Identifying Precursors to Severe Problem Behavior

项目摘要/摘要 严重问题行为(SPB；例如，攻击性、私奔和自伤) 智力和发育障碍是一个主要的公共卫生问题。这些行为可能会非常严重 即使是SPB的一个实例也可能导致对自己或他人的伤害。一种有希望的治疗策略 包括确定SPB即将发作的行为指标，并中断不断升级的 SPB发生前的行为顺序。这些行为指标被称为SPB的前驱，并且是 不像SPB那样严重或危险。鉴于SPB可能对自己或他人造成伤害，识别前体 对SPB来说尤其重要；然而，现有的关于前体的研究一直是机会主义的，导致了 临床病例报告收集松散。拟议的研究将检查识别和更好地识别和 了解前兆。具体地说，这项研究将评估SPB前驱疾病的可能性(研究1 和2)并改进现有的前兆识别方法，以更好地理解具体关系 前体和SPB之间的关系(研究3)。这项研究将在80名个人样本中进行， 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是如何 在两个实验条件下的变化，以确定前兆和SPB是否发生在 同样的原因。在研究3中，我们将通过预防 前驱物质的赋存状态及其对SPB的影响。此外，尽管不是主要的焦点， 在这项研究中，将对特定于行为的变量和特定于参与者的变量进行二次分析 前身既有也没有找到。最后，尽管目前前体治疗研究还为时过早，但我们 将收集有关前体治疗的试点数据，为未来的研究提供信息。我们预计我们将能够 确定前体，并在参与的高比例个人中确定前体与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前体的治疗方法 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。

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.