Institute on Community Integration, University of Minnesota(,) Minneapolis, MN, USA.
Dept. of Educational Psychology, University of Minnesota(,) Minneapolis, MN, USA.
Clin Psychol Rev. 2022 Jun;94:102158. doi: 10.1016/j.cpr.2022.102158. Epub 2022 Apr 22.
Self-injurious behavior (SIB) by individuals with intellectual and developmental disabilities including autism (I/DD) is among the most clinically disturbing, socially costly, and scientifically challenging behavior disorders. Forty years of clinical research has produced a knowledge base supporting idiographic behavioral assessment and treatment approaches. Despite the treatment progress, from a public health and population perspective, we argue it is less clear that we have reduced the disorder's burden. The developmental course of the disorder is mostly unknown and empirically informed population-level models of risk are absent. In this review, we systematically examined the published scientific literature specific to risk for SIB in the I/DD population. We reviewed study methodology in detail intentionally informed by an epidemiological perspective with a set of questions intended to test the quality of the inferences about risk. Results are discussed in terms of conceptual, methodological, and translational issues with respect to what needs to be done to create credible and useful clinical models for SIB risk in the I/DD population.
自我伤害行为（SIB）是指智力和发育障碍者（包括自闭症患者）表现出的一种行为障碍，这种行为不仅在临床上令人困扰，而且还会给社会造成严重的经济负担，同时也是科学界面临的极具挑战性的问题之一。四十年来，临床研究已经为特定行为评估和治疗方法提供了相关知识基础。尽管治疗取得了一定的进展，但从公共卫生和人群的角度来看，我们认为该障碍的负担是否有所减轻还不太明确。该障碍的发展过程大部分还不为人知，也缺乏基于实证的人群风险模型。在这篇综述中，我们系统地检查了特定于智力和发育障碍者中 SIB 风险的已发表科学文献。我们详细审查了研究方法，从流行病学的角度出发提出了一系列问题，旨在检验关于风险的推断的质量。结果从概念、方法和转化的角度进行了讨论，这些问题涉及到如何在智力和发育障碍者人群中创建可信和有用的 SIB 风险临床模型。
