SEROTONERGIC MECHANISMS AND SELF-INJURIOUS BEHAVIOR

“自残行为”(SIB)指的是通常 在性质上重复，并导致直接的物理损害 个人的。SIB是一个重大问题。在兰特曼州立大学 位于加利福尼亚州波莫纳的发展中心，SIB每天的发生率高达14% 常住人口的比例。SIB限制受影响的人 教育和社会机会，并可将安置限制为 机构设置。据估计，每年只有一次护理 拥有SIB的个人接近10万美元，而国家的成本 20000名受影响的个人超过30亿美元 1988年。 我们将重点介绍自残行为的发病机制和治疗。 在发育障碍的人群中。有两个目标，即建立和 检查这种行为的适当模型，以及仔细的临床 对一大批发育障碍个体的研究 参与频繁的SIB。要检验的假设可以概括为： 临床前研究：5-羟色胺激动剂间氯苯哌嗪 (MCPP)可使大鼠血浆肾上腺皮质激素(ACTH)升高。这 神经内分泌反应将因慢性疾病而不同地改变 5-羟色胺能激动剂和拮抗剂的给药。药理作用 或者手术诱导的自我伤害也会改变神经内分泌。 对mcpp的反应。这些模型中的SIB将被更改或紧急阻止 通过一些5-羟色胺拮抗剂的短期治疗；然而，长期的 使用5-羟色胺激动剂，特别是丁螺环酮或mCPP，或 再摄取阻滞剂如氟西汀或舍曲林也将减弱SIB在 这些系统。临床研究：部分患者自残 行为将表现出功能差异，以响应特定 神经内分泌挑战与发育障碍和 正常对照组。在使用5-羟色胺能药物进行慢性治疗后 丁螺环酮和氟西汀对这些神经内分泌的功能性反应 挑战将在正常志愿者和一个子组中改变 患有SIB的个体。

"Self-injurious behavior" (SIB) refers to acts which are usually highly repetitive in character and which result in direct physical damage to the individual. SIB is a significant problem. At the Lanterman State Developmental Center in Pomona, California, SIB occurs daily in fully 14% of the resident population. SIB restricts the affected person from educational and social opportunities and can restrict placement to institutional settings. It is estimated that the annual care for a single individual with SIB approaches $100,000 while cost to the nation of the twenty thousand afflicted individuals exceeded three billion dollars in 1988. We will focus on the pathogenesis and treatment of self-injurious behavior in the developmentally disabled. With a two-fold aim of establishing and examining appropriate models of this behavior, and of careful clinical study of a large population of developmentally disabled individuals who engage in frequent SIB. The hypothesis to be tested can be summarized: Pre-Clinical Studies: The serotonin agonist m-chlorophenylpiperazine (mCPP) will increase rat plasma adrenocorticoptopic hormone (ACTH). This neuroendocrine response will be differentially modified by the chronic administration of serotonergic agonists and antagonists. Pharmacological or surgical induction of self-injury will also modify the neuroendocrine response to mCPP. SIB in these models will be altered or acutely prevented by short-term treatment with some 5-HT antagonists; however, long-term treatment with 5-HT agonists, particularly buspirone or mCPP, or with re-uptake blockers like fluoxetine or sertraline will also attenuate SIB in these systems. Clinical studies: Some patients with self-injurious behavior will demonstrate functional differences in response to specific neuroendocrine challenge when compared to developmentally disabled and to normal controls. Following chronic treatment with the serotonergic agents buspirone and fluoxetine, the functional response to these neuroendocrine challenges will be altered both in normal volunteers and in a subgroup of individuals with SIB.