Petty Jane, Oliver Chris
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
Curr Opin Psychiatry. 2005 Sep;18(5):484-9. doi: 10.1097/01.yco.0000179484.62391.dc.
In this paper we review literature published in 2004 on self-injurious behaviour in individuals with intellectual disabilities. Reviewed studies examine phenomenology and comorbidity, pharmacological and other interventions, genetic syndromes, and behavioural assessment and treatment.
Key findings include the possible association between self-injury and impulse control and stereotyped behaviours. Reports on the use of pharmacological interventions provide little evidence for the use such interventions, although the findings of studies on naltrexone seem stronger. In the behavioural phenotype literature the predictors of self-injury in Prader-Willi syndrome are becoming more refined. The behaviour analysis literature reports further development of assessment methodology to cater for idiosyncratic functions and low-rate behaviours.
Developments in the fields of applied behaviour analysis and genetic syndromes highlight the importance of tailored assessments and interventions. Evidence from the pharmacological literature suggests that although significant numbers of individuals are prescribed such interventions, the research evidence for their efficacy is, at best, weak.
本文回顾了2004年发表的有关智障人士自伤行为的文献。所回顾的研究探讨了现象学与共病情况、药物及其他干预措施、遗传综合征以及行为评估与治疗。
主要发现包括自伤行为与冲动控制及刻板行为之间可能存在的关联。关于药物干预措施使用情况的报告几乎没有为这类干预措施的应用提供证据，不过有关纳曲酮的研究结果似乎更具说服力。在行为表型文献中，普拉德-威利综合征自伤行为的预测因素正变得更加精确。行为分析文献报告了评估方法的进一步发展，以适应特殊功能和低频率行为。
应用行为分析和遗传综合征领域的进展凸显了量身定制评估和干预措施的重要性。药理学文献的证据表明，尽管有大量个体被开具这类干预措施的处方，但其疗效的研究证据充其量很薄弱。
