Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK.
Curr Opin Psychiatry. 2017 Mar;30(2):97-101. doi: 10.1097/YCO.0000000000000313.
This review summarises the recent trends in research in the field of self-injurious behaviour in people with intellectual disability and autism spectrum disorder.
New data on incidence, persistence and severity add to studies of prevalence to indicate the large scale of the clinical need. A number of person characteristics have been repeatedly identified in prevalence and cohort studies that: can be considered as risk markers (e.g. stereotyped behaviour, autism spectrum disorder) and indicate possible causal mechanisms (e.g. sleep disorder, anxiety). Studies have started to integrate traditional operant learning paradigms with known person characteristics and reviews and meta-analyses of applied behaviour analytic procedures can now inform practice.
Despite these positive developments interventions and appropriate support falls far short of the required need. Expansions in applied research are warranted to develop and evaluate innovative service delivery models that can translate knowledge of risk markers and operant learning paradigms into widespread, low cost routine clinical practice. Alongside this, further pure research is needed to elucidate the direction of causality of implicated risk factors, in order to understand and intervene more effectively in self-injury.
本文总结了智障和自闭症谱系障碍患者自伤行为领域的研究新趋势。
发病率、持续性和严重程度的新数据增加了患病率研究，表明临床需求规模很大。在患病率和队列研究中，已经反复确定了一些人的特征，这些特征可以被认为是风险标志物（例如刻板行为、自闭症谱系障碍），并表明可能的因果机制（例如睡眠障碍、焦虑）。研究已经开始将传统的操作性学习范式与已知的人的特征相结合，现在可以通过应用行为分析程序的综述和荟萃分析为实践提供信息。
尽管有这些积极的发展，干预措施和适当的支持仍然远远不能满足需求。扩大应用研究是必要的，以开发和评估创新的服务提供模式，将风险标志物和操作性学习范式的知识转化为广泛的、低成本的常规临床实践。与此同时，还需要进一步的纯研究来阐明所涉及的风险因素的因果关系方向，以便更有效地理解和干预自伤行为。
