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Handbook of Crisis Intervention and Developmental Disabilities pp 199–211Cite as

The Motivation for Self-Injury: Looking Backward to Move Forward

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Part of the book series: Issues in Clinical Child Psychology ((ICCP))

Abstract

Self-injurious behavior (SIB) is among the most disturbing, destructive, and costly behavior disorders among people with developmental, psychiatric, and neurological disorders. In people with intellectual or developmental disorders (I/DD), there are numerous forms including self-hitting, pinching, scratching, and biting (Schroeder et al., 2001). In almost all cases of SIB, the etiology of the behavior disorder is unknown, and any underlying pathogenesis and pathophysiology is only partly understood. The field of behavior analysis has made enormous progress in understanding and treating SIB among individuals with I/DD population since the 1970s, but there is still much to do. This chapter will provide a selective review of clinical research findings and a synthesis of the underlying behavioral approach that has led to a better understanding of SIB, its forms, functions, and effective intervention. It is important to note that the review is focused almost exclusively on maintaining factors related to SIB. Discussion of the etiology of SIB is beyond the scope of the chapter. Clinical examples of SIB are used to illustrate practical applications of functional assessment technology and illustrate basic principles of behavior in relation to behavioral mechanisms (e.g., positive, negative) as well as the intersection of behavior and biology.

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References

  • Barrera, F. J., Teodoro, J. M., Selmeci, T., & Madappuli, A. (1994). Self-injury, pain, and the endorphin theory. Journal of Developmental and Physical Disabilities, 6, 169–192.

    Article  Google Scholar 

  • Barrera, F. J., Violo, R. A., & Graver, E. E. (2007). On the form and function of severe self-injurious behavior. Behavioral Interventions, 22, 5–33.

    Article  Google Scholar 

  • Baumeister, A. A., & Rollings, J. P. (1976). Self-injurious behavior. In N. R. Ellis (Ed.), International review in mental retardation (Vol. 9). New York: Academic.

    Google Scholar 

  • Bosch, J., Van Dyke, D. C., Smith, S. M., & Poulton, S. (1997). Role of medical conditions in the exacerbation of self-injurious behavior: An exploratory study. Mental Retardation, 35(124), 130.

    Google Scholar 

  • Breau, L. M., Camfield, C. S., Symons, F. J., Bodfish, J. W., MacKay, A., Finley, G. A., et al. (2003). The relation between pain and self-injurious behavior in non-verbal children with severe cognitive impairments. The Journal of Pediatrics, 142, 498–503.

    Article  PubMed  Google Scholar 

  • Breese, G. R., Criswell, H. E., Duncan, G. E., Moy, S. S., Johnson, K. B., Wong, D. R., et al. (1995). Model for reduced brain dopamine in Lesch-Nyhan Syndrome and the mentally retarded: Neurobiology of neonatal-6-hydroxydopamine lesioned rats. Mental Retardation and Developmental Disability Research Reviews., 1, 111–119.

    Article  Google Scholar 

  • Brewer, K. L., Lee, J. W., Downs, H., Oaklander, A. L., & Yesierski, R. P. (2008). Dermatomal scratching after intramedullary quisqualate injection: Correlation with cutaneous denervation. The Journal of Pain, 9, 999–1005.

    Article  PubMed  Google Scholar 

  • Carr, E. G. (1977). The motivation of self-injurious behavior: A review of some hypotheses. Psychological Bulletin, 84, 800–816.

    Article  PubMed  Google Scholar 

  • Crosland, K. A., Zarcone, J. R., Lindauer, S. E., Valdovinos, M. G., Zarcone, T. J., Hellings, J. A., et al. (2003). Use of functional analysis methodology in the evaluation of medication effects. Journal of Autism and Developmental Disorders, 33, 271–279.

    Article  PubMed  Google Scholar 

  • Derby, K. M., Wacker, D. P., Sasso, G., Steege, M., Northup, J., Cigrand, K., et al. (1992). Brief functional assessment techniques to evaluate aberrant behavior in an outpatient setting: A summary of 79 cases. Journal of Applied Behavior Analysis, 25, 713–721.

    Article  PubMed  Google Scholar 

  • Edelson, S. M. (1984). Implications of sensory stimulation in self-destructive behavior. American Journal of Mental Deficiency, 89(2), 140–145.

    PubMed  Google Scholar 

  • Freeman, R., Horner, R., & Reichle, J. (1999). Relation between heart rate and problem behaviors. American Journal on Mental Retardation, 104, 330–345.

    Article  PubMed  Google Scholar 

  • Garcia, D., & Smith, R. G. (1999). Using analog baselines to assess the effects of naltrexone on self-injurious behavior. Research in Developmental Disabilities, 20, 1–21.

