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社区环境下的自伤行为描述性分析:探索行为-行为关联。

A descriptive analysis of self-injury in community settings: exploring behaviour-behaviour contingencies.

机构信息

Department of Counseling and Applied Behavioral Studies, University of Saint Joseph, West Hartford, CT, USA.

Department of Special Education, Vanderbilt University, Nashville, TN, USA.

出版信息

J Intellect Disabil Res. 2018 Dec;62(12):1097-1107. doi: 10.1111/jir.12485. Epub 2018 Mar 14.

Abstract

BACKGROUND

Self-injurious behaviour (SIB) is a treatment-resistant aberrant behaviour that significantly impacts the lives of people with intellectual disabilities (ID). Direct observations of SIB under naturally occurring conditions can inform the unique structural properties of these behaviours, and the contexts in which they occur. While previous applications of sequential analyses have identified strong temporal associations between instances of SIB, they have relied on methods that do not adequately control for chance sequencing and may mask within-participant variability by pooling data across contexts and response topographies. We applied a new sequential analysis method to quantify SIB-SIB contingencies within and across topographies for individuals with ID in community settings. We also explored the extent to which the direction and strength of SIB-SIB contingencies varied by context.

METHOD

Seven individuals with chronic SIB were video-recorded during their daily routines. A continuous, timed-event data collection system was used to measure frequencies of five topographies of SIB and duration of staff interactions. We used an event lag with pauses sequential analysis method to estimate SIB-SIB contingencies within and across topographies and during times with and without staff interaction.

RESULTS

Positive SIB-SIB contingencies were identified for all participants, with contingency strengths varying among participants and topographies. The strength and direction of the SIB-SIB contingencies also varied by the presence and absence of staff interaction.

CONCLUSIONS

Our results suggest the direction and strength of SIB-SIB contingencies may be fluid based on the presence or absence of certain environmental context variables. Evaluating SIB-SIB contingencies under different environmental conditions may help identify contexts in which SIB is likely to persist.

摘要

背景

自伤行为(SIB)是一种治疗抵抗性的异常行为,严重影响智力障碍(ID)患者的生活。在自然发生的情况下对 SIB 进行直接观察,可以了解这些行为的独特结构特性,以及它们发生的背景。虽然先前对序列分析的应用已经确定了 SIB 之间存在强烈的时间关联,但它们依赖于不能充分控制随机序列的方法,并且可能通过跨背景和反应地形合并数据来掩盖参与者内的变异性。我们应用了一种新的序列分析方法,来量化社区环境中 ID 个体的 SIB-SIB 关联的内部和跨地形。我们还探讨了 SIB-SIB 关联的方向和强度因背景而异的程度。

方法

对七名患有慢性 SIB 的个体在其日常生活中进行录像。使用连续的、计时事件数据收集系统来测量五种 SIB 地形的频率和员工互动的持续时间。我们使用具有停顿的事件滞后序列分析方法来估计 SIB-SIB 关联的内部和跨地形,以及在有和没有员工互动的情况下。

结果

所有参与者都确定了正 SIB-SIB 关联,关联强度在参与者和地形之间存在差异。SIB-SIB 关联的强度和方向也因员工互动的存在与否而变化。

结论

我们的结果表明,SIB-SIB 关联的方向和强度可能是基于某些环境上下文变量的存在或缺失而变化的。在不同的环境条件下评估 SIB-SIB 关联可能有助于识别 SIB 可能持续存在的背景。

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