Singh N N, Winton A S
Appl Res Ment Retard. 1984;5(1):161-70. doi: 10.1016/s0270-3092(84)80028-4.
Pharmacological interventions are often the treatment of choice for controlling the maladaptive behavior of institutionalized mentally retarded children. However, the efficacy of various psychotropic drugs for controlling the behavior of given individuals has not been well established. Further, it is not always clear that decisions to alter a drug regimen are based on actual changes in the behavior of interest. The present study illustrates the use of behavioral observation to assess the effects of various drugs prescribed for the self-injurious behavior of a profoundly mentally retarded 15 year old male. The clinical effectiveness of various dosages of carbamazepine (Tegretol), thioridazine (Melleril), and chlorpromazine (Largactil) was assessed. Except for Melleril 100 mg, tid, when a marked downward trend in the daily rate was observed, no significant reduction in self-injury occurred. Subsequently overcorrection (forced arm exercise) made contingent on each response reduced self-injury to near zero, but only when the last prescribed drug, Tegretol 200 mg, tid, had been withdrawn for several days.
药物干预常常是控制收容机构中智力发育迟缓儿童适应不良行为的首选治疗方法。然而，各种精神药物对特定个体行为控制的疗效尚未得到充分证实。此外，改变药物治疗方案的决定是否基于所关注行为的实际变化也并不总是明确的。本研究阐述了如何运用行为观察来评估为一名重度智力发育迟缓的15岁男性的自伤行为所开的各种药物的效果。评估了不同剂量的卡马西平（痛惊宁）、硫利达嗪（甲硫达嗪）和氯丙嗪（氯普马嗪）的临床疗效。除了每日服用三次、每次100毫克的甲硫达嗪时观察到每日自伤频率有明显下降趋势外，自伤行为并未显著减少。随后，每次自伤行为发生后进行的过度矫正（强迫手臂运动）将自伤行为减少到了几乎为零，但这只是在停用最后开的药物、每日服用三次、每次200毫克的痛惊宁几天后才出现的情况。
