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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article is part of a special section on 'self-injurious behaviour and autism' and is mainly based on a book edited by Luiselli, Matson and Singh (1992) addressing empirical data on self-injurious behaviour and mental retardation from a behavioural perspective. Within the overview of the book some information on autism is also presented and critically discussed. Self-injurious behaviour is a poorly understood phenomenon and problematic in many ways; its definition is not easy; little is known about the causes and neuroscientific models. Demographic data are scarce and functional analysis and interventions (behavioural techniques, medication, education) need to be further developed, under the protection of human rights committees.
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PMID:Self-injurious behaviour (SIB)--from definition to human rights. 813 13

A comparison of shock intensity was conducted while treating a young woman with mental retardation and severe self-injurious behavior (SIB). Two levels of shock intensity were evaluated: 3.5 milliamps (mA) delivered via the Self-Injurious Behavior Inhibiting System (SIBIS) and 18.5 mA delivered via the Hot Shot Power Mite. A combined reversal and multiple baseline across behaviors design was used to evaluate treatment effects. SIBIS in conjunction with differential reinforcement and extinction of self-injurious escape behavior produced minimal reductions in SIB. The Hot Shot combined with extinction of self-injurious escape behavior and reinforcement for compliance resulted in immediate and large reductions in SIB. Residential staff were trained to implement contingencies by the fourth day of treatment with excellent generalization from 30-min sessions to the natural environment across all waking hours. Continuous protective restraints were eliminated within the first month of treatment. Progress occurred in personal care, vocational training, independence, and communication. Treatment effects were maintained for approximately 6 months until a relapse occurred after home visits.
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PMID:A comparison of shock intensity in the treatment of longstanding and severe self-injurious behavior. 831 83

Data on the long-term effectiveness of behavioral treatment for self-injurious behavior in individuals with mental retardation is rare. We present 4-year follow-up data on a 28-year-old man whose severe self-injurious behavior was treated with brief contingent electric stimulation via the Self-Injurious Behavior Inhibiting System (SIBIS). Event data collected throughout follow-up showed reductions in head-hitting and head-banging from over 2,600 responses per hour to approximately 1 response per hour during much of the first 31 months of treatment. However, the rate of head-banging began increasing thereafter, with the SIBIS losing its effectiveness to such an extent that it was no longer clinically useful.
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PMID:A 4-year follow-up of treatment of self-injury. 837 Jul 98

This review assesses the efficacy and specificity of psychotropic medications used to control aberrant behavior in persons with mental retardation. It is concluded that neuroleptics, the most widely used psychotropic agents in this population, suppress aberrant behavior, but do so by suppressing behavior generally. An exception to this conclusion is that it may be possible to selectively suppress stereotyped behavior with neuroleptics. In addition, the empirical evidence indicates that, in some persons with mental retardation, opioid antagonists and methylphenidate are useful therapies for self-injurious behavior and hyperactivity, respectively. Lithium and beta-blockers are potentially useful for treating aggression.
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PMID:Efficacy and specificity of pharmacological therapies for behavioral disorders in persons with mental retardation. 837 12

The treatment of self-injurious behavior in adults with mental retardation is a major challenge. A critical review of the literature compares sensory-based treatment studies by behavioral psychologists with sensory integrative treatment studies by occupational therapists. In general, therapists have used direct intervention in concentrated daily sessions. This report includes a single subject study that (a) demonstrates the clinical reasoning involved in the assessment and treatment planning process, (b) documents the efficacy of multiple short treatment sessions spread throughout the day, and (c) presents an alternative model of service provision in which direct care staff provide sensory and adaptive activities under the supervision of an occupational therapist. The use of sensory integration with adults with profound handicaps is presented as a valid application of a theory and treatment that was originally developed from work with higher functioning children with learning disabilities.
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PMID:Using a sensory integrative approach to treat self-injurious behavior in an adult with profound mental retardation. 849 64

