Function-Based Analysis of Psychotrophic Effects on Problem Behavior in IDD

基于功能的精神营养对 IDD 问题行为的影响分析

基本信息

  • 批准号:
    8287256
  • 负责人:
  • 金额:
    $ 38.77万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2012
  • 资助国家:
    美国
  • 起止时间:
    2012-09-01 至 2016-08-31
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Psychotropic medications are prescribed to treat problem behavior (e.g., aggression and self-injury) of persons with intellectual and developmental disabilities (IDD). In the past, these medications were used to chemically restrain individuals with IDD and problem behavior, and this practice resulted in federal involvement to monitor medication use. Despite the changes that have been made in the use of psychotropic medications in the IDD population, a large percentage of the population is prescribed psychotropic medication with a majority of the individuals taking more than one medication (i.e., polypharmacy). This practice is concerning because individuals with IDD have been found to be more susceptible to experiencing adverse side effects (ASE). Furthermore, given difficulties with communication, they are less likely to report these ASEs. Although psychotropic medications are prescribed to treat disruptive behavior, there is ample evidence that demonstrates how behavior can also be treated by addressing environmental variables impacting behavior. Research has also demonstrated that psychotropic medication can exert differential effects on disruptive behavior impacting the circumstances in which behavior occurs. However, these studies have focused on single drug treatments, when in fact; polypharmacy is the reality of treatment. At present, it is unknown if, and if so how, polypharmacy and changes in polypharmacy regimens affect the relationship between behavior and the contingencies maintaining them. Even less is known regarding the role ASEs play in mediating this relationship. Further research needs to be conducted to extend what is known about the impact that polypharmacy regimens and their alterations have on problem behavior and reinforcement contingencies. Furthermore, research needs to determine what role, if any, ASEs play in impacting these behaviors and contingencies. The information yielded from this research could greatly contribute to the most efficacious behavioral and medicinal treatment for individuals with IDD. This line of research will enhance our understanding of how polypharmacy use impacts problem behavior of individuals with IDD, specifically how these medications may mediate the relationship between behavior and the environment in which it occurs. The purpose of the proposed study will be to investigate how polypharmacy use systematically affects problem behavior of persons with IDD. Direct observations will be conducted to monitor behavior throughout the study and analogue functional analyses (AFA) will be conducted when changes are made to polypharmacy regimens. Given previous research findings, we anticipate that changes in medication will produce changes in the results of AFAs. The findings of this research will confirm the importance and need for continued monitoring of behavior function, in addition to monitoring frequency and intensity, of problem behavior in order to determine the most efficacious treatment. Thus far, preliminary research results suggest that after psychotropic medication alterations are made, changes are indeed observed in behavior. The principle investigator has extensive experience, in both clinical and applied research settings, conducting AFAs to evaluate medication effects. Additionally, the principle investigator has ties to the community from which participants would be recruited and has ample students interested in conducting this type of research. Mission of NICHD. The proposed study fits well with NICHD's mission on several levels. First, completion of the specific aims should result in important insights for advancing clinical understanding of how changes in psychotropic medication regimens and potential medication ASEs can affect disruptive behaviors of individuals with IDD. Second, the proposed study is constructed to train undergraduate students to conduct scientific research to ensure the health, productivity, independence, and well-being of all people. PUBLIC HEALTH RELEVANCE: The relevance of this research to public health is that it will empirically validate a more robust method (i.e., continuous monitoring of behavior function) for determining the treatment effectiveness of psychotropic medication for problem behaviors such as aggression and self-injurious behavior in individuals with intellectual disabilities (ID). These behaviors often serve as a barrier for individuals with ID to living in community (versus institutional) settings. Furthermore, the number and combination of medications used to treat these behaviors can produce adverse side effects that can compromise one's quality of life. Based on the findings of this research, the likelihood that psychotropic medication will be used with greater efficacy and in combination with more appropriate behavioral interventions may increase. Furthermore, the outcomes of this research may provide psychiatrists with a new way of monitoring medication effectiveness and ultimately impact how medication is prescribed.
描述(由申请人提供):精神药物用于治疗智力和发育障碍(IDD)患者的问题行为(例如,攻击性和自伤)。在过去,这些药物被用来化学地限制患有IDD和问题行为的个人,这种做法导致联邦政府参与监测用药情况。尽管IDD人群中精神药物的使用发生了变化,但很大比例的人口是开精神药物处方的,大多数人服用一种以上的药物(即多药联用)。这种做法令人担忧,因为人们发现IDD患者更容易出现不良副作用(ASE)。此外,鉴于沟通方面的困难,他们不太可能报告这些ASE。虽然精神药物是用来治疗破坏性行为的,但有充分的证据表明,如何也可以通过解决影响行为的环境变量来治疗行为。研究还表明,精神药物可以对破坏性行为产生不同的影响,影响行为发生的环境。然而,这些研究都集中在单一药物的治疗上,而事实上,多药并存才是治疗的现实。目前,多药联用和多药联用方案的变化是否以及如何影响行为与维持行为的偶然性之间的关系尚不清楚。关于AS在调节这种关系中所起的作用,人们更是知之甚少。需要进行进一步的研究,以扩大已知的多药联合疗法及其改变对问题行为和强化偶发事件的影响。此外,研究需要确定AS在影响这些行为和意外情况方面扮演的角色(如果有的话)。从这项研究中获得的信息可以极大地有助于对IDD患者进行最有效的行为和药物治疗。这一系列研究将增强我们对多药联用如何影响IDD患者问题行为的理解,特别是这些药物如何调节行为与发生环境之间的关系。这项拟议的研究的目的将是调查复合药房的使用如何系统性地影响IDD患者的问题行为。在整个研究过程中,将进行直接观察以监测行为,并将在改变多药疗法时进行模拟功能分析(AFA)。根据以前的研究结果,我们预计药物的变化将导致AFAs结果的变化。这项研究的结果将证实,除了监测问题行为的频率和强度外,继续监测行为功能的重要性和必要性,以确定最有效的治疗方法。到目前为止,初步研究结果表明,在精神药物改变后,确实可以观察到行为的变化。首席调查员在临床和应用研究环境中拥有丰富的经验,进行AFA以评估药物效果。此外,首席调查员与将从其招募参与者的社区有联系,并有足够的学生对进行此类研究感兴趣。NICHD的使命。这项拟议的研究在几个层面上与NICHD的使命非常契合。首先,完成特定的目标应该带来重要的见解,以促进临床理解精神药物用药方案的变化和潜在的用药ASE如何影响IDD患者的破坏性行为。第二,建议的研究旨在培养本科生进行科学研究,以确保所有人的健康、生产力、独立性和幸福感。 公共卫生相关性:这项研究与公共卫生的相关性在于,它将实证验证一种更可靠的方法(即,持续监测行为功能),以确定精神药物对智障人士的攻击性和自伤行为等问题行为的治疗效果。这些 行为常常成为智障人士在社区(而不是机构)环境中生活的障碍。此外,用于治疗这些行为的药物的数量和组合可能会产生不良副作用,可能会损害一个人的生活质量。根据这项研究的发现,精神药物将以更有效的方式使用并与更适当的行为干预相结合的可能性可能会增加。此外,这项研究的结果可能为精神病学家提供一种监测药物有效性的新方法,并最终影响药物的处方方式。

