The Eli and Edythe L. Broad Center for Asperger Research, University of California at Santa Barbara, CA 93106-9490, USA.
Res Dev Disabil. 2010 Mar-Apr;31(2):304-15. doi: 10.1016/j.ridd.2009.10.017. Epub 2009 Dec 5.
Skin-picking is a type of self-injurious behavior involving the pulling, scratching, lancing, digging, or gouging of one's own body. It is associated with social impairment, and increased medical and mental health concerns. While there are several reports showing that skin-picking is common in individuals with developmental disabilities, knowledge about effective treatment approaches is sparse. We therefore reviewed studies involving the treatment of chronic skin-picking in individuals with developmental disabilities. Systematic searches of electronic databases, journals, and reference lists identified 16 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) participants, (b) functional assessment procedures and results, (c) intervention procedures, (d) results of the intervention, and (e) certainty of evidence. Across the 16 studies, intervention was provided to a total of 19 participants aged 6-42 years. Functional assessment procedures included direct observations, analog functional analyses, and functional assessment interviews. The most commonly identified function was automatic reinforcement. Treatment approaches included combinations of differential reinforcement, providing preferred items and activities stimuli (e.g., toys), wearing protective clothing (e.g., helmets or gloves), response interruption and redirection, punishment, and extinction. Improvements in behavior were reported in all of the reviewed studies. Suggestions for future intervention research are offered.
皮肤搔抓是一种自我伤害行为，涉及拉扯、抓挠、刺破、挖掘或刮擦自己的身体。它与社交障碍以及增加的医疗和心理健康问题有关。虽然有几项报告表明，在发育障碍个体中，皮肤搔抓很常见，但关于有效治疗方法的知识却很少。因此，我们回顾了涉及治疗发育障碍个体慢性皮肤搔抓的研究。通过电子数据库、期刊和参考文献的系统搜索，确定了符合纳入标准的 16 项研究。这些研究从以下几个方面进行了评估：（a）参与者，（b）功能评估程序和结果，（c）干预程序，（d）干预结果，以及（e）证据的确定性。在这 16 项研究中，共对 19 名年龄在 6-42 岁的参与者进行了干预。功能评估程序包括直接观察、模拟功能分析和功能评估访谈。最常确定的功能是自动强化。治疗方法包括差别强化、提供喜好物品和活动刺激（例如，玩具）、穿着防护服装（例如，头盔或手套）、反应中断和引导、惩罚和消退。所有回顾的研究都报告了行为的改善。提出了未来干预研究的建议。
