Self-injurious Behaviour in People with Intellectual Disability

Chris Oliver; Caroline Richards

Disclosures

Curr Opin Psychiatry. 2010;23(5):412-416. 

In This Article

Abstract and Introduction

Abstract

Purpose of review To provide a critical evaluation of a broad range of peer-reviewed published studies of relevance to self-injurious behaviour in people with intellectual disability and autism spectrum disorders.
Recent findings The review covers the prevalence of self-injurious behaviour, the characteristics of those showing the behaviour, self-injury in autism spectrum disorders, biological influences on self-injurious behaviour, behavioural assessment and psychological and pharmacological interventions.
Summary The recent literature describes systematic evaluation of the efficacy of aripiprazole, and parent training combined with risperidone. Meta-analyses of behavioural interventions provide evidence of their efficacy and related research describes beneficial modification to behavioural assessment procedures. The prevalence literature provides data on individual characteristics that are associated with persistence and presence of self-injury and that might be considered as risk markers. Pain behaviour appears to be associated with self-injury, with implications for theories of the involvement of endorphins, and as a causal factor. In combination, these research findings demonstrate the multiple influences on self-injurious behaviour that must be taken into account in the assessment, formulation, intervention process.

Introduction

There are discernible trends in the recent research literature on self-injurious behaviour. One is the quality and strength of evidence for interventions with the emergence of medication trials of robust design and meta-analyses of behavioural procedures. The second is the identification of individual characteristics that are associated with self-injury becoming incorporated into causal models. Finally, there is some evidence of integration of biological and environmental influence in constructing interventions and the examination of likely contextual variables on intervention. These trends are positive and can ultimately influence the quality and availability of clinical services. The review is divided into sections on prevalence and individual characteristics, autism spectrum disorders, biological influences on self-injury, behavioural assessment and psychological and pharmacological intervention.

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