Emergence of SIB in Developmentally Delayed Individuals

发育迟缓个体中 SIB 的出现

• 批准号: 7093716
• 负责人: CURT ALAN SANDMAN
• 金额: $ 41.6万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-20 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7093716
• 关键词: behavioral /social science research tag; clinical research; clinical trials; developmental disease /disorder; drug screening /evaluation; endogenous opioid; environmental stressor; hormone metabolism; housing; human subject; human therapy evaluation; hypothalamic pituitary adrenal axis; mental disorder chemotherapy; mental health epidemiology; naltrexone; patient oriented research; psychopharmacology; self destructive behavior; stress; time resolved data

DESCRIPTION (provided by applicant): Self-injuring behavior (SIB) surprisingly prevalent among neurodevelopmentally delayed and mentally retarded individuals, has no known cause and no agreed upon treatment. Expression of SIB may persist throughout the lifespan and into later stages of life, with little change in frequency or quality. Two distinct patterns of SIB have been proposed. One pattern consists of short bouts that may be maintained by environmental contingencies. A second pattern involves protracted periods of SIB that probably is motivated by biological factors. Recent studies from our laboratory indicated that self-injuring behavior was predicted best (and in some cases only) by its own recent history. In a significant majority of individuals, SIB episodes were self-perpetuating and not related to antecedent conditions. We report in this application that individuals exhibiting "contagious" (i.e. sequentially dependent) patterns of SIB also have a disregulated hypothalamic- pituitary-adrenal (HPA) stress axis. We have concluded that there is both a biological predisposition to, and a biological consequence for, the maintenance of SIB. These conclusions may be premature and a more extensive evaluation of the environmental context is warranted. Moreover, there are no data about what initiates a contagious cycle. The purpose of this proposal is to examine the behavioral, environmental and biological circumstances that initiate and maintain SIB episodes. Thirty individuals exhibiting SIB and thirty control subjects, all residing in a large residential facility will be observed in vivo and during an experimental functional analysis of behavior (FAB). Their behavior, interactions and the environmental conditions will be recorded with computer-assisted procedures. Blood will be collected for measures of HPA activity in the morning on a separate day. The Specific Aims are: (i) Determine how the patterns of SIB are affected by environmental context in both in vivo and FAB conditions using sequentially- and temporally-dependent time series analysis, (ii) Determine if there are consistent patterns of environmental events or relations among behaviors that are antecedent to the first or isolated SIB episodes; (Hi) Determine the relation between the HPA stress axis the initiation of SIB, (iv) Apply and evaluate a rational pharmacological treatment to a selected cohort of subjects who present clear evidence of biological (or internal) motivation for SIB. Findings from this project will contribute to the understanding of the emergence and maintenance of SIB.

描述（由申请人提供）：自伤行为（SIB）在神经发育迟缓和智力迟钝的个体中非常普遍，没有已知的原因，也没有商定的治疗方法。SIB的表达可能持续整个生命周期并进入生命的后期阶段，频率或质量几乎没有变化。提出了两种不同的SIB模式。一种模式由可能由环境偶然性维持的短暂回合组成。第二种模式涉及长期的SIB，可能是由生物因素引起的。我们实验室最近的研究表明，自伤行为最好（在某些情况下只有）通过其自身的近期历史来预测。在绝大多数个体中，SIB发作是自我延续的，与先前的条件无关。我们在本应用中报告，表现出SIB“传染性”（即顺序依赖）模式的个体也具有下丘脑-垂体-肾上腺（HPA）应激轴失调。我们的结论是，SIB的维持既有生物学上的倾向，也有生物学上的后果。这些结论可能为时过早，有必要对环境背景进行更广泛的评价。此外，没有数据表明是什么引发了传染周期。本提案的目的是研究引发和维持SIB发作的行为、环境和生物环境。30名患有SIB的个体和30名对照组，均居住在一个大型住宅设施中，将在体内观察和实验功能行为分析（FAB）期间进行观察。它们的行为、相互作用和环境条件将用计算机辅助程序记录下来。将在另一天的早晨采集血液以测量HPA的活性。具体目标是：(i)使用顺序依赖和时间依赖的时间序列分析确定SIB的模式如何受到体内和FAB条件下环境背景的影响；（ii）确定在首次或孤立的SIB发作之前是否存在一致的环境事件模式或行为之间的关系；(1)确定HPA应激轴与SIB发生之间的关系；(4)对有明确证据表明SIB的生物学（或内在）动机的选定受试者队列应用并评估合理的药物治疗。该项目的研究结果将有助于理解SIB的出现和维持。