Biobehavioral Analysis of Self-Injury & Pain

描述(申请人提供)：对非社会中介的自我伤害行为的感觉和神经生物学基础知之甚少。在SIB的行为模型中，感觉机制起着积极或消极的自动强化作用，但很少有证据直接将行为机制和生物学机制联系起来。来自慢性疼痛及其行为后遗症的临床和动物研究的证据支持这一假设，即某些形式的SIB可能受到改变的疼痛机制的调节。大量文献和研究者的初步数据初步支持了慢性非社会性SIB的感觉功能障碍和疼痛假说，并指出疼痛的外周和中枢机制在慢性非社会性SIB的表达中起着重要作用。这项拟议的研究的目的是比较社会和非社会中介的SIB病例在一系列与感觉功能和疼痛行为相关的行为和生物学指标上的差异。总体目标是完善对慢性非社会性SIB背后的行为和生物学机制的综合分析。为此，我们开发了一套伤害和疼痛的行为和生物标记物，可以在发育障碍和SIB患者中可靠地测量。遵循垂直研究策略，慢性SIB病例(N=80)将根据行为机制(即，社会调解与非社会调解)进行功能亚型划分。每个受试者的SIB的代表性样本将被精确测量其形式、频率、强度和身体位置。每个受试者将使用疼痛的行为表达(面部动作单位)、形态(表皮神经纤维的密度)和神经化学(P物质，皮质醇)的测量来进一步表征。这项研究将提供第一次机会，系统地研究慢性非社会中介SIB背后的疼痛特定机制。

DESCRIPTION (provided by applicant): Little is known about the sensory and neurobiological basis of nonsocially-mediated self-injurious behavior. In behavioral models of SIB, sensory mechanisms function as putative positive or negative automatic reinforcers but there is little evidence directly linking behavioral and biological mechanisms. Evidence from both clinical and animal studies of chronic pain and its behavioral sequelae supports the hypothesis that some forms of SIB may be regulated by altered pain mechanisms. An established body of literature and the investigator's preliminary data provide initial support for the sensory dysfunction and pain hypothesis of chronic nonsocial SIB and point to an important role for the peripheral and central mechanisms of pain in the expression of chronic nonsocial SIB. The purpose of the proposed study is to compare socially and nonsocially-mediated SIB cases on a set of behavioral and biological measures related to sensory function and pain behavior. The overall goal is to refine an integrative analysis of the behavioral and biological mechanisms underlying chronic nonsocial SIB. Towards this end, we have developed a set of behavioral and biological markers of injury and pain that can be reliably measured in persons with developmental disorders and SIB. Following a vertical research strategy, chronic SIB cases (N = 80) will be functionally subtyped by behavioral mechanism (i.e., social versus nonsocial mediation). Representative samples of each subject's SIB will be precisely measured for its form, frequency, intensity, and body location. Each subject will be further characterized using measures of behavioral expression of pain (facial action units), morphology (density of epidermal nerve fibers), and neurochemistry (substance P, cortisol). This study will provide the first opportunity to systematically investigate mechanisms specific to pain underlying chronic nonsocially-mediated SIB.