    Article  PubMed  Google Scholar 

  • Harding, J. W., Wacker, D. P., Berg, W. K., & Winborn-Kemmerer, L. (2009). Analysis of multiple manding topographies during functional communication training. Education and Treatment of Children, 32, 21–36.

    Article  PubMed  Google Scholar 

  • Hartman, E. C., Gilles, E., McComas, J. J., Danov, S. E., & Symons, F. J. (2008). Clinical observation of self-injurious behavior correlated with changes in scalp morphology in a child with congenital hydrocephalus. Journal of Child Neurology, 23, 1062–1065.

    Article  PubMed  Google Scholar 

  • Iwata, B. A., Dorsey, M. F., Slifer, K. J., Bauman, K. E., & Richman, G. S. (1982/1994). Toward a functional analysis of self-injury. Journal of Applied Behavior Analysis, 27, 197–209. Reprinted from Analysis and Intervention in Developmental Disabilities, 2, 3–20.

    Google Scholar 

  • Kennedy, C. H., & O’Reilly, M. E. (2006). Pain, health conditions, and problem behavior in people with developmental disabilities. In T. F. Oberlander & F. J. Symons (Eds.), Pain in children and adults with developmental disabilities (pp. 121–138). Baltimore: Paul H. Brookes.

    Google Scholar 

  • Kennedy, C. H., & Souza, G. (1995). Functional analysis and treatment of eye poking. Journal of Applied Behavior Analysis, 28, 27–37.

    Article  PubMed  Google Scholar 

  • King, B. H., McCracken, J. T., & Poland, R. E. (1991). Deficiency in the opioid hypothesis of self-injurious behavior. American Journal on Mental Retardation, 95, 692–994.

    PubMed  Google Scholar 

  • Kurtz, P. F., Chin, M. D., Huete, J. M., Tarbox, R. S. F., O’Connor, J. T., Paclawskyj, T. R., et al. (2003). Functional analysis and treatment of self-injurious behavior in young children: A summary of 30 cases. Journal of Applied Behavior Analysis, 36, 205–219.

    Article  PubMed  Google Scholar 

  • LaChapelle, D. L., Hadjistavropoulos, T., & Craig, K. D. (1999). Pain measurement in persons with intellectual disabilities. The Clinical Journal of Pain, 15, 13–23.

    Article  PubMed  Google Scholar 

  • Lindberg, J. S., Iwata, B. A., & Kahng, S. W. (1999). On the relation between object manipulation and stereotypic self-injurious behavior. Journal of Applied Behavior Analysis, 32, 51–62.

    Article  PubMed  Google Scholar 

  • Nagai, Y., Cavanna, A., & Critchley, H. D. (2009). Influence of sympathetic arousal on tics: Implications for a therapeutic behavioral intervention for Tourette syndrome. Journal of Psychosomatic Research, 67, 599–605.

    Article  PubMed  Google Scholar 

  • Newell, K. M., Challis, J. H., Boros, R. L., & Bodfish, J. W. (2002). Further evidence on the dynamics of self-injurious behaviors: Impact forces and limb motions. American Journal on Mental Retardation, 107, 60–68.

    Article  PubMed  Google Scholar 

  • Nock, M. K., & Mendes, W. B. (2008). Physiological arousal, distress tolerance, and social problem-solving deficits among adolescent self-injurers. Journal of Consulting and Clinical Psychology, 76, 28–38.

    Article  PubMed  Google Scholar 

  • O’Reilly, M. F. (1997). Functional analysis of episodic self-injury correlated with recurrent otitis media. Journal of Applied Behavior Analysis, 30, 165–167.

    Article  PubMed  Google Scholar 

  • Oaklander, A. L., Cohen, S. P., & Raju, S. V. Y. (2002). Intractable postherpetic itch and cutaneous deafferentation after facial shingles. Pain, 96, 9–12.

    Article  PubMed  Google Scholar 

  • Patel, M. R., Carr, J. E., Kim, C., Robles, A., & Eastridge, D. (2000). Functional analysis of aberrant behavior maintained by automatic reinforcement: Assessments of specific sensory reinforcers. Research in Developmental Disabilities, 21, 393–407.

    Article  PubMed  Google Scholar 

  • Rojahn, J., Schroeder, S., & Hoch, T. A. (2008). Self-Injurious behavior in intellectual disabilities. New York: Elsevier.

    Google Scholar 

  • Romanczyk, R. G. (1986). Self-injurious behavior: Conceptualization, assessment, and treatment. In K. Gadow (Ed.), Advances in learning and behavioral disabilities. Greenwich, CT: JAI Press.

