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Psychological treatment of self-injury.

Behavioural treatment techniques were used for eliminating self-injurious behaviours of two mentally retarded patients. During treatment, each self-injurious response resulted in punishment followed by a timeout period and then differential reinforcement of other behaviours incompatible with self-injury. This procedure was effective in rapidly eliminating self-injury.

Behavior Therapy

A biological approach to two forms of human self-injury.

One hundred cases of self-injury, comprising 39 self-cutters and 61 self-poisoners, were interviewed when they became able to describe the act: 83 in a casualty department, 17 in a hospital. Standardized recordings were made of their feeling state before and after the act, together with an account of the social circumstances under which it occurred. The information was obtained in a way which allowed comparison with existing animal data on self-injury, although comparisons were made between what is known of animal behavior in this area and human feelings as reported by these subjects. The results indicate similarities between what is known of animal self-injury and self-cutting in man in the form of the injury, in the social situation preceding the act, and in the agitation preceding it. Similarities also exist, but are less close, for the self-poisoners. The most obvious effect of the act is a reduction in tension; this may constitute its physiological value.

Adolescent

Suicidal behavior as a form of communication in married couples.

Suicidal behavior, specifically threats of suicide and acts of self-injury and self-poisoning, are interpreted by suicidologists as acts of communication directed to some person important in the social life of the potential victim. Four groups of married couples were studied using a measure of their marital communication habits and an intensive personal interview. These groups included wives who (a) were volunteer workers in a suicide prevention center, (b) were experiencing marital problems but were not actively suicidal, (c) had called the suicide prevention center and made a verbal threat of suicide, and (d) had actually committed acts of self-injury or self-poisoning for which they received emergency room or hospital treatment. Analysis of the data revealed that the quality of interpersonal communication between spouses significantly deteriorated across the groups as the degree of suicidal behavior increased. Descriptive data are discussed for their relevance to clinicians who, if they correctly interpret the meaning of the "suicide attempt," may be in a position to facilitate its being a successful one.

Attitude

Self-injury in the de Lange syndrome.

Self-injury, a common problem among retarded children is thought to be a behavioural manifestation of an organic disease and the usual treatment has been through drugs or physical restraint. Psychological treatment techniques were used to control such behaviour in a de Lange syndrome patient. The treatment was effective in producing clinically significant control of self-injurious behaviour.

Adolescent

Speech skill levels and prevalence of maladaptive behaviors in autistic and mentally retarded children: a statistical study.

Forty-seven autistic and 128 mentally retarded children, ages 6 to 14, from a special school were assessed in terms of nine maladaptive behaviors and speech skill levels. The results indicated that the group of the mentally retarded children with withdrawal had significantly lower speech skill levels than the group of those without withdrawal, and the group of the autistic children with self-injury had significantly lower speech skill levels than the group of those without self-injury.

Adolescent

Auto-mutilation in animals and its relevance to self-injury in man.

Self-mutilation in non-human mammals is a well-established, although not a widely known phenomenon, which has been reported under zoo and laboratory conditions. In macaque monkeys, laboratory rearing and isolation are important predisposing factors, and the more serious self-injury is initiated by some immediate stimulating event. It is commonly accompanied by behaviour normally shown by the animal in a fighting context. Lower mammals are also known to mutilate themselves under laboratory conditions after administration of drugs wich probably cause increased sympathetic activity. The implications of this behaviour for an understanding of states of self-injury in man are discussed.

Aggression

The syndrome of abuse dwarfism (psychosocial dwarfism or reversible hyposomatotropism).

In abuse dwarfism the behavioral signs include some or all of the following: (1) a history of unusual eating and drinking behavior, reversible on change of domicile, such as eating from a garbage can and drinking from a toilet bowl, stealing food, alleged picky eating and rejecting food at the table, polydipsia and polyphagia, possibly alternating with vomiting and possibly also with self-starvation; (2) a history of such behavioral symptoms as enuresis, encopresis, social apathy or inertia, defiant aggressiveness, sudden tantrums, crying spasms, insomnia, eccentric sleeping and waking schedule, pain agnosia, and self-injury, all occurring only in the growth-retarding environment; (3) retarded motor development, with improvement on removal of the child from the domiclle of abuse; (4) retarded intellectual growht, reversible on change of domicile by as much as 30 to 50 IQ points; and (5) a history of pathologic family relationships, including unusual cruelty and neglect, either somatic or psychic or both.

Adolescent

Systematic Review of Symptoms of Catatonia in Autism Spectrum Disorder.

Catatonia is a complex neuropsychiatric syndrome characterized by disturbances in mood, motor function, behavior and speech. It is increasingly recognized in individuals with autism spectrum disorder (ASD), although its identification remains challenging due to the overlapping clinical features of the two conditions. Shared characteristics, such as echophenomena, mannerisms, social indifference and repetitive behaviors can obscure accurate diagnosis. Although reports suggest a significant prevalence of catatonia among individuals with ASD, the condition remains poorly understood and frequently under recognized, leading to substantial diagnostic and treatment challenges. A systematic review was conducted to characterize the symptoms of catatonia in individuals with ASD. The literature search included peer-reviewed journal articles published in English from 1980 onward, focusing on studies examining co-occurring catatonia and ASD. A qualitative framework analysis was implemented to evaluate 45 peer-reviewed studies, with findings interpreted in relation to, and extending beyond, the diagnostic criteria for catatonia outlined in the International Classification of Diseases, 11th revision (ICD-11). The objective was to identify symptom patterns extending beyond current diagnostic frameworks and to support improved clinical recognition and diagnostic precision in ASD populations. The review identified six primary symptom clusters associated with catatonia in individuals with ASD: (1) psychomotor activity, (2) speech disturbances, (3) changes in behavior/skills/functions, (4) mental health symptoms, (5) physiological symptoms, and (6) symptoms related to arousal and awareness. Notably, several symptoms observed within these clusters are not currently included in the ICD-11 diagnostic criteria for catatonia. These additional symptoms include tics, motor compliance, incoherent speech, self-injury, impaired cognition, and appetite changes, suggesting a broader clinical presentation of catatonia in ASD populations than is presently captured in existing diagnostic frameworks. The findings of this review highlight the significance of enhancing clinicians' awareness and understanding of how catatonia manifests in individuals with ASD. Most notably, six symptom clusters, psychomotor changes, speech disturbances, behavioral and functional regression, affective and psychiatric symptoms, physiological symptoms, and arousal/awareness disturbances, were observed. Several symptoms identified in this review are not included in the current diagnostic criteria, and their recognition may facilitate in earlier identification and timely intervention, potentially preventing the severe consequences of untreated catatonia in this population.

Humans

Differences between mentally retarded and normally intelligent autistic children.

Autistic children with an IQ below 70 and with an IQ above 70 were systematically compared. The two groups differed somewhat in the pattern of symptoms, but were closely similar in terms of the main phenomena specifically associated with autism. However, the low IQ and high IQ autistic children differed more substantially in terms of other symptoms such as self-injury and stereotypies and there were major differences in outcome. The possibility that the nature of the autistic disorder may differ according to the presence or absence of associated mental retardation needs to be taken into account in planning studies of etiology.

Achievement