Burkhart Center for Autism Education and Research, Texas Tech University, Lubbock, TX 79409-1071, USA.
J Intellect Disabil Res. 2013 May;57(5):429-39. doi: 10.1111/j.1365-2788.2012.01628.x. Epub 2012 Sep 24.
Presence of an autism spectrum disorder is a risk factor for development of self-injurious behaviour (SIB) exhibited by individuals with developmental disorders. The most salient SIB risk factors historically studied within developmental disorders are level of intellectual disability, communication deficits and presence of specific genetic disorders. Recent SIB research has expanded the search for risk factors to include less commonly studied variables for people with developmental disorders: negative affect, hyperactivity and impulsivity.
A heterogeneous sample of 617 individuals with autism spectrum disorder diagnoses was derived from the National Database of Autism Research. Latent constructs were estimated from items of the community version of the Aberrant Behaviour Checklist. Structural equation modelling was used to assess whether impulsivity, hyperactivity, negative affect, severity of stereotypy, intellectual functioning or severity of autism symptoms predicted severity of SIB.
Impulsivity (β = 0.46), followed by intellectual functioning (β = -0.39), and stereotypy (β = 0.23) were the variables most highly predictive of increased SIB; impulsivity and stereotypy remained significant predictors of SIB after severity of autism symptoms and intelligence quotient (IQ) were controlled for.
High levels of impulsivity and stereotypy were significant predictors of SIB in a large and diverse sample of people with confirmed autism diagnoses. Future research is needed on the effects of reducing impulsivity and stereotypy on the outcomes of treatment, early intervention and attempts to prevent the development of SIB.
自闭症谱系障碍的存在是导致发育障碍患者出现自伤行为（SIB）的一个风险因素。历史上，在发育障碍中研究的最显著的 SIB 风险因素是智力残疾程度、沟通障碍和特定遗传障碍的存在。最近的 SIB 研究扩大了对风险因素的搜索范围，包括对发育障碍患者研究较少的变量：负性情绪、多动和冲动。
从自闭症国家数据库中提取了一个由 617 名自闭症谱系障碍诊断个体组成的异质样本。使用社区版异常行为检查表的项目来估计潜在结构。结构方程模型用于评估冲动、多动、负性情绪、刻板行为严重程度、智力功能或自闭症症状严重程度是否预测 SIB 的严重程度。
冲动（β=0.46），其次是智力功能（β=-0.39）和刻板行为（β=0.23）是最能预测 SIB 严重程度的变量；在控制自闭症症状严重程度和智商后，冲动和刻板行为仍然是 SIB 的显著预测因素。
在一个有确诊自闭症诊断的大而多样化的样本中，高水平的冲动和刻板行为是 SIB 的显著预测因素。需要进一步研究减少冲动和刻板行为对治疗、早期干预和预防 SIB 发展的效果。
