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At least 19 recordsLinked to original sources
PubMed1976

Self-injurious behavior in schizophrenic and retarded children.

Self-injurious behavior is a problem with some children who are primarily nonverval and low-functioning. This behavior has resulted in management difficulties far out of proportion to its incidence. In the present paper, we have considered possible operant and respondent paradigms instrumental in the acquisition and maintenance of several different topographies of self-injurious behavior. Support for these paradigms was gathered from existing epidemiological literature dealing with humans and primates and from the literature concerned with treatment of self-injurious behavior. Immediate outcome and results of subsequent follow-up were presented as a function of type of intervention, the nature of positive reinforcement utilized, and the topography of the self-injurious response involved. Implications were drawn for future research and treatment.

Attention↗
PubMed1979

Comparison of DRO and DRI on rate of suppression of self-injurious behavior.

Two procedures were used to compare the effects of differential reinforcement of other behavior (DRO) and differential reinforcement of incompatible behavior (DRI) on self-injurious behavior (SIB) of three profoundly retarded head-bangers in a multiple-schedule within-subjects design. We found that rewarding a response specifically incompatible with SIB suppressed it more rapidly than applying DRO without specifying an alternative response. The relationship of collateral behaviors to SIB were dependent upon the repertoires of the individual clients.

Adult↗
PubMed1978

Prevalence of self-injurious behaviors in a large state facility for the retarded: a three-year follow-up study.

A combined informant questionnaire and interview survey of self-injurious behavior (SIB) at a large state facility for the retarded was conducted independently three times over a 3-year period. Prevalence consistently was about 10% of the population. SIB cases tended to be younger and institutionalized longer than the rest of the population. Severe cases had a longer history of chronic SIB. SIB cases had more seizure disorders, severe language handicaps, visual impairments, and severe or profound retardation than the rest of the population. They appeared to fulfill most of the Rutter (1966) criteria for autism. But unlike the severely autistic, there was little relation of sex to incidence of SIB. Over 90% of SIB cases changed status over 3 years, suggesting that SIB was amenable to behavior modification in most cases (94%). Psychotropic behavior control medications helped in some intervention programs (32%). SIB remitted spontaneously in 21% of SIB cases where there had been no behavioral or drug intervention.

Adolescent↗
PubMed2026

Implementation of Mobile Health Intervention Targeting Belongingness and Burdensomeness: An Ecological Momentary Assessment Study of Self-Injurious Thoughts and Behaviors in LGBTQ+ Individuals.

OBJECTIVE: The goal of this paper was to test a mobile health intervention designed to reduce self-injurious thoughts and behaviors in LGBTQ+ individuals. The intervention consisted of brief messages aimed at increasing feelings of belongingness and meaning. METHOD: We recruited LGBTQ+ individuals (N = 55) with past-month self-injurious thoughts and/or behaviors. Participants completed 14 days of ecological momentary assessment (EMA) of minority stress, thwarted belongingness, perceived burdensomeness, and self-injurious thoughts and behaviors. Then, participants were randomly assigned to receive brief messages designed to instill belongingness and meaning/purpose, or no intervention for 14 days. Then, participants completed an additional 14 days of EMA. RESULTS: Our results showed that participants in the control condition had significant increases in self-injurious thoughts and planning over time, whereas those in the intervention condition showed no significant change. For self-injurious behavior, thwarted belongingness, and perceived burdensomeness, there were significant decreases in the intervention condition, but no changes in the control condition. CONCLUSIONS: These results provide support for the interpersonal theory of suicide and indicate a potentially scalable mobile health intervention. PUBLIC HEALTH SIGNIFICANCE: This paper found evidence that a brief mobile health intervention reduced suicidal and non-suicidal self-injurious thoughts and behaviors among LGBTQ+ individuals.

Humans↗
PubMed1977

Some determinants of the reinforcing and punishing effects of timeout.

Some determinants of the reinforcing and punishing properties of timeout were investigated in two experiments. Experiment I began as an attempt to reduce the frequency of tantrums in a 6-yr-old autistic girl by using timeout. Unexpectedly, the result was a substantial increase in the frequency of tantrums. Using a reversal design, subsequent manipulations showed that the opportunity to engage in self-stimulatory behavior during the timeout period was largely responsible for the increase in tantrums. Experiment II was initiated following the failure of timeout to reduce the spitting and self-injurious behavior of a 16-yr-old retarded boy. Using a multiple-baseline design, the nature of the timein environment was shown to be an important determinant of the effects of timeout. When the timein environment was "enriched", timeout was effective as a punisher. A conception of timeout in terms of the relative reinforcing properties of timein and timeout and their clinical implications are discussed.

