A cross-over study of 24 Ss with self-injurious behavior (SIB) was conducted over a continuous 10-week period. Treatment with naltrexone (NTX) was provided for 3 weeks in a randomized, reversal design with different doses or placebo each week. Videotaped observations (20 hr/subject), neurological examinations, and ratings of adaptive and maladaptive behavior were collected. Treatment with 2 mg/kg NTX produced at least a 50% reduction in SIB in a significant (p < .01) number of Ss. The 1.0 mg/kg was less effective (p < .02), and no significant change was observed at 0.5 mg/kg. Eighteen of 21 Ss achieved at least a 25% reduction in SIB after treatment of at least 1 dose of NTX (p < .0001). More than half of the Ss (52%) had a >50% reduction (p < .001), and a significant number of Ss (33%) decreased SIB by more than 75% after at least 1 dose of NTX. Significant improvement was measured after NTX on measures of learning and attention.
The opiate antagonist naloxone was effective in reducing self-abusive behavior in two mentally retarded clients with an extensive history of such behavior. Three doses of naloxone (0.1, 0.2, 0.4 mg) were compared with a vehicle solution in a double-blind, crossover design. Naloxone greatly attenuated self-abusive episodes in one client and eliminated them entirely in the second client. In addition, use of self-restraining behavior by one client was reduced. The findings suggested that some clients with self-injurious behavior may have disturbances of the endogenous opiate system. Maintenance of self-abuse by tonically elevated pain threshold and/or by the putative addictive characteristics of such behavior was discussed.
Performance on tests of memory in 39 patients who met Center for Disease Control (CDC) criteria for chronic fatigue immune dysfunction syndrome (CFIDS) was compared with 23 depressed patients (DSM-III-R) and 129 healthy controls. Although the CFIDS patients had normal neuropsychological profiles, they significantly overestimated their ability (metamemory), performed significantly worse on tests of recall as context increased (e.g., recognition), made more errors when rehearsal was prevented, and had delayed mental scanning as memory load increased. The overall pattern indicated that CFIDS patients had a significant memory deficit, far worse than implied by CDC criteria. The pattern for CFIDS patients was consistent with temporal-limbic dysfunction and significantly different than depressed patients and control subjects.
Paradoxical response to sedative medication has been reported previously among patients with Self-injurious (SIB) and Stereotypic (ST) Behavior (Barron and Sandman, 1983, 1985). The prevalence of this marker was examined in 648 consecutive developmentally delayed patients tested in the EEG laboratory. Several analyses compared response to sedative~hypnotics, assessment of the EEG, and behavioral profiles from the most recent annual comprehensive behavioral~medical evaluation (CDER). The presence of SIB and ST were significantly related to paradoxical response. The EEG was not related to paradoxical response, but had fewer epileptic loci in frequent or severe S1B and~or ST.
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