequency and possible associations in a population of 257 patients

Self-injurious behavior (SIB) has been observed in people with tuberous sclerosis complex (TSC), although the frequency of SIB in TSC is largely unknown. SIB is associated with intellectual and developmental disabilities, but there is no single cause of SIB. We retrospectively examined the frequency of SIB in a population of 257 patients with TSC and determined possible associations with SIB. We found a 10% frequency of SIB in our TSC population. When compared with patients without psychiatric symptoms, we identified a significantly higher rate of electroencephalographic interictal spikes in the left frontal lobe and a significantly lower number of tubers in the left occipital, parietal, and posterior temporal lobes. We also found that frequency of TSC2 mutation, history of infantile spasms, history of seizures, mental retardation, and autism are significantly associated with SIB.

Comparison of behavioral intervention and sensory-integration therapy in the treatment of self-injurious behavior

The current study investigates the comparative effects of sensory-integration therapy and behavioral interventions on rates of self-injurious behavior (SIB) in a 9-year-old boy with diagnosis of autism. A functional analysis was conducted to identify the variables maintaining the self-injurious behavior. This analysis demonstrated that SIB was maintained by negative reinforcement as a result of escaping or avoiding demand situations. A sensory-integration therapy and a behavioral intervention were compared within an alternating treatments design. Results from this study clearly demonstrate that the behavioral intervention was more effective in reducing SIB than the sensory-integration therapy. Finally, in the best treatment phase, the behavioral intervention only was implemented and further reduction was observed in the frequency of SIB.

Is There a Link between Traumatic Experiences and Self-Injurious Behaviors in Eating-Disordered Patients?

To find out more about the relationship between the presence of self-injurious behavior (SIB) and a history of traumatic experiences, we studied this link in 70 patients with an eating disorder (ED). The sample showed a high frequency of SIB (38.6%), particularly in patients with bulimia nervosa. We also found high percentages of self-reported experiences of physical (32.3%) and sexual abuse (47.7%). The presence of SIB turned out to be associated with a history of physical and/or sexual abuse. Patients who had suffered interpersonal abuse before the age of 15 were more likely to develop self-destructive behaviors. In line with other investigations, we found that high levels of dissociation and self-criticism differentiated sexually abused ED patients with SIB from those without SIB. We discuss some clinical implications of our findings, with suggestions for treatment.

Relation between pain and self-injurious behavior in nonverbal children with severe cognitive impairments

Objectives To explore whether self-injurious behavior (SIB) alters pain expression in children with severe cognitive impairments and the relation between SIB and chronic pain. Study design Caregivers of 101 nonverbal children 3 to 18 years of age (55% boys) completed the Non-Communicating Children's Pain Checklist-Revised (NCCPC-R) retrospectively and for an observed pain episode. Caregivers of children with SIB (n = 44) completed the Behavior Problems Inventory, the Self-Injury Grid, and the Self-Injury and Self-Restraint Checklist. Results Multivariate analysis of variance indicated that NCCPC-R scores did not differ between children with and those without SIB. However, t tests indicated that children with chronic pain (n = 13) self-injured less body surface (P =.01) and fewer body sites (P =.04) than did children without (n = 31). Multiple Correspondence Analysis generated 2 dimensions (49% variance), suggesting a distinction between two SIB forms: (1) high frequency of SIB to the head/hand and absence of chronic pain and (2) less frequent SIB near the site of pain. Conclusions Children with severe cognitive impairments who display SIB do not have reduced pain expression, and chronic pain may influence the frequency and location of SIB. Further research should examine the usefulness of these findings for management of SIB and pain. (J Pediatr 2003;142:498-503 )

Self-injurious behaviour in persons with a mental handicap: an epidemiological study in an Irish population

