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Trichotillomania (hair-pulling) and delicate self-cutting are self-destructive behaviors which utilize the body as a vehicle for self-expression. Like anorexia and bulimia, these behaviors occur primarily in young women. This study compared groups of women college students who engage in these self-destructive behaviors with those who do not. It was hypothesized that the self-destructive women would have lower self-esteem, higher scores on a depression inventory, a greater tendency to repress their anger, and be more likely to engage in other harmful behaviors. Women college students (N=24) completed the State-Trait Anger Expression Inventory, the Texas Social Behavior Inventory, the Beck Depression Inventory, the Body Image Questionnaire and the Eating Disorders Inventory. They also completed a demographic questionnaire, and answered questions relating to eating behaviors and history of sexual abuse. There were no significant differences between the groups on either the state or trait anger inventories or the on self-esteem. As hypothesized, the self-destructive women obtained significantly higher scores on the depression inventory. They also reported significant concerns about their body image. Forty-six percent of the self-destructive women reported that they used drugs, while drug use was reported by only 9 percent of the non-self destructive women. The groups did not differ in their reports of sexual abuse or belief that they had an eating disorder. (LLL)

Many jurisdictions require psychiatrists to assess patient "dangerousness" in the process of involuntary hospitalization. Considerable research indicates that psychiatric prediction of dangerous behavior is rather inaccurate, the principal error being one of overprediction. Inaccuracy may result, in part, from the psychiatrist's role in the health care organization. The Mental Health Associate (MHA) role, not sharing some of these structural disadvantages, is hypothesized to yield more accurate predictions of patient "dangerousness." However, a follow-up study of clients originally assessed on potential dangerousness indicated MHA predictions did not significantly differentiate between those actually manifesting dangerous behavior and those who did not. Further investigation revealed that incidence of stress events was significantly associated with the occurrence of dangerous behavior during the follow-up period and influences the accuracy of MHA assessments. MHA predictions significantly differentiate those manifesting dangerous behavior and those who do not when stress is low during the follow-up period. Under high stress conditions, MHA predictions are less accurate. Implications for the process of attributing dangerousness for involuntary commitment are discussed. (Author)

The study investigated intrapersonal and interpersonal behaviors and events in self-injurious disabled persons (2-22 years old). The study involved four components: (1) a survey of 82 Ss using the self-injurious behavior (SIB) Perception Questionnaire, Antecedent/Consequent Card Sort, and the American Association on Mental Deficiency Adaptive Behavior Scale; (2) a cognitive assessment by 43 Ss using Piagetian based and standarized assessment; (3) standard activities (N=48) of easy, difficult, preferred, nonpreferred tasks; and (4) naturalistic observations (N=8) for 4 consecutive days within classroom settings. Survey findings revealed increasing SIB frequency and number of topograhies at successive age group and rate group levels, a prototypic profile of 11 classes of antecedents to SIB along with individual variations in profiles, and increased adaptive behavior skills with age but decreased standing relative to institutional norms. Based on assessments, 70% of Ss were functioning within the sensorimotor and 30% within the preoperational period of cognitive development. During standard activities, negative/manipulative and task behaviors covaried with task condition, and non-SIB negative behavior decreased while SIB and task compliance increased with age. Naturalistic observations revealed individual antecedent/consequence patterns. Questionnaire results generally were consistent with observational findings. (Author/CL)

The pilot study focused on the effective design of adaptive biofeedback equipment for use in the control of self-mutilating behaviors in individuals with Lesch-Nyhan syndrome, typically characterized by apasticity, mental retardation, and violent biting of the lips and fingers. Utilizing an electromyographic (EMG) monitor and a custom-designed relay connected to either a computer game or a tape player, a 15-year-old male learned to control sudden high levels of arousal-related muscular tension which were the antecedents of self-abuse. A subsequent study of the experimental treatment protocol (rather than the viability of the instrumentation) is proposed. (Author/JW)

Investigated depression and hostility among self-mutilating patients in a sample of 60 mutilators, depressives, and controls. Nonsignificant differences in intropunitive hostility and depression were found between the clinical groups. Specific item differences in the depression assessment indicated a definite qualitative rather than quantitative difference in depressive symptomatology. (JAC)

Investigated the distribution of self-injury in London, Ontario. Multivariate analysis revealed that living arrangements, such as high housing density and single-person households, and low socioeconomic status were closely related to inflated self-injury rates. Self-injury occurred more frequently in the inner city. (JAC)

The effectiveness of four operant procedures (differential reinforcement of incompatible behavior, omission training, overcorrection, and reinforcement withdrawal) in changing self injurious behavior (SIB) of 16 severely handicapped students was examined. Analysis of correlations between reduction in SIB and subject characteristics, adaptive behavior changes, and enviornmental stimulation suggested three recommendations for treatment: 1) the child should be programed in a social and educational interaction as much as possible, with materials and commands programed in a gradated fashion to avoid aversiveness; 2) a punishment procedure should be contingently applied with the appearance of SIB; and 3) maximally reinforcing stimuli should be identified and contingently applied to on-task responses. Phase 2 of the study showed that teachers and parents were effective behavioral recorders and modifiers in dealing with SIB. (CL)

