Biobehavioral Analysis of Self-Injury & Pain

描述（由申请人提供）：关于非社会介导的自伤行为的感觉和神经生物学基础知之甚少。在SIB的行为模型中，感觉机制被认为是积极或消极的自动强化因素，但很少有证据表明行为机制和生物机制之间存在直接联系。来自慢性疼痛及其行为后遗症的临床和动物研究的证据支持这样的假设，即某些形式的SIB可能受到改变的疼痛机制的调节。已有的文献和研究者的初步数据为慢性非社会性SIB的感觉功能障碍和疼痛假说提供了初步支持，并指出疼痛的外周和中枢机制在慢性非社会性SIB的表达中发挥了重要作用。本研究的目的是比较社会和非社会介导的SIB病例在一系列与感觉功能和疼痛行为相关的行为和生物学测量。总体目标是完善慢性非社会性SIB的行为和生物学机制的综合分析。为此，我们开发了一套损伤和疼痛的行为和生物学标记，可以可靠地测量发育障碍和SIB患者。遵循垂直研究策略，慢性SIB病例（N = 80）将根据行为机制（即社会与非社会调解）进行功能亚型。每个受试者SIB的代表性样本将被精确测量其形式、频率、强度和身体位置。每位受试者将通过疼痛的行为表达（面部动作单位）、形态学（表皮神经纤维密度）和神经化学（P物质，皮质醇）进一步表征。这项研究将提供第一个机会，系统地研究慢性非社会介导的SIB的疼痛机制。

DESCRIPTION (provided by applicant): Little is known about the sensory and neurobiological basis of nonsocially-mediated self-injurious behavior. In behavioral models of SIB, sensory mechanisms function as putative positive or negative automatic reinforcers but there is little evidence directly linking behavioral and biological mechanisms. Evidence from both clinical and animal studies of chronic pain and its behavioral sequelae supports the hypothesis that some forms of SIB may be regulated by altered pain mechanisms. An established body of literature and the investigator's preliminary data provide initial support for the sensory dysfunction and pain hypothesis of chronic nonsocial SIB and point to an important role for the peripheral and central mechanisms of pain in the expression of chronic nonsocial SIB. The purpose of the proposed study is to compare socially and nonsocially-mediated SIB cases on a set of behavioral and biological measures related to sensory function and pain behavior. The overall goal is to refine an integrative analysis of the behavioral and biological mechanisms underlying chronic nonsocial SIB. Towards this end, we have developed a set of behavioral and biological markers of injury and pain that can be reliably measured in persons with developmental disorders and SIB. Following a vertical research strategy, chronic SIB cases (N = 80) will be functionally subtyped by behavioral mechanism (i.e., social versus nonsocial mediation). Representative samples of each subject's SIB will be precisely measured for its form, frequency, intensity, and body location. Each subject will be further characterized using measures of behavioral expression of pain (facial action units), morphology (density of epidermal nerve fibers), and neurochemistry (substance P, cortisol). This study will provide the first opportunity to systematically investigate mechanisms specific to pain underlying chronic nonsocially-mediated SIB.