There are no reports of an association between the menstrual cycle and self-injurious behavior (SIB) in the mentally retarded population. However, the endogenous opiate system has been implicated in both menstrual cycling and SIB. Catamenial and behavioral records of 9 women with mental retardation who exhibited SIB were analyzed for 6 months to determine the association between phases of the menstrual cycle and rates of SIB. Menstrual cycles were divided into four phases: (a) menses and early follicular phase, (b) late follicular phase, (c) early luteal phase, and (d) late luteal or premenstrual phase. Analysis showed that the highest frequency of SIB occurred in the first two phases: 43.5% during early follicular phase and 47.3% in the late follicular phase. Pairwise t and binomial expansion tests confirmed that SIB was cyclic across the menstrual cycle with Phase 1 > Phase 3, Phase 1 > Phase 4, Phase 2 > Phase 3, and Phase 2 > Phase 4. Seven of the 9 women were cyclers and manifested identical phase/SIB relations. The cyclical character of SIB may relate to changing peripheral and central endorphin and pain threshold during the cycle.
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PMID:Self-injurious behavior within the menstrual cycle of women with mental retardation. 851 46

Measurement methods from behavioral psychology were used to assess antiepileptic drug behavioral side effects in 5 individuals with mental retardation. When the suspected antiepileptic drug was altered, an 81% reduction of maladaptive behaviors occurred. Quality of life outcomes included successful community placement and termination of an aversive intervention procedure. Three cases demonstrated antiepileptic drug exacerbation of disruptive vocalizations, agitation, self-injurious behavior, and property destruction; 2 demonstrated improved aggression, but illustrated a common clinical problem. When seizure control must be maintained and a suspected antiepileptic drug cannot be reduced before a second antiepileptic drug with potential psychotropic properties is initiated, it was not possible to absolutely conclude that the first antiepileptic drug was responsible for the behavior problem. Overall, these measurement methods were instrumental in the systematic clinical evaluation of antiepileptic drug behavioral side effects in individuals unable to verbally communicate the presence of these side effects.
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PMID:Antiepileptic drug behavioral side effects in individuals with mental retardation and the use of behavioral measurement techniques. 856 87

The efficacy of the serotonin (5-HT) uptake inhibitor clomipramine in the treatment of self-injurious behavior (SIB) was tested in individuals with severe and profound mental retardation. Six of the 8 subjects who completed a double-blind, placebo-controlled crossover trial exhibited a clinically significant improvement (50% or greater reduction from placebo) in the frequency of SIB. Clomipramine treatment was also associated with improvement in SIB intensity, frequency of stereotypy and compulsions, teacher ratings of stereotypy and social withdrawal, and frequency of staff intervention required for problem behaviors. Adverse effects (seizure and tachycardia/agitation) occurred in 2 of the 8 subjects. These results represent the first controlled trial of a 5-HT uptake inhibitor in the treatment of SIB in mental retardation.
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PMID:Clomipramine treatment for self-injurious behavior of individuals with mental retardation: a double-blind comparison with placebo. 873 78

Two interrelated cross-sectional studies were conducted to expand earlier findings about correlates of outwardly directed aggressive behavior in children with mental retardation. In Study 1 we compared children with mental retardation, 27 with and 23 without aggression. Aggression was best predicted by concurrent self-injurious behavior (SIB). In Study 2 we examined the likelihood that aggression was predicted by concurrent SIB and other nondestructive maladaptive behaviors in an archival cohort of 701 children younger than 21 with IQs below 70. Self-injurious behavior significantly predicted outwardly directed aggression for all children regardless of age. Additional predictors besides SIB showed only minimal improvements in model R2 values. Results were discussed in light of recent research proposing a common basis for aggression and SIB.
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PMID:Characteristics of children and adolescents with mental retardation and frequent outwardly directed aggressive behavior. 893 99

An inventory for assessing the degree of mechanical restraint imposed by others to prevent individuals from inflicting physical injuries to themselves or to others, the Imposed Mechanical Restraint Inventory (IMRI), was developed. The inventory was administered to pairs of residential direct-care staff members to assess 113 individuals with mental retardation who showed self-injurious behavior while various sorts of mechanical restraint were imposed on them. The results indicate that the inventory showed acceptable levels of interobserver reliability, intraobserver reliability, and accuracy.
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PMID:An inventory method for assessing the degree of restraint imposed by others. 919 8


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