项目成果

期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Characterizing Mood States in Individuals Diagnosed with Bipolar Disorder and Intellectual Disability.
描述被诊断患有双相情感障碍和智力障碍的个体的情绪状态。
Adverse Side Effects of Psychotropic Medication and Challenging Behavior: Pilot Work Assessing Impact.
精神药物的不良副作用和挑战行为:试点工作评估影响。
  • DOI:
    10.1007/s10882-017-9570-0
  • 发表时间:
    2017
  • 期刊:
  • 影响因子:
    1.8
  • 作者:
    Valdovinos,MariaG;Schieber,Elizabeth;McMahon,Meara;Beard,Lisa;Wilkinson,Alyssa;Carpenter,Jaimie
  • 通讯作者:
    Carpenter,Jaimie
Changes in Stereotypical Behavior Following Chlorpromazine Termination: Polypharmcy Effects on Response Class Membership.
  • DOI:
    10.1007/s41252-020-00158-7
  • 发表时间:
    2020-09
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Valdovinos MG;Aguilar M;Piersma D;Wilkinson A;Kennedy CH
  • 通讯作者:
    Kennedy CH
Descriptive Longitudinal Analysis of Stereotypy and Corresponding Changes in Psychotropic Medication.
  • DOI:
    10.1080/17518423.2021.2011461
  • 发表时间:
    2022-07
  • 期刊:
  • 影响因子:
    1.3
  • 作者:
    Piersma, Drew;Aguilar, Marisela;Seibert, Haley;Boyle, Bailey;Griffith, Gabrielle;Valdovinos, Maria G.
  • 通讯作者:
    Valdovinos, Maria G.
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MARIA G VALDOVINOS其他文献

MARIA G VALDOVINOS的其他文献

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{{ truncateString('MARIA G VALDOVINOS', 18)}}的其他基金

MINORITY PREDOCTORAL FELLOWSHIP PROGRAM
少数族裔博士前奖学金计划
  • 批准号:
    6401186
  • 财政年份:
    2001
  • 资助金额:
    $ 38.77万
  • 项目类别:

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