Pyles D A, Muniz K, Cade A, Silva R
W. A. Howe Developmental Center, Tinley Park, IL 60477-3697, USA.
Res Dev Disabil. 1997 May-Jun;18(3):185-214. doi: 10.1016/s0891-4222(97)00003-6.
Aberrant behaviors exhibited by people with developmental disabilities have been well documented. Often, psychotropic medications, especially neuroleptics, have been used to control behaviors such as self-injury, physical aggression, property destruction, and hyperactivity. Serious side effects of these medications have occurred, resulting in litigation and regulation of their use by courts, surveyors, and accrediting bodies. Rules and regulations have been developed requiring that behaviors/symptoms necessitating that medication usage be clearly delineated, that behavior programs be developed and implemented to reduce need, and that the interdisciplinary team approach be used to monitor effectiveness of interventions. Currently, little guidance exists on how behavioral and psychopharmacological interventions should be applied or combined. This paper presents a paradigm for integrating behavior-analytic and psychopharmacological treatment interventions in the treatment of persons with developmental disabilities that meets applicable standards. Our model is consistent with the least restrictive, yet effective treatment philosophy. Implications for research and treatment are presented.
发育障碍患者表现出的异常行为已有充分记录。通常，精神药物，尤其是抗精神病药物，已被用于控制诸如自我伤害、身体攻击、破坏财产和多动等行为。这些药物出现了严重的副作用，导致了诉讼以及法院、检查员和认证机构对其使用的监管。已制定规则和条例，要求明确界定需要使用药物的行为/症状，制定并实施行为方案以减少需求，并采用跨学科团队方法来监测干预措施的有效性。目前，关于行为和心理药物干预应如何应用或结合的指导很少。本文提出了一种将行为分析和心理药物治疗干预相结合的范式，用于治疗符合适用标准的发育障碍患者。我们的模型与限制最少但有效的治疗理念一致。文中还阐述了对研究和治疗的启示。
