Emergence of SIB in Developmentally Delayed Individuals

发育迟缓个体中 SIB 的出现

• 批准号: 7581084
• 负责人: CURT ALAN SANDMAN
• 金额: $ 47.92万
• 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/7581084
• 关键词: Address; Adrenal Glands; Affect; Behavior; Behavioral; Biological; Biological Factors; Blood; Chronic; Computer Assisted; Critiques; Data; Dependence; Dependency; Dimensions; Environment; Equilibrium; Evaluation; Event; Exhibits; Frequencies; Genetic; Hydrocortisone; Hypothalamic structure; Individual; Laboratories; Life; Living Arrangement; Longevity; Maintenance; Measures; Mentally Disabled Persons; Methods; Motivation; Naltrexone; Outcome; Pattern; Pharmacological Treatment; Phenotype; Pituitary Gland; Population; Predisposition; Probability; Procedures; Recording of previous events; Regulation; Reporting; Residential Facilities; Self-Injurious Behavior; Sleep; Staging; Stress; System; Testing; Time; Time Series Analysis; Validation; base; behavior change; cohort; endogenous opioids; environmental change; improved; in vivo; injured; novel; premature; response

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.

自残行为 (SIB) 在神经发育迟缓和精神障碍患者中出奇地普遍 智力低下的个体，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。两种截然不同的 已经提出了 SIB 模式。一种模式由短回合组成，可以通过以下方式维持： 环境突发事件。第二种模式涉及长期的 SIB，这可能是出于动机 由生物因素。我们实验室最近的研究表明，自残行为是可以预测的 最好的（并且仅在某些情况下）是根据其最近的历史来确定的。在绝大多数人中，SIB 发作 是自我延续的，与先前条件无关。我们在此申请中报告，个人 表现出 SIB 的“传染性”（即顺序依赖性）模式也导致下丘脑失调 垂体-肾上腺 (HPA) 应力轴。我们得出的结论是，存在生物倾向，并且 维持 SIB 的生物学后果。这些结论可能还为时过早 有必要对环境背景进行广泛评估。此外，没有任何数据表明 启动传染循环。该提案的目的是检查行为、环境和 引发和维持 SIB 发作的生物环境。三十人参加 SIB 展览，三十人参加 控制受试者，所有居住在大型住宅设施中的受试者都将在实验期间进行体内观察 行为功能分析（FAB）。他们的行为、互动和环境条件将 用计算机辅助程序记录。将采集血液以测量 HPA 活性 另一天的早晨。具体目标是： (i) 确定 SIB 的模式如何受到以下因素的影响： 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，(ii) 确定环境事件或之间的关系是否存在一致的模式 第一次或孤立的 SIB 发作之前的行为； （嗨）确定之间的关系 HPA 应激轴引发 SIB，(iv) 对患者应用并评估合理的药物治疗 选定的一组受试者提供了 SIB 生物学（或内部）动机的明确证据。发现 从这个项目中将有助于理解SIB的出现和维护。