Classification of injuries observed in functional classes of self-injurious behaviour.
G W Rooker, N L Hausman, A B Fisher and 3 others
PMID 30043452WHAT IT FOUND
Among 64 people with intellectual or developmental disabilities and self-injury, automatically reinforced self-injury was linked to more severe head injuries; socially reinforced self-injury was linked to more severe torso and extremity injuries.
Key findings
01Injury was significantly more likely when a person engaged in a single form of self-injury (77.8%) than multiple forms (45.6%).
02When injuries were examined by body location and severity together, automatically reinforced self-injury was linked to more severe head injuries, while socially reinforced self-injury was linked to more severe torso and extremity injuries.
03A greater proportion of individuals in the automatic group had moderate to severe head injuries (55.5%) than in the social group (23.5%), and a greater proportion in the social group had moderate to severe torso or extremity injuries (41.8%) than in the automatic group (11.1%).
STILL TO COME
How it was doneWhat they found
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What it does not show
Of 134 people initially identified, 70 were excluded because they lacked a physical examination or interpretable functional analysis, leaving 64. This was a retrospective record review from one hospital unit, so it is not randomised and may not represent people with self-injury in other settings. The injuries were already present at admission, so the study cannot confirm that self-injury caused them. Physical examinations often did not report the number of injuries within a body site, only whether a site was injured. The sample was small for some injury types, such as torso injuries, so more detailed modelling was not possible. The analysis treated automatically reinforced and socially reinforced self-injury as broad groups, which may hide differences within each group. The rate of self-injury was measured in a functional analysis play condition designed to reduce motivation to self-injure, so it may not reflect everyday self-injury rate.
Declared interests
The supplied text lists N.I.H., Extramural research support but does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not read the head injury difference as proof that automatically reinforced self-injury caused head injuries. Injuries were recorded after they occurred, before hospital admission, and the study cannot guarantee they were produced by self-injury.