Identifying Precursors to Severe Problem Behavior

识别严重问题行为的前兆

• 批准号: 10016839
• 负责人: Griffin Wesley Rooker
• 金额: $ 8.08万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-11 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10016839
• 关键词: Address; Aggressive behavior; Behavior; Behavior Therapy; Behavioral; Behavioral Research; Caring; Case Study; Characteristics; Clinical; Collection; Controlled Study; Dangerousness; Data; Data Analyses; Development; Educational process of instructing; Event; Healthcare; Hospitals; Individual; Injury; Intellectual functioning disability; Interruption; Lead; Literature; Low Prevalence; Methodology; Methods; Participant; Population; Probability; Procedures; Psychological reinforcement; Public Health; Publishing; Punishment; Research; Research Design; Risk; Sampling; Schedule; Self-Injurious Behavior; Severities; Signal Transduction; System; Time; base; behavior change; behavioral study; clinical care; clinical practice; design; experimental analysis; inattention; member; premature; prevent; reinforcer; response; secondary analysis; severe behavior problem; treatment strategy

Project Summary/Abstract Severe problem behavior (SPB; e.g., aggression, elopement, and self-injury) engaged in by individuals with intellectual and developmental disability is a major public health concern. These behaviors can be so severe that even a single instance of SPB may result in injury to self or others. One promising treatment strategy involves identifying behavioral indicators that an episode of SPB is imminent and interrupting the escalating sequence of behavior before SPB occurs. These behavioral indicators are called precursors to SPB, and are not as severe or dangerous as SPB. Given that SPB may cause harm to self or others, identifying precursors to SPB is particularly important; however existing research on precursors has been opportunistic, resulting in a loose collection of clinical case reports. The proposed research will examine methods to identify and better understand precursors. Specifically, this research will assess the likelihood of precursors to SPB (Studies 1 and 2) and refine existing methodologies of precursor identification to better understand the specific relation between precursors and SPB (Study 3). This research will be conducted within a sample of 80 individuals who are at the most risk for injury due to the severity of their SPB. In Study 1, we will examine the context in which SPB is occurring using second-by-second data analysis to identify likely precursors through a probability analysis. In Study 2, we will examining how precursors and SPB change across two experimental conditions to determine whether the precursor and SPB are occurring for the same reason. In Study 3, we will determine the relation between the precursor and SPB by preventing the occurrence of the precursor and examining the effect on SPB. In addition, although not the primary focus of this study, secondary analyses will be conducted on behavior-specific and participant specific variables where precursors are and are not found. Finally, although a precursor-treatment study is premature at this time, we will collect pilot data on precursor-based treatments to inform future research. We anticipate that we will able to identify a precursor and determine the precursor-SPB relation in a high proportion of individuals who engage in SPB. Findings could both inform practice, and promote research investigating precursor-based treatments that that could prevent occurrences of SPB, and thus help limit the risks associated with these behaviors.

项目总结/摘要 严重问题行为（SPB;例如，侵略，私奔，和自我伤害）从事的个人与 智力和发育残疾是一个主要公共卫生问题。这些行为会非常严重 即使是一个单一的SPB实例也可能导致对自己或他人的伤害。一种有前景的治疗策略 包括识别SPB即将发作的行为指标，并中断升级 在SPB发生之前的行为序列。这些行为指标被称为SPB的前兆， 不像SPB那么严重或危险。鉴于SPB可能会对自己或他人造成伤害， 特别重要;然而，现有的前体研究一直是机会主义的， 临床病例报告的松散收集。拟议中的研究将研究确定和更好地 了解先驱。具体而言，本研究将评估SPB前兆的可能性（研究1 2）改进现有的前兆识别方法，以更好地理解 前体和SPB之间的关系（研究3）。这项研究将在80名个人的样本中进行， 由于SPB的严重性，他们受伤的风险最大。 在研究1中，我们将使用逐秒的数据分析来检查SPB发生的背景， 通过概率分析确定可能的前兆。在研究2中，我们将研究前体和SPB 在两个实验条件下进行变化，以确定前体和SPB是否发生 同样的原因。在研究3中，我们将通过防止 前体的出现并检查对SPB的影响。此外，虽然不是主要的重点， 在本研究中，将对特定行为和特定参与者变量进行二次分析， 最后，尽管目前进行药物治疗研究还为时过早，但我们 将收集基于药物治疗的试点数据，为未来的研究提供信息。我们预计我们将能够 确定一个前体，并确定高比例的个人谁从事SPB的关系 SPB。这些发现既可以为实践提供信息，也可以促进研究基于神经元的治疗方法， 这可以防止SPB的发生，从而有助于限制与这些行为相关的风险。