Adolescent↗
PubMed2026

ADCY2 promoter hypomethylation in adolescents with borderline personality disorder: An RRBS study with targeted BSP replication.

BACKGROUND: Borderline Personality Disorder (BPD) is characterized by emotional dysregulation, impulsivity, and interpersonal instability. Although genetic and environmental contributions to BPD have been investigated, epigenetic correlates in adolescents remain poorly understood. The cyclic adenosine monophosphate (cAMP) signaling pathway is implicated in stress responsivity and emotion regulation, but its epigenetic variation in adolescent BPD remains understudied. METHODS: DNA methylation profiling was performed using Reduced Representation Bisulfite Sequencing (RRBS) in buccal epithelial DNA from adolescents with BPD (n = 15) and healthy controls (HC; n = 15). Differentially methylated regions (DMRs) were identified using metilene, a computational tool for detecting DMRs from bisulfite sequencing data, and subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Associations between methylation signals and borderline personality features were examined. Adenylate cyclase 2 (ADCY2) promoter methylation was examined using targeted bisulfite sequencing PCR (BSP) in an independent cohort (BPD n = 5; HC n = 5). RESULTS: RRBS identified 7641 DMRs between BPD and HC, with enrichment in pathways related to neuronal signaling and synaptic organization. A hypomethylated DMR was detected in the ADCY2 promoter, a gene implicated in cAMP signaling. Lower ADCY2 promoter methylation was associated with greater clinical severity, including emotional dysregulation, borderline traits, anxiety symptoms, and self-injury behaviors (r=-0.71 to -0.83; all p < 0.0001). Hypomethylation of the ADCY2 promoter was replicated in the independent cohort. CONCLUSIONS: This exploratory two-stage epigenetic study suggests that ADCY2 promoter hypomethylation in peripheral buccal epithelial DNA is associated with core symptom dimensions of adolescent BPD. These findings support a role for cAMP-related epigenetic variation in BPD and warrant replication in longitudinal studies.

ADCY2↗
PubMed1977

Oral factitious injuries.

The subject of oral factitious injuries is reviewed and four cases are reported. It is noted that self-inflicted oral injuries are not limited to the soft tissue but may result in destruction of bone and tooth structure. While children are more often the subjects of self-injurious behavior about the oral cavity, adults may also exhibit similar conduct. Emotional problems are often co-existent with self-inflicted oral injuries, however, in some cases there does not seem to be a readily descernible emotional disturbance. Since factitious injuries often pose diagnostic problems for the dentist, some diagnostic suggestions are included.

Adult↗
PubMed1976

Age and parasuicide ('attempted suicide').

A one-year cohort of parasuicide patients (n = 882) was divided into three age groups, subdivided by sex where indicated. Systematic comparisons of the groups were made, and significant discrepancies validated using a second cohort of patients. A number of social, demographic and clinical differences were found, as well as some unexpected similarities. The rates for subsequent (completed) suicide were conspicuously different in the six age-sex subgroups.

Adolescent↗
PubMed1979

Parasuicide in young Edinburgh women, 1968--75.

Between 1968 and 1975 there was a marked, non-artefactual rise in the numbers of young female parasuicides admitted to the Regional Poisoning Treatment Centre in Edinburgh. The greatest increase in rates occurred among girls aged 15--19 (for events, persons and 'first-ever' episodes). Among teenagers the most marked increase occurred for those who were married; this group also reported a greater increase than did the non-married in the frequency of physical violence and serious debt. 'Marginel' social-sexual roles have also become progressively more common in this age group. The 20- to 24-year group showed a more modest increase in rates, similar for the married and the non-married. In this age group there was no consistent pattern of change for reported violence or debt over the study period, nor were changes in these variables related to marital status. An increase in consumption of alcohol before parasuicide was noted for both age groups.

Adolescent↗
PubMed1979

Influence of experience and nationality on assessment and outcome of parasuicide.

In Sheffield 544 consecutive cases of attempted suicide (parasuicide) were seen at 2 large hospitals over a 12-month period, and allocated in sequence to the junior and senior psychiatric staff, of British and foreign origin. During the follow-up period of 12 months, 31 patients had a further episode of parasuicide and 5 patients committed suicide. The outcome (as measured by repeat parasuicide or suicide) was not significantly affected by the country of origin of the psychiatrist, nor his length of training in psychiatry.

