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Identifying the variables maintaining self-injurious behavior.

Reliability and validity data are reported for an instrument designed to identify variables maintaining self-injurious behavior. The Motivation Assessment Scale (MAS) is a 16-item questionnaire that addresses the situational determinants of self-injurious behavior in persons with autism and other developmental disorders. The reliability study indicated that teachers of 50 developmentally disabled persons could agree on the variables presumably maintaining their student's self-injury (interrater reliability), and that they would be in agreement again 30 days later (test-retest reliability). The validity study indicated that teacher's ratings on the MAS of 8 subjects' self-injury predicted how their students would behave in analogue situations. Specifically, the MAS predicted the subjects' self-injurious behavior in situations with decreased adult attention, with increased academic demands, with restricted access to tangibles, and in unstructured settings. The MAS is presented as an alternative or adjunct to more formal functional analyses in efforts to identify the variables controlling self-injurious behavior.

Adolescent↗

Thioridazine dose effects with reference to stereotypic behavior in mentally retarded residents.

Eleven residents receiving long-term thioridazine treatment were studied while receiving their previous dose, standardized low and high doses (1.25 and 2.50 mg/kg per day), and placebo conditions. For theoretical reasons, subjects were also classified by degree of stereotypic behavior on the Fairview Problem Behavior Checklist (Barron & Sandman, 1983). Ratings of hyperactivity and self-injury were significantly lower during the higher as compared with the lower dose condition. Subjects classified as in the high-stereotypy group had significantly and substantially higher levels of maladaptive behavior on several other clinical variables. When all four drug conditions were compared, no significant drug effects were detected. However, high-stereotypy subjects responded significantly better to the drug than low-stereotypy subjects on ratings of Lethargy/Social Withdrawal and Hyperactivity on the Aberrant Behavior Checklist (Aman, Singh, Stewart, & Field, 1985a). The findings were related to previous dosage research and the literature on stereotypic behavior.

Dose-Response Relationship, Drug↗

A case report of naltrexone treatment of self-injury and social withdrawal in autism.

The endogenous opiate release theory of self-injurious behavior (SIB) was investigated through double-blind placebo-controlled administration of naltrexone hydrochloride (Trexan) to a 14-year-old autistic and mentally retarded male for treatment of severe SIB. Results yielded a marked decrease in SIB during two phases of active drug treatment, though SIB did not revert to originally observed placebo levels during a second placebo phase. An increase in social relatedness also was observed during phases of active drug treatment. Opiate theories of self-injury and the possible interrelationship of self-injury with pituitary-adrenal arousal and with social relatedness are discussed.

Adolescent↗

The definition, taxonomy, epidemiology, and ecology of self-injurious behavior.

The paper is a theoretical analysis of the evolution of the concepts related primarily to the definition and to the antecedents of self-injurious behavior (SIB). It was found that the definition of SIB as currently used contains surplus meanings unrelated to its scientific utility. At present, a restricted definition of SIB is not warranted because its basic parameters have not been studied adequately. Analysis of SIB taxonomies suggests two subclasses of SIB: social and nonsocial. Epidemiological studies of SIB suggest chronic and acute subsamples that differ in organicity, chronicity, and length of institutionalization. Ecological analysis suggests that a variety of antecedent conditions affect rates and topographies of SIB, e.g., ambient environmental conditions, background settings, situational demands, self-restraint, and type of daily routine activity. Implications were drawn for the organization of therapeutic environments, the study of covariation among collateral topographies, the dynamics of SIB responding, and sequential dependencies among SIB and related topographies.

Autistic Disorder↗

Self-inflicted transanal stripping of colorectal mucosa: report of an unusual case.

A young mentally retarded patient with self-abusive behavior managed to dissect between the mucosa and muscularis layers of the anal canal, through the anus, using his fingers; he managed then to strip the mucosal-submucosal layers of his rectum and colon all the way up to the splenic flexure and presented with an unusual two-yard long "rectal prolapse" which was actually stripped colorectal mucosal-submucosal tube. Diagnosis and management of this unusual patient are discussed. The authors could not find any similar case report in the English Medical literature.

Adult↗

[Self-induced injuries--surgical aspects].

So far, psychiatric-psychoanalytic theories have been able to explain the phenomenon "self-injury" only unsatisfactorily. Moreover, the patients do not turn to a psychiatrist in the first place, but to surgeons, dermatologists, gynecologists or general practitioners. This is therefore an interdisciplinary problem. Since general medical knowledge is relatively unhelpful in diagnosing self-inflicted disease and its treatment, these patients often do not receive adequate psychiatric co-management or further care or indeed often get the chance to delegate the act of self-injury to the physician. In view of the sustained tendency for the disorder to chronify, this frequently results in severe, partly irreversible and sometimes iatrogenically co-induced physical impairments. In the final analysis, it also leads to enormous financial burdens for the agencies which bear the costs.

Adult↗

Decapod crustacean chelipeds: an overview.

The structure, growth, differentiation and function of crustacean chelipeds are reviewed. In many decapod crustaceans growth of chelae is isometric with allometry level reaching unity till the puberty moult. Afterwards the same trend continues in females, while in males there is a marked spurt in the level of allometry accompanied by a sudden increase in the relative size of chelae. Subsequently they are differentiated morphologically into crusher and cutter making them heterochelous and sexually dimorphic. Of the two, the major chela is used during agonistic encounters while the minor is used for prey capture and grooming. Various biotic and abiotic factors exert a negative effect on cheliped growth. The dimorphic growth pattern of chelae can be adversely affected by factors such as parasitic infection and substrate conditions. Display patterns of chelipeds have an important role in agonistic and aggressive interactions. Of the five pairs of pereiopods, the chelae are versatile organs of offence and defence which also make them the most vulnerable for autotomy. Regeneration of the autotomized chelipeds imposes an additional energy demand called "regeneration load" on the incumbent, altering energy allocation for somatic and/or reproductive processes. Partial withdrawal of chelae leading to incomplete exuviation is reported for the first time in the laboratory and field in Macrobrachium species.

Agonistic Behavior↗

Interpersonal violence, aggression, and antisocial behaviours in the adolescents.

Violence is a growing problem among adolescents all over the world. Exposure to violence can have lasting and pervasive effects on an adolescent's mental and physical health, general well-being, and ability to become a productive adult. Research on adolescent violence in India and Southeast Asia is limited; very little is written in clinical journals. Addressing adolescent violence is currently a low priority for medical practitioners because disease, poverty, and infant maternal health pose more immediate threats to morbidity and mortality in Asia. Physicians, especially in India, have a unique opportunity to take preventative actions now, to stem the tide of morbidity and mortality from gun violence that plagues the United States. Adolescents in Asia are at greatest risk for violence exposure in their homes. Pediatricians who are proactive and educate their patients, families, and the community can help reduce or prevent morbidity and mortality resulting from violence in adolescents.

Adolescent↗