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This study compared differential reinforcement of other behavior (DRO) and noncontingent reinforcement (NCR) in the reduction of self-injurious behavior in three adult females with severe or profound mental retardation. Both procedures were highly effective in reducing self-injury, with NCR less limited than DRO. (Author/DB)

A reevaluation of data from Berkman and Meyer (1988), a study supporting the effectiveness of positive-oriented programing approaches with persons with mental retardation, suggests that medication, especially the introduction of Thorazine (with subsequent increases of dosage), may have been related to reductions in the client's self-injurious behavior. (DB)

This response to a critique (EC 605 541) of the authors' case study, supporting the effectiveness of positive-oriented programing approaches with persons with mental retardation, offers follow-up information on the individual involved, including his complete medication history, and defends the view that the self-determination supported by their intervention contributed to the positive outcome. (DB)

In this case study, interactions were examined between features of Rett syndrome and operant conditioning as determinants of self-injurious behavior (SIB). Analysis suggested different functions for two forms of SIB: automatic reinforcement by sensory stimulation and escape from social interactions. Features of Rett syndrome tended to maximize the operant conditioning of SIB. (Author/DB)

The function of self-injurious behavior (SIB) by an adult with severe mental retardation was analyzed via descriptive and experimental analysis methodologies. Results indicated that SIB occurred more often when the participant was presented with nonpreferred novel activities. Intervention resulted in the use of negation to terminate the nonpreferred activity and redirect adaptive responding. (Author/JDD)

The severe self-injurious behavior of a woman with profound mental retardation was treated with 3.5 milliamps of shock combined with reinforcement and extinction techniques, with minimal results. Treatment with the Hot Shot Power Mite, which delivers 18.5 milliamps, combined with reinforcement for compliance and extinction of self-injurious escape behavior, was effective. (Author/JDD)

Catamenial and behavioral records of nine women with mental retardation who exhibited self-injurious behavior (SIB) were analyzed for six months. Analysis confirmed that SIB was cyclic across the menstrual cycle, with the highest frequency occurring in the early follicular and late follicular phases. (Author/JDD)

Eight young adults (ages 19-39) with autism were given the opiate antagonist naltrexone to control self-injurious behavior and maladaptive idiosyncratic mannerisms. Although one subject appeared to have partial decreases in maladaptive behaviors, the drug did not clearly reduce the self-injurious and other maladaptive behaviors of the subjects. (Author/JDD)

This study investigated the relationship between self-restraint (e.g., entanglement of limbs in clothing or furniture) and self-injurious behavior (SIB) using functional analysis with five males with severe mental retardation. Results suggested that self-restraint, like SIB, may be maintained by idiosyncratic contingencies. (Author/DB)

A modified functional analysis was used to assess the behavioral function of a profoundly retarded man's self-injurious behavior (SIB). Differential reinforcement of alternative behavior effectively reduced SIB and related behavior problems, while compliance of a self-care acquisition task increased markedly. (Author/DB)

Potential long-term effects of the trauma of severe sexual abuse on a child's sense of living in his/her body and in the world are explored. Trauma and dissociation are analyzed and linked to a posttraumatic sense of personal identity. Then dissociation, multiple personality disorder, eating disorders, somatization disorder, self-mutilation, and suicide are examined in relation to embodiment. (BRM)

This paper summarizes brief functional assessments of 79 cases of people with developmental disabilities and self-injurious, aggressive, stereotypic, or other aberrant behavior. Outcomes were evaluated across three variables: (1) referring topography, (2) control over behavior, and (3) the identified maintaining conditions for aberrant behavior. (Author/DB)

Two studies of three youths (ages 12-14) with severe mental retardation, who used aggression and self-injury to avoid difficult instructional situations, found that simple commands interspersed among more challenging instructional trials were effective at increasing the learners' responsiveness to instructions and decreasing levels of problem behaviors. (Author/JDD)

This paper describes current neurological knowledge regarding the recognition, diagnosis, and classification of frontal lobe seizures, and then critiques a study by A. Gedye which suggested that self-injury may be involuntary and related to frontal lobe seizure activity. (JDD)

This paper responds to a critique (EC 601 489) of a paper on the possible involuntary nature of self-injurious movements in persons with mental retardation, resulting from undiagnosed frontal lobe seizures. The response discusses electroencephalographic techniques, the importance of observable ictal phenomena, the need for other corroborating evidence, and other concerns. (JDD)

Four individuals (ages 5-21) with severe mental retardation and autism were administered Naltrexone. Results indicated a reduction in such symptoms as hyperactivity, aggressiveness, self-injurious behavior, stereotyped behaviors; and promotion of positive social behaviors. Intermittent administration at low doses seemed more beneficial than more frequent daily administration of higher doses. (JDD)

Thirty-seven adult dissociative disorder patients who reported ritual abuse in childhood by satanic cults are described. A clinical syndrome is presented that includes dissociative states with satanic overtones, posttraumatic stress disorder, survivor guilt, unusual fears, and substance abuse. Questions concerning reliability, credibility, and verifiability are addressed. (Author/BRM)

Investigated dress and body markings of 100 hospitalized and never-hospitalized adolescent psychiatric patients using in-depth interviews. Found that hospitalized patients had higher incidence of self-scarring, but other individual expressions of appearance did not differentiate two groups. Suggests that dress and appearance observations, questionnaires, photo reviews, self-portraits, and family discussions contributed to beneficial effect of psychotherapy. (Author/PVV)

This article summarizes and critically analyzes the literature on self-restraint (in which a mentally retarded individual restricts or prevents motion of a body part), particularly its identification, etiology, modification, and relationship to self-injurious behavior. The paper examines the hypotheses of negative reinforcement and stimulus control in explaining self-restraint. (Author/JDD)