Adolescent↗
PubMed1979

Predictive scales for parasuicide repetition. Further results.

A six-item predictive scale for parasuicide repetition was retested on a second sample of Italian parasuicides. All the patients firstever admitted after a deliberate self-harm to the psychiatric department of a general hospital during the period April 1973-March 1976 were interviewed and followed-up after an interval of 1 year. The scale showed the same predictive power found in the first sample (1970-73) and gave a range of probability of repetition within 1 year of 15% at a score of 0 up to 44.8% at the scores 3, 4, 5, and 6. Moreover it discriminated between repeaters and non-repeaters at a significant level. Only two items (diagnosis of sociopathy and change of domicile in the last year) of the five items which discriminated repeaters from non-repeaters in the first study were still significantly associated with repetition, while four additional items (previous in-patient psychiatric treatment; previous parasuicide resulting in hospital admission; unemployment; criminal record) appeared as new discriminating factors. In spite of these changes the rate of repetition remained constant over the years at around 26%.

Follow-Up Studies↗
PubMed1979

Types of attempted suicide (parasuicide).

The clinical usefulness of a typology of parasuicide, reported in a previous paper, has been improved. A finer grained classification, using six instead of only three clusters, has proved itself to be clinically highly realistic. By a new method of cluster analysis which examines 80 attributes in each of 350 patients, the following types of parasuicide emerge: (1) operant, not alienated; (2) repeaters; (3) depressed with high life endangerment; (4) operant and alienated; (5) wristcutters; (6) undifferentiated. This more detailed typology may offer some advantages for clinical management and research.

Humans↗
PubMed2026

Risk of subsequent self-harm, suicide attempts and suicide following a first hospital-treated self-harm episode among young people: a population-based cohort study.

BACKGROUND: Self-harm in young people is associated with elevated risks for subsequent self-harm, suicide attempts and suicide, particularly during the first year. Yet the trajectory across sex, age and self-harm methods remains poorly understood. OBJECTIVE: To estimate risk for subsequent self-harm, suicide attempts and suicide following a first hospital-treated self-harm event in young people. METHODS: This study included 77&#x2009;647 individuals (57.0% female) whose first hospital-treated (ie, within inpatient or outpatient specialised healthcare) self-harm episode occurred between ages 10-24 years during 1973-2019. We estimated cumulative incidence and incidence rate for subsequent self-harm, suicide attempts and suicide at 1&#x2009;month, 3 months and 1 year following the initial episode. FINDINGS: Within 1 year, the cumulative incidence was 17.3% (95% CI 17.0 to17.5) for subsequent self-harm, 8.3% (8.1 to 8.5) for suicide attempt and 0.3% (0.2 to 0.3) for suicide. The highest risks occurred in the first month: 8.4% (8.2 to 8.6) for self-harm, 2.9% (2.8 to 3.0) for suicide attempt and 0.04% (0.03 to 0.05) for suicide. In the first month, the incidence rate of self-harm was 2.97 per 1000 person-days (2.90 to 3.05), falling to 0.55 (0.54 to 0.56) over the year. The suicide attempt rate declined from 0.98 (0.94 to 1.02)&#x2009;to 0.24 (0.24 to 0.25) and the suicide rate from 0.013 (0.009 to 0.019)&#x2009;to 0.007 (0.006 to 0.008). Males exhibited the highest suicide risk and females the highest attempts risk. First-month self-harm risk was greatest among males and children aged 10-12. CONCLUSIONS: The month following a self-harm episode is marked by an elevated risk of subsequent self-harm, suicide attempts and suicide, yet risk remains elevated over the full year. CLINICAL IMPLICATIONS: These findings underscore the need for both acute and sustained prevention efforts. Special attention should be given to males and children aged 10-12 presenting with self-harm of ambiguous intent, as their risk of repetition may otherwise go unrecognised.

Humans↗
PubMed1979

A comparison of social workers and psychiatrists in evaluating parasuicide.

Sixty parasuicide patients admitted to medical wards were assessed by social workers prior to routine psychiatric assessment. Both disciplines completed a rating schedule. The social workers' and psychiatrists' rating schedule responses were compared, and their decisions were examined against further information obtained by a research psychiatrist, which included standardized mental state assessment. Overall the results show that social workers can safely and reliably assess these patients, but they are more cautious. A management approach involving social workers assessors of parasuicide patients is discussed.

Humans↗