| Self-injurious behavior often refers to any behavior that can cause
tissue damage, such as bruises, redness, and open wounds. The most
common forms of these behaviors include head-banging, hand-biting,
and excessive scratching or rubbing. There are two major sets of theories
on why people engage in self-injury-- physiological and social. Some
of the physiological theories (and suggested treatments) are:
These behaviors release beta-endorphins in the person's brain,
which in turn, provides the person with a form of internal pleasure
(beta-endorphins are endogenous opiate-like substances in the brain).
(Treatment: If a person is given naltrexone, a beta-endorphin inhibitor,
self-injury may decrease.)
Sudden episodes of self-injury may be caused by sub-clinical seizures.
Sub-clinical seizures are not typically associated with the characteristic
behaviors of conventional seizures, but they are characterized by
abnormal EEG patterns. (Treatment: The person should receive an
extensive EEG to determine if the self-injury is associated with
sub-clinical seizures.)
Head-banging or ear hitting may be caused by a middle ear infection.
(Treatment: The person should be given an extensive ear examination.)
Some forms of self-injury may be a result of overarousal (such
as frustration). Self-injury acts as a release, and thus, lowers
arousal. (Treatment: One should try to reduce the person's general
arousal level, such as through relaxation/visual imagery therapy,
deep pressure, and exercise.)
In some cases, self-injury may be a form of self-stimulatory, stereotypic
behaviors. That is, they are repetitive, ritualistic behaviors which
provide the individual with some form of sensory stimulation or
arousal. (Treatment: Person could be given sensory integration therapy
to normalize the senses.)
Some of the social theories explaining these behaviors are:
Some individuals engage in self-injurious behaviors to obtain attention
from other people. (Treatment: People in the environment should
ignore the person when he/she engages in self-injury; thus, the
person will learn that the behavior will not lead to attention.)
Some individuals exhibit self-injury to escape or avoid a task.
(Treatment: The person should be asked to complete the task rather
than escape the task.)
Although it has not been discussed in the research literature, there
is also the possibility that these behaviors could be related to
hypersensitivity to certain sounds in the environment. For example,
if a sound bothers an individual, he/she may react by hitting one's
head or ears. (Treatment: One may consider trying auditory integration
training.) Basically, there are many reasons why people engage in
self-injurious behavior. The best way to determine the reason for
the behavior in an individual is to conduct a functional analysis.
This involves analyzing what occurs prior to the behavior as well
as what happens immediately after the behavior. If one can rule
out possible social influences on the behavior, then physiological
causes should be investigated.
Author
Stephen M. Edelson, Ph.D.
Center for the Study of Autism, Salem, Oregon
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