A timeout stimulus control procedure for reducing self-stimulation and disruptive behaviors in autistic children was examined. The three subjects were diagnosed as autistic, exhibiting numerous behaviors incompatible with learning. Severe hand biting, inappropriate noises, and prolonged tantrums were the target behaviors linked with the timeout stimulus control procedure in this study. The timeout stimulus control areas were within a special education classroom setting. No restrictive walls or partitions demarcated these areas, but the timeout areas were distinctively colored. When the target behaviors were linked with simple verbal commands and extinction procedures, a significant decrease was observed. The timeout stimulus control procedure further reduced the target behaviors to a stable low level. This study demonstrates the effectiveness of non-intrusive procedures which can be used in a classroom setting to eliminate severe disruptive behaviors in autistic children. (Author)

After a brief review of the literature the research proposal focuses on the comparative effectiveness of non-verbal positive reinforcement vs. verbal negative reinforcement in the reduction of self-inflicted injury on 23 elementary age autistic children. In the two phase study each child would be paired by age, sex, length of time in school, developmental placement, verbal communication level, and presence of handicap; one child in each pair receiving positive (the other negative) reinforcement in phase one, and reversed in phase two. The children are to be observed for 10 days, 3 times a day, by two different observers, scoring observed head hitting behavior. A 12 step procedure is outlined, methods of data analysis are proposed, and a time schedule and budget are included. (PHR)

Four treatment procedures were evaluated for effectiveness in reducing self injurious behavior (SIB) of 22 severely handicapped students. Treatment procedures included contingent restraint, reinforcement withdrawal, differential reinforcement of incompatible behavior, and ommission training (rewarding the S for not emitting the SIB response). Results indicated the superiority of the contingent restraint (CR) procedure. CR was the only technique using a contingent application of an aversive stimulus. A theoretical analysis considered implications for treatment of SIB from positive and negative reinforcement interpretations. Three recommendations for treatment were made: the child should be programmed in a social and educational interaction as much as possible; educational materials and instructional commands should be programmed in a graduated fashion allowing aversive materials and commands to be avoided at first; and efforts should be made to identify maximally reinforcing stimuli. Cooperating teachers and parents were shown to be able to implement behavior modification techniques to reduce SIB. In a second study, SIB was found to be correlated with the type of task engaged in by a 16 year old severely retarded female. A third study demonstrated a relationship between task difficulty and aberrant behavior. Among appendixes are sample consent forms and data sheets, and three related papers: "An Analysis of Antecedent, Response, and Consequence Events in the Treatment of Self Injurious Behavior,""A Decision Model for the Treatment of Aberrant Behavior in Applied Settings," and "The Relationship Between Task Difficulty and Inappropriate Behavior in Severely Retarded Children." (CL)

The study evaluated the effectiveness of an electric vibrator on the deceleration and/or extinction of 10 self abusive and aberrant behaviors in a profoundly retarded, nonambulatory 25 year old female who could not hear, see, or speak. At the end of 41 twenty minute sessions, seven of the target behaviors approached extinction and three were substantially reduced. Findings suggested that electric vibration may act as a powerful reinforcer for other sensorially impaired individuals who exhibit self abusive behaviors. (Author/SBH)

This paper reports a case study of an 8-year-old deaf, blind, and mentally impaired girl who was self-abusive. The behavior was excessive to the point that she sustained fractures to her jaw and arm and had to be restrained. Several treatment techniques were unsuccessfully attempted, including sensory stimulation, aversive conditioning, and extinction. Subsequently, a sensory affective training approach was used, with a staff member holding the girl throughout the school day, massaging her, rocking her, developing a trusting relationship. The intervention was successful, with hitting behaviors dropping from 400 times per hour to an average of two times per day. The girl became more autonomous and interested in her environment and later learned to sign and to take care of her basic needs. (JDD)

The report documents the theoretical basis and application of massage therapy, with six students who exhibited self-injurious behaviors (SIB), in two studies. The first study investigated the relationship between physical and/or emotional stress and self-abusive behavior in five severely mentally impaired students. Subjects received two to three 45-minute massage treatments per week. The program appeared to benefit three of the five subjects, who showed both quantitative and qualitative behavior improvements. The two remaining subjects had severe autistic characteristics which made the physical contact of massage therapy difficult. The second study describes a 15-year-old male with severe insomnia as well as very frequent self-injurious behavior. Massage therapy (three or four sessions per week) was added to his behavioral education program. The subject began to sleep 9 to 12 hours per night immediately with the introduction of massage therapy. A substantially decreased incidence of SIB was also observed. (DB)

Breaking a capsule of aromatic ammonia under the 5 year old retarded boy's nose contingent upon his self poking was found to be the most effective form of treatment. (Author/DLS)

In a longitudinal study of children with congenital rubella, 85 deaf adolescents, 85 deaf multihandicapped, and 34 normal controls were studied with respect to impulsivity. (Author/PHR)

Four deaf-blind students at the Massachusetts Association for the Blind were involved in a pilot aerobic program consisting of jogging for 15-20 minutes three times a week. Students were chosen based on their enjoyment of this fast movement and they were given clearance for this activity by both a doctor and a physical therapist. The students' pulse rates were taken periodically to determine whether their cardiovascular systems were benefiting from this activity. After the jogging was completed, the students walked back to class where they were given orange juice both as a reward and as a fluid replacement. Many positive changes were seen in these students. This was an excellent opportunity for students to release energy and frustrations with an appropriate activity. The four students displayed a decrease of self-abuse and self-stimulatory behaviors. The physical changes that were made consisted of a lowered resting pulse rate indicating that the cardiovascular system had to work less hard and was operating more efficiently. Since the staff noticed this positive development, more support and assistance were given and requests were made to have more students participate in this activity. Plans were made for expanding the program to incorporate walking, swimming, and mini-trampoline jumping. (EM)