This replication study found that only 16 of 55 raters agreed on the category of reinforcement maintaining a disabled individual's self-injurious behavior after using the Motivation Assessment Scale. Additionally, only 15 percent of the correlation coefficients obtained were above 80 percent, and none of the reliability scores was above 80 percent. (Author/DB)

This rejoinder to critiques (EC 602 213-215) of the authors' article (EC 602 212) on stereotypy and self-injury in the disabled responds to specific objections raised, including misleading statements, failure to address other existing models, misunderstandings, and need to include neurochemical factors. (DB)

A three-level model explains the emergence and maintenance of rhythmic stereotypy and self-injury in disabled individuals: Level 1, internally regulated rhythmic behaviors; Level 2, stereotypy and self-injury as adaptive responses to understimulating or overstimulating environments; and Level 3, stereotypy and self-injury as learned behaviors to control others. (Author/DB)

This response to a paper by Guess and Carr (EC 602 212) on stereotypy and self-injury in the disabled evaluates their interpretation of the literature, use of conceptual terms, and treatment of behavior analysis principles. They are critiqued for using descriptive analogies and intervening variables to support their theory. (DB)

This response to a paper by Guess and Carr (EC 602 212) on stereotypy and self-injurious behavior in the disabled focuses on (1) potentially misleading statements that may discourage practitioners from operant approaches to stereotypy and self-injury, and (2) strengths and weaknesses of the model compared to existing operant models. (DB)

The report describes the successful treatment of trichotillomania (compulsive hair pulling) in a mentally retarded 11-year-old boy with autism and severe mental retardation. Administration of haloperidol resulted in complete cessation of hair pulling which reappeared when the dosage was decreased and ceased again when dosage was reestablished. (DB)

Literature is reviewed and a case report is presented concerning blockers of the beta-adrenergic function of the sympathetic nervous system, postulated to have efficacy in treatment of aggressive or self-injurious syndromes in persons with mental retardation. Concerns are raised regarding endorsement of beta-blocking medications before they have been adequately studied. (Author/JDD)

Four adults with severe/profound mental retardation and self-injurious behavior (SIB) received naltrexone in a double-blind procedure. All patients exhibited decreased SIB when treated with naltrexone; three patients decreased SIB as naltrexone dose increased. There were no consistent effects of naltrexone on stereotypy, activity, or performance on behavior rating scales. (Author/JDD)

B-endorphin and cortisol concentrations were examined in the plasma of mentally retarded adults who displayed symptoms of self-injurious behavior (SIB) (N=9), stereotypy (N=17), or SIB plus stereotypy (N=14). Compared to matched controls, patients with SIB plus stereotypy had elevated b-endorphin plasma, while cortisol levels were identical for all groups. (Author/JDD)

This case study presents a 9-year-old boy who exhibited severe stereotypic self-injurious behavior. An escalating differential-reinforcement-of-other-behavior schedule, mediated through token reinforcement, eliminated self-injurious behavior quickly for up to 30-minute periods, and was more effective than social reinforcement. Crying behavior occurred following nondelivery of reinforcement. (Author/JDD)

Two severely handicapped children (ages 5-6) exhibiting self-injurious behavior were treated with negative reinforcement (brief escape from grooming activities) contingent upon a behavior that was incompatible with self-injury (pressing a microswitch that activated a "stop" message). Treatment led to decreased self-injury, which was maintained at followup for one child. (Author/JDD)

The 10-year followup study of a severely retarded man treated for self-injurious behavior with a multiphased behavioral and vocational program found the incidence of self injurious behavior remained infrequent and rarely resulted in tissue damage. (Author/DB)

The study compared the effectiveness of (1) reinforcement of other behavior, (2) verbal reprimands, and (3) movement suppression time-out in eliminating self injury and aggressive behaviors in two severely mentally retarded adult males. Improvements were only apparent when movement suppression was paired with either or both of the other interventions. (Author/DB)

The consensus statement of a panel of experts on treatment of destructive and self-injurious behaviors in persons with developmental disabilities addresses such areas as approaches used to manage these behaviors; evidence for the effectiveness of various approaches; the risks and benefits of the various approaches; recommendations; and needed research. (DB)

Evaluation of treatment acceptability was conducted with 78 staff members at a community-based residential facility for youth with severe behavior disorders and mental retardation, where the institutional treatment philosophy was explicitly behavioral. Unlike a previous study, in this setting acceptability ratings were not influenced by severity of self-injurious behavior. (Author/DB)

This introduction to several articles on punishment in treating persons with mental retardation notes the ethical dilemmas involved and offers the editor's view that research on the side effects and relative efficacy of various treatments for reducing self-injurious behaviors should continue, and clinical practice should be guided by research findings. (DB)

Naltrexone hydrochloride was administered to an autistic mentally retarded male, age 14, to investigate the endogenous opiate release theory of self-injurious behavior (SIB). Results yielded a marked decrease in SIB and increased social relatedness during two phases of drug treatment. SIB did not revert to original placebo levels during a second placebo phase. (Author/JDD)

Three studies investigated environmental correlates of self-injurious behavior in seven developmentally disabled children and adolescents which were then later used for treatment. Correlates investigated included positive reinforcement, negative reinforcement, automatic reinforcement, and control. "Escape extinction" was successfully applied during educational sessions. (Author/DB)

The Self-Injurious Behavior Inhibiting System (in which mild and brief contingent electric stimulation is delivered) was evaluated with five cases involving severe mental retardation and previously unmanageable self-injurious behavior. Findings indicated almost complete elimination of the self-injurious behavior with followup suggesting continuing benefits and absence of detrimental side effects. (Author/DB)