Emergence of SIB in Developmentally Delayed Individuals

发育迟缓个体中 SIB 的出现

• 批准号: 7093716
• 负责人: CURT ALAN SANDMAN
• 金额: $ 41.6万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-20 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7093716
• 关键词: behavioral /social science research tag; clinical research; clinical trials; developmental disease /disorder; drug screening /evaluation; endogenous opioid; environmental stressor; hormone metabolism; housing; human subject; human therapy evaluation; hypothalamic pituitary adrenal axis; mental disorder chemotherapy; mental health epidemiology; naltrexone; patient oriented research; psychopharmacology; self destructive behavior; stress; time resolved data

DESCRIPTION (provided by applicant): Self-injuring behavior (SIB) surprisingly prevalent among neurodevelopmentally delayed and mentally retarded individuals, has no known cause and no agreed upon treatment. Expression of SIB may persist throughout the lifespan and into later stages of life, with little change in frequency or quality. Two distinct patterns of SIB have been proposed. One pattern consists of short bouts that may be maintained by environmental contingencies. A second pattern involves protracted periods of SIB that probably is motivated by biological factors. Recent studies from our laboratory indicated that self-injuring behavior was predicted best (and in some cases only) by its own recent history. In a significant majority of individuals, SIB episodes were self-perpetuating and not related to antecedent conditions. We report in this application that individuals exhibiting "contagious" (i.e. sequentially dependent) patterns of SIB also have a disregulated hypothalamic- pituitary-adrenal (HPA) stress axis. We have concluded that there is both a biological predisposition to, and a biological consequence for, the maintenance of SIB. These conclusions may be premature and a more extensive evaluation of the environmental context is warranted. Moreover, there are no data about what initiates a contagious cycle. The purpose of this proposal is to examine the behavioral, environmental and biological circumstances that initiate and maintain SIB episodes. Thirty individuals exhibiting SIB and thirty control subjects, all residing in a large residential facility will be observed in vivo and during an experimental functional analysis of behavior (FAB). Their behavior, interactions and the environmental conditions will be recorded with computer-assisted procedures. Blood will be collected for measures of HPA activity in the morning on a separate day. The Specific Aims are: (i) Determine how the patterns of SIB are affected by environmental context in both in vivo and FAB conditions using sequentially- and temporally-dependent time series analysis, (ii) Determine if there are consistent patterns of environmental events or relations among behaviors that are antecedent to the first or isolated SIB episodes; (Hi) Determine the relation between the HPA stress axis the initiation of SIB, (iv) Apply and evaluate a rational pharmacological treatment to a selected cohort of subjects who present clear evidence of biological (or internal) motivation for SIB. Findings from this project will contribute to the understanding of the emergence and maintenance of SIB.

描述（由申请人提供）：自残行为（SIB）在神经发育迟缓和智力迟钝的个体中出人意料地普遍存在，原因不明，也没有商定的治疗方法。 SIB 的表达可能持续整个生命周期并持续到生命的后期，频率或质量几乎没有变化。人们提出了两种不同的 SIB 模式。一种模式由可能因环境意外事件而维持的短暂发作组成。第二种模式涉及长时间的 SIB，这可能是由生物因素引起的。我们实验室的最新研究表明，自残行为最好（并且仅在某些情况下）通过其最近的历史来预测。在绝大多数个体中，SIB 发作是自我延续的，与先前的条件无关。我们在本申请中报告说，表现出 SIB“传染性”（即顺序依赖性）模式的个体也具有下丘脑-垂体-肾上腺（HPA）应激轴失调。我们得出的结论是，SIB 的维持既有生物学倾向，也有生物学后果。这些结论可能还为时过早，有必要对环境背景进行更广泛的评估。此外，没有关于是什么引发传染周期的数据。该提案的目的是检查引发和维持 SIB 发作的行为、环境和生物环境。三十名表现出 SIB 的个体和三十名对照受试者都居住在大型住宅设施中，将在行为功能实验分析 (FAB) 期间对他们进行体内观察。他们的行为、互动和环境条件将通过计算机辅助程序进行记录。将在另一天的早晨采集血液以测量 HPA 活性。具体目标是：(i) 使用顺序和时间相关的时间序列分析确定 SIB 模式如何受到体内和 FAB 条件下环境背景的影响，(ii) 确定是否存在一致的环境事件模式或第一次或孤立的 SIB 发作之前的行为之间的关系； (Hi) 确定 HPA 应激轴与 SIB 发生之间的关系，(iv) 对选定的一组受试者应用并评估合理的药物治疗，这些受试者提供了 SIB 生物学（或内部）动机的明确证据。该项目的研究结果将有助于理解 SIB 的出现和维护。