Ter Mors Bert Jan, van Heugten Caroline M, van Harten Peter N
Department of Brain Injury, Huize Padua, GGZ Oost Brabant, Boekel, The Netherlands.
BMJ Case Rep. 2012 Aug 24;2012:bcr0220125932. doi: 10.1136/bcr-02-2012-5932.
Inappropriate sexual behaviour after acquired brain injury is a severe complication. Evidence for effective treatment is not available. Electrical aversion therapy (EAT) is a behavioural therapeutic option used in persons with intellectual disabilities, which might be suitable for brain-injured individuals for whom other therapies are not effective. The effect of EAT in brain injury has not been investigated previously. A single case experimental design was used. In an ABBA (baseline-treatment-treatment-withdrawal) design the frequency of the target behaviour (ie, inappropriate sexual behaviour) in a 40-year-old man was measured daily. A total of 551 measurements were recorded. A significant reduction of the target behaviour was seen after the first treatment phase (baseline 12.18 (2.59) vs 3.15 (3.19) mean target behaviours daily); this reduction remained stable over time. We conclude that EAT was effective in this patient with inappropriate sexual behaviour due to severe brain injury. EAT can therefore be considered in therapy resistant inappropriate sexual behaviour in brain-injured patients.
获得性脑损伤后出现的不当性行为是一种严重的并发症。目前尚无有效治疗的证据。电厌恶疗法(EAT)是用于智障人士的一种行为治疗选择,可能适用于其他疗法无效的脑损伤个体。此前尚未研究过EAT对脑损伤的影响。采用单病例实验设计。在ABBA(基线-治疗-治疗撤销)设计中,每天测量一名40岁男性的目标行为(即不当性行为)频率。共记录了551次测量。在第一个治疗阶段后,目标行为显著减少(基线时平均每天12.18(2.59)次目标行为,而治疗后为3.15(3.19)次);这种减少随时间保持稳定。我们得出结论,EAT对这名因严重脑损伤而出现不当性行为的患者有效。因此,对于脑损伤患者中治疗抵抗性的不当性行为,可考虑采用EAT。