    Google Scholar 

  • Sandman, C. A., Barron, J. L., Chicz-DeMet, A., & DeMet, E. M. (1991). Plasma B-endorphin levels in patients with self-injurious behavior and stereotypy. American Journal on Mental Retardation, 95, 84–92.

    Google Scholar 

  • Sandman, C. A., Spence, M. A., & Smith, M. (1999). Proopiomelanocortin (POMC) disregulation and response to opiate blockers. Mental Retardation and Developmental Disabilities Research Reviews, 5, 314–321.

    Article  Google Scholar 

  • Sandman, C. A., Touchette, P., Lenjavi, M., Marion, S., & Chicz-DeMet, A. (2003). β-Endorphin and ACTH are dissociated after self-injury in adults with developmental disabilities. American Journal on Mental Retardation, 108, 414–424.

    Article  PubMed  Google Scholar 

  • Schroeder, S. R., Oster-Granite, M. L., Berkson, G., Bodfish, J. W., Breese, G. R., Cataldo, M. F., et al. (2001). Self-injurious behavior: Gene-brain-behavior relationships. Mental Retardation and Developmental Disabilities Research Reviews, 7, 3–12.

    Article  PubMed  Google Scholar 

  • Steege, M. W., Wacker, D. P., Cigrand, K. C., Berg, W. K., Novak, C. G., Reimers, T. M., et al. (1990). Use of negative reinforcement in the treatment of self-injurious behavior. Journal of Applied Behavior Analysis, 23, 459–467.

    Article  PubMed  Google Scholar 

  • Symons, F. J. (2011). Self-injurious behavior and neurodevelopmental disorders: Relevance of nociceptive and sensory mechanisms. Neuroscience and Biobehavioral Reviews, 35, 1266–1274.

    Article  PubMed  Google Scholar 

  • Symons, F. J., Fox, N. D., & Thompson, T. (1998). Functional communication training and naltrexone treatment of self-injurious behavior: An experimental case report. Journal of Applied Research in Intellectual Disabilities, 11, 273–292.

    Article  Google Scholar 

  • Symons, F. J., Shinde, S., Clary, J., Harper, V., & Bodfish, J. W. (2010). A sham-controlled sensory testing protocol for nonverbal individuals with intellectual and developmental disabilities: Self-injury and gender effects. The Journal of Pain, 11, 773–781.

    Article  PubMed  Google Scholar 

  • Symons, F. J., Thompson, A., & Rodriguez, M. R. (2004). Self-injurious behavior and the efficacy of naltrexone treatment: A quantitative review. Mental Retardation and Developmental Disabilities Research Reviews, 10, 193–200.

    Article  PubMed  Google Scholar 

  • Symons, F. J., Wendelschafer-Crabb, G., Kennedy, W., & Bodfish, J. W. (2009). Degranulated mast cells in the skin of adults with self-injurious behavior and neurodevelopmental disorders. Brain, Behavior, and Immunity, 23, 365–370.

    Article  PubMed  Google Scholar 

  • Thompson, T. (1981). Behavioral mechanisms and the loci of drug dependence: An overview. In T. Thompson & C. E. Johanson (Eds.), Behavioral pharmacology of human drug dependence. NIH Washington, DC: NIDA Research Monograph No. 37.

    Google Scholar 

  • Thompson, T., Moore, T., & Symons, F. J. (2007). Psychopharmacology and positive behavior support. In S. L. Odom, R. Horner, M. Snell, & J. Blacher (Eds.), Handbook of developmental disabilities (pp. 501–528). New York, NY: Guilford Press.

    Google Scholar 

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Acknowledgments

Portions of the manuscript were written with support, in part, from NIH Grant No. 44763 & 47201.

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Authors and Affiliations

  1. Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA

    Jennifer McComas & Frank J. Symons

Authors
  1. Jennifer McComas
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  2. Frank J. Symons
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Correspondence to Jennifer McComas .

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Editors and Affiliations

  1. , Dept. Applied Behavioral Science, University of Kansas, Sunnyside Avenue 1000, Lawrence, 66045, Kansas, USA

    Derek D. Reed

  2. , Dept. Applied Behavioral Science, University of Kansas, Sunnyside Avenue 1000, Lawrence, 66044, Kansas, USA

    Florence D. DiGennaro Reed

  3. May Institute, Pacella Park Drive 41, Randolph, 02368, Massachusetts, USA

    James K. Luiselli

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McComas, J., Symons, F.J. (2013). The Motivation for Self-Injury: Looking Backward to Move Forward. In: Reed, D., DiGennaro Reed, F., Luiselli, J. (eds) Handbook of Crisis Intervention and Developmental Disabilities. Issues in Clinical Child Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6531-7_12

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