Persistence and predictors of self-injurious behaviour in autism: a ten-year prospective cohort study
Persistence and predictors of self-injurious behaviour in autism: a ten-year prospective cohort study
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DOI：
10.1186/s13229-019-0307-z
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发表时间：
2020-01-20
期刊：
影响因子：
6.2
通讯作者：
Richards, Caroline
中科院分区：
文献类型：
--
作者：
Laverty, Catherine;Oliver, Chris;Richards, Caroline
背景自我伤害行为，如头部撞击，头发拉扯，皮肤采摘和抓挠，在自闭症患者中很常见。尽管患病率很高，但缺乏纵向研究来完善风险和机制模型并为服务规划提供信息。在这项纵向研究中，我们调查了10年以上自闭症患者的自伤情况，以确定与持续自伤相关的行为和人口统计学特征。方法67名自闭症患者的照顾者在10年后的T-1（平均[SD]年龄13.4 [7.7]）和T-3（平均[SD]年龄23.9 [7.7]）完成了与自我伤害和相关风险标志物相关的问卷调查。其中46人还参加了T-2（首次参加后3年）。分析评估了自伤的人口统计学和行为风险标志物，以及在T（1）和T-2评估的项目的预测价值。结果：在10年的时间里，44%的个体持续存在自伤，冲动（p <0.001）和过度活跃（p = 0.002）的行为特征被确定为持续性的风险标志。自我伤害的预测模型来自LASSO分析，基线冲动，兴趣和快乐，刻板行为，社会沟通和适应功能预测自我伤害超过10年。结论在这个独特的纵向调查持续性自伤的非临床样本的自闭症患者超过10年的时间，我们已经确定了一个新的，强大的和稳定的配置文件的行为特征与持续性自伤。研究结果支持早期干预策略，针对被确定为发展自我伤害行为的风险较高的个人。
Background Self-injurious behaviours, such as head banging, hair pulling, skin picking and scratching, are common in individuals with autism. Despite high prevalence rates, there is a paucity of longitudinal research to refine models of risk and mechanism and inform service planning. In this longitudinal study, we investigated self-injury in a cohort of individuals with autism over 10 years to identify behavioural and demographic characteristics associated with persistent self-injury. Methods Carers of 67 individuals with autism completed questionnaires relating to the presence of self-injury and relevant risk markers at T-1 (mean [SD] age in years 13.4 [7.7]) and T-3 (mean [SD] age in years 23.9 [7.7]) 10 years later. Forty-six of these also took part at T-2 (3 years after initial participation). Analysis assessed demographic and behavioural risk markers for self-injury, as well as the predictive value of items assessed at T(1)and T-2. Results Self-injury was persistent in 44% of individuals over the 10-year period, with behavioural characteristics of impulsivity (p < .001) and overactivity (p = .002), identified as risk markers for persistence. A predictive model of self-injury was derived from LASSO analysis, with baseline impulsivity, interest and pleasure, stereotyped behaviour, social communication and adaptive functioning predicting self-injury over 10 years. Conclusions In this unique longitudinal investigation into the persistence of self-injury in a non-clinical sample of individuals with autism over a 10 year period, we have identified a novel, robust and stable profile of behavioural characteristics associated with persistent self-injury. Findings support an early intervention strategy targeted towards individuals identified to be at a higher risk of developing self-injurious behaviour.