Crews W D, Rhodes R D, Bonaventura S H, Rowe F B, Goering A M
Central Virginia Training Center, Lynchburg, VA 24505, USA.
Res Dev Disabil. 1999 Jan-Feb;20(1):23-30. doi: 10.1016/s0891-4222(98)00029-8.
Longitudinal follow-ups of the cessation of long-term Naltrexone administration (1 year of drug therapy) were conducted with a young woman (in her early 30s) with profound mental retardation who had previously displayed dramatic decreases in her self-injurious behaviors (SIB) both during, and for a period of at least 6 months following termination of drug treatment. After 2 and 4 years, post-Naltrexone therapy, the subject continued to exhibit near-zero rates of SIB episodes despite significant turnovers in her direct care staff by the 2-year follow-up, and changes in her physical/living environment and fellow residents by 4-year follow-up. These findings provide further support to the idea that long-term Naltrexone administration may result in highly durable reductions in SIB long after treatment ends and argue against certain aspects of the subject's environment affecting her rates of SIB significantly. These results are discussed in light of the endogenous opiate system theories of SIB. A functional analysis and discussion of the effectiveness of behavioral treatments for her few remaining SIB episodes are also provided.
对一名患有严重智力障碍的年轻女性（30岁出头）进行了长期纳曲酮给药（1年药物治疗）停止后的纵向随访。该女性此前在药物治疗期间及停药后至少6个月内，其自伤行为（SIB）显著减少。在纳曲酮治疗后2年和4年，尽管到2年随访时其直接护理人员有显著变动，到4年随访时其身体/生活环境及同住居民有变化，但该受试者的SIB发作率仍持续接近零。这些发现进一步支持了以下观点：长期服用纳曲酮可能在治疗结束后很长时间内使SIB持续大幅减少，并反驳了受试者环境的某些方面会显著影响其SIB发生率的观点。根据SIB的内源性阿片系统理论对这些结果进行了讨论。还对针对她仅存的少数SIB发作的行为治疗效果进行了功能分析和讨论。
