Emergence of SIB in Developmentally Delayed Individuals

自我伤害行为（SIB）在神经发育迟缓和精神发育迟缓的人中惊人地普遍存在。 弱智者，没有已知的原因，也没有商定的治疗方法。SIB表达可能持续存在 在整个生命周期和生命的后期阶段，频率或质量几乎没有变化。两个不同 已经提出了SIB的模式。一种模式由短时间的回合组成， 环境突发事件。第二种模式涉及长时间的SIB， 生物因素。我们实验室最近的研究表明，自我伤害行为是可以预测的， 最好的（在某些情况下只有）通过自己的近代历史。在绝大多数个体中， 是自我延续的，与先前的条件无关。我们在本申请中报告， 表现出“传染性”（即顺序依赖性）SIB模式的人也具有失调的下丘脑- 垂体-肾上腺（HPA）应力轴。我们得出结论，既有生物学上的倾向， 一种维持SIB的生物学后果。这些结论可能为时过早， 有必要对环境背景进行广泛评估。此外，没有数据表明 引发一个传染循环本提案的目的是审查行为、环境和 引发和维持SIB发作的生物学环境。30个人表现出SIB， 所有居住在大型住宅设施中的对照受试者将在体内和实验期间被观察。 行为功能分析（FAB）。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。将收集血液用于测量HPA活性， 在另一天的早晨。具体目标是：（i）确定SIB的模式如何受到 使用顺序和时间依赖性时间在体内和FAB条件下的环境背景 系列分析，（二）确定环境事件的模式是否一致， 在第一次或孤立的SIB发作之前的行为;（iii）确定 HPA应力轴的启动SIB，（iv）应用和评估合理的药物治疗， 选择的受试者队列，这些受试者提供了SIB的生物学（或内部）动机的明确证据。结果 本项目的研究成果将有助于理解SIB的产生和维持。

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.