An analysis of the topography, severity, potential sources of reinforcement, and treatments utilized for skin picking in Prader-Willi syndrome
An analysis of the topography, severity, potential sources of reinforcement, and treatments utilized for skin picking in Prader-Willi syndrome
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DOI：
10.1016/j.ridd.2013.06.014
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发表时间：
2013-09-01
影响因子：
3.1
通讯作者：
Hall, Scott S.
中科院分区：
文献类型：
--
作者：
Hustyi, Kristin M.;Hammond, Jennifer L.;Hall, Scott S.
我们研究了Prader-Willi综合征（PWS）患者的地形、严重程度、潜在的强化来源和用于抓皮行为的治疗方法。使用自伤创伤量表（SIT; lwata, Pace, Kissel, Nau, & Farber, 1990）和功能分析筛选工具（FAST; Iwata, DeLeon, & Roscoe, 2013）对55名年龄在6-25岁的PWS患者的父母进行了关于他们孩子抠皮肤行为的访谈。结果显示，PWS患者的四肢（臂、腿、手、足）搔皮占75%，造成肢体损伤占83.7%。41.8%的病例中，抠皮对个体构成高风险。在大多数情况下，自动感觉刺激被认为是强化的潜在来源（52.7%），其次是获得社会注意或喜欢的物品（36.4%）。家长使用的治疗方法以行为策略为主（56.3%），其次是基础急救（54.5%）。缺失型（DEL）和单亲二体型（UPD）在地形、严重程度和潜在强化来源方面没有差异。综上所述，这些数据表明，PWS患者所表现出的抠皮行为是一种特别严重和棘手的行为问题，可能是由（尚不清楚的）感官后果维持的。因此，需要进一步研究以确定PWS中拾取皮肤的决定因素。讨论了干预措施的含义。(C) 2013 Elsevier Ltd.版权所有。
We examined the topography, severity, potential sources of reinforcement, and treatments utilized for skin-picking behavior shown by individuals with Prader-Willi syndrome (PWS). The parents of 55 individuals with PWS, aged 6-25 years, were interviewed about their child's skin-picking behavior using the Self-Injury Trauma Scale (SIT; lwata, Pace, Kissel, Nau, & Farber, 1990) and the Functional Analysis Screening Tool (FAST; Iwata, DeLeon, & Roscoe, 2013). Results showed that skin picking in PWS occurred on the extremities (i.e., arms, legs, hands, and feet) for 75% of cases and resulted in bodily injury for 83.7% cases. Skin picking posed a high risk to the individual concerned in 41.8% of cases. Automatic sensory stimulation was identified as a potential source of reinforcement in the majority of cases (52.7%) followed by access to social attention or preferred items (36.4%). Treatments utilized by parents were primarily behavioral strategies (56.3%) followed by basic first aid (54.5%). There were no differences in the topography, severity or potential source of reinforcement between those with the deletion (DEL) subtype and those with the uniparental disomy (UPD) subtype. Taken together, these data indicate that skin picking shown by individuals with PWS is a particularly severe and intractable behavioral issue that may be maintained by (as yet unknown) sensory consequences. Further studies to identify the determinants of skin picking in PWS are therefore needed. The implications for interventions are discussed. (C) 2013 Elsevier Ltd. All rights reserved.