Byiers Breanne J, Gunderson Jaclyn, Huebner Andrea, Symons Frank J
Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
J Intellect Disabil Res. 2025 Jun;69(6):465-479. doi: 10.1111/jir.13228. Epub 2025 Mar 19.
Self-injurious behaviour (SIB) is a common problem among individuals with intellectual and developmental disabilities (IDDs) with important impacts on quality of life. Although some evidence suggests that SIB may increase with age, perhaps in a curvilinear pattern, this is primarily based on cross-sectional studies. Therefore, the purpose of the current study was to conduct a prospective, longitudinal analysis of age-related changes in a high-risk cohort of children with developmental disabilities/delays.
A total of 110 participants, between 2 and 12 years of age at enrolment (70% male), were followed for between 2 and 4 years. Caregivers completed the RBS-EC SIB subscale annually, for a total of 317 assessments. The SIB total score, SIB interference ratings and endorsement of specific topographies were selected as dependent measures. Generalised linear models evaluating linear, quadratic and cubic age-related changes and differences by intellectual disability (ID) status (no or mild ID vs. moderate to profound ID) were created for each outcome.
For SIB total scores, the model suggested complex developmental patterns that varied by degree of ID. For SIB interference ratings, the model suggested that individuals with moderate to profound ID showed relatively high and stable levels of SIB interference across ages, whereas individuals with no or mild ID showed an increasing trend with age. Patterns varied across the specific SIB topographies.
The results suggest that age-related changes in SIB are complex and may vary across topographies. Overall, the results are concerning in that they indicate a potentially increasing trend in frequency of SIB and its impact on daily activities as individuals approach adolescence, indicating the need for further longitudinal work across the lifespan.
自伤行为（SIB）是智力和发育障碍（IDD）个体中的常见问题，对生活质量有重要影响。尽管一些证据表明SIB可能随年龄增长，或许呈曲线模式，但这主要基于横断面研究。因此，本研究的目的是对发育障碍/发育迟缓高危儿童队列中与年龄相关的变化进行前瞻性纵向分析。
共有110名参与者，入组时年龄在2至12岁之间（70%为男性），随访2至4年。照顾者每年完成RBS-EC SIB子量表，共进行317次评估。选择SIB总分、SIB干扰评分和特定行为表现的认可情况作为因变量。针对每个结果创建广义线性模型，评估按智力残疾（ID）状态（无或轻度ID与中度至重度ID）划分的线性、二次和三次与年龄相关的变化及差异。
对于SIB总分，模型显示出因ID程度而异的复杂发育模式。对于SIB干扰评分，模型表明中度至重度ID个体在各年龄段的SIB干扰水平相对较高且稳定，而无或轻度ID个体则随年龄呈上升趋势。不同特定SIB行为表现的模式各不相同。
结果表明，SIB中与年龄相关的变化很复杂，可能因行为表现而异。总体而言，结果令人担忧，因为它们表明随着个体接近青春期，SIB频率及其对日常活动的影响可能呈上升趋势，这表明需要在整个生命周期进行进一步的纵向研究。