AbstractObjective: The repeated, self-inflicted, non-accidental injury known as Self Injurious Behaviour (SIB) is a cause of severe stress to carers and a challenge to multi-disciplinary teams working with people with a mental handicap. A need for Irish data on this problem was answered by collecting a representative cohort and following its members up to record the prevalence of SIB.Method: The group studied included all people with an IQ of less than 50 (that is those in the moderate, profound and severe range of intellectual ability) whose place of origin was within the geographical borders of a single community care area. Following a preliminary tracing process, each person was followed up for one calendar month using a specifically prepared format to record daily occurrence of SIB.Results: The group resulting from the tracing process consisted of 429 people (= 0.4% of the total population), 62 (=14 %) of this group exhibited SIB, during the time of the study. Of the demographic variables studied SIB was found to be related to IQ. Of those who self-injured those who showed multiple topographies and those who showed the greatest frequency of SIB were more likely to be found in the population who lived in a residential facility.Conclusions: SIB is related to IQ but in a non-linear way suggesting that factors other than IQ militate against more severely handicapped people displaying this behaviour. SIB is not caused by living in a residential centre however our results suggest that living in a residential facility is the result of displaying SIB. This study suggests that implications for future treatment approaches and service provision for those exhibiting SIB in Ireland can be made with reference to research from other countries.

Cyclical self-injurious behavior, contingent water mist treatment, and the possibility of rapid-cycling bipolar disorder

Cyclical self-injurious behavior (SIB) in the form of self-slapping was treated in a 45-year-old, profoundly retarded woman who had a life-long history of SIB. Her SIB alternated between high (mean=8.54 responses per min; SD=6.77 and low (mean=0.05 responses per min; SD=0.20) frequencies every 8 weeks on average. Instances of self-slapping produced water mist treatment paired with a verbal command, “No hitting”. Absence of selp-slapping and/or completion of a work task led to a variety of outcomes, including brief back rubs, sips of water, small edibles, and praise. Water mist treatment reduced the frequency of SIB within treatment days during high frequency periods, but produced no reduction across treatment days. Treatment onset was associated with a slight increase in the frequency of SIB during three of the five low frequency periods. However, water mist treatment suppressed SIB completely in sessions during low frequency periods and the suppression continued across treatment days. Water mist treatment produced no discernible changes in the length of the high and low frequency periods of SIB.

Naltrexone attenuates self-injurious behavior in mentally retarded subjects

The effect of naltrexone on the frequency of self-injurious behavior (SIB) was investigated in 6 male subjects with profound mental retardation. Following a double-blind placebo-controlled crossover design, naltrexone was administered in a dose of 50 mg once daily for 3 consecutive weeks. In 2 of 5 subjects, a significant decrease of SIB frequency could be demonstrated, and in 1, a tendency to a reduction was found. No effect on duration of restrain time was found in 3 subjects. These data suggest that disturbances of the endogenous opioid systems may be involved in the pathophysiology of SIB of certain patients.

A possible role of proopiomelanocortin peptides in self-injurious behavior

Herman, Barbara H.: A possible role of proopiomelanocortin peptides In self-injurious behavior. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1990, 14 (supple): S109–S139. 1. 1. The hypothesis that opioids may be involved in self-injurious behavior is supported by fifteen years of basic animal research suggesting that opioid peptides of the brain and spinal cord participate in the modulation of antinociception in animals and research of animal models for self-injurious behavior utilizing exogenously administered opiate agonists. 2. 2. Clinical biochemical and pharmacological research conducted over the past five years has also suggested the possibility that opiold peptides may play an important etiological role in the elaboration of self -injurious behavior in some individuals. 3. 3. An oploid overactivity self-injurious hypothesis is supported by results of one study indicating elevated Fraction II opioids (enkephalins) in the lumbar-thecal cerebrospinal fluid of self-injurious children compared to controls and by the five out of six published studies demonstrating statistically significant decreases in the frequency of self-Injurious behavior with the opiate antagonist, naltrexone. 4. 4. A very recent Investigation has suggested that some self-injurious individuals show abnormalities in their plasma proopiomelanocortin peptide response to naltrexone, thereby indicating a possible dysfunction in the responsitivity of the proopiomelanocortin system of the hypothalamic — pituitary — adrenal axis of these individuals. 5. 5. These data and results of other investigations have resulted in the elaboration of the original opioid hypothesis to a more comprehensive biochemical model that focuses on this proopiomelancortin dysregulation. 6. 6. Because of biochemical and functional Interrelationships between proopiomelancortin peptides and certain other neurochemical systems in the brain, it is proposed that pineal melatonin and serotonin may also be involved in this dysregulation. Further basic and clinical research will be needed to test the proposed biochemical model for self-injurious behavior.