Naltrexone in treatment of self injurious behavior: A clinical study

Szymanski, Ludwik S.; Kedesdy, Jurgen H.; Sulkes, Steven; Cutler, Ann; Stevens-Our, Paula

doi:10.1016/0891-4222(87)90002-3

Cited by 58 publications

(3 citation statements)

References 16 publications

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“…A wide variety of treatment approaches have been used in attempts to ameliorate SIB, one form of intervention being the use of medical treatments such as drugs (eg, Aman and White, 1988;Durant, 1982;Szymanski, 1987). However, in their conclusion the report of the American Association of Behavioural Therapy Task Force (Favell et al, 1982) suggests that most cases of medical interventions may be neither necessary nor sufficient in reducing SIB.…”

Section: Introductionmentioning

confidence: 96%

A Functional Analysis of Self Injurious Behaviour

Coman

Houghton²

1991

Educational Psychology in Practice

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Self Injurious Behaviour (SIB) refers to behaviour in which individuals attempt to self inflict physical damage to their tissues. It is a most disturbing behaviour to observe and one which is difficult to manage. This paper presents a functional analysis of the antecedents and consequences of the SIB of an intellectually retarded 17 year old male subject. The findings from a series of observations carried out are discussed in the light of three postulated theories of why individuals self injure. In conclusion recommendations are made as to the direction future research might take and also how staff working with the subject of this study might attempt to ameliorate his SIB.

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Section: Introductionmentioning

confidence: 96%

A Functional Analysis of Self Injurious Behaviour

Coman

Houghton²

1991

Educational Psychology in Practice

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“…1987, Luisellietal. 1989, Szymanski et al 1987). The partial clinical effectiveness of naltrexone and naloxone has provided encouragement for a pharmacological hypothesis of SIB based on endorphin mechanisms (Sandman 1990(Sandman /1991.…”

Section: Introductionmentioning

confidence: 94%

Therapeutic Effect of Fluoxetine on Naltrexone-Resistant Self-Injurious Behavior in an Adolescent with Mental Retardation

Bass¹,

Beltis²

1991

Journal of Child and Adolescent Psychopharmacology

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A significant and sustained reduction in self-injurious behavior (SIB) was observed in a 17-year-old male with severe to profound mental retardation who was treated in an open clinical trial with fluoxetine. The 45-55% reduction in SIB was accompanied by improvement in affective stability, motor capacities, and social activity. No adverse effects or diminishing therapeutic effects were observed during 2 years of treatment at 40 mg daily. Twelve weeks before the start of the fluoxetine trial, this adolescent had been found to be unresponsive to the opiate receptor blocker naltrexone in a double-blind placebo-controlled trial following identical methodology. This case raises the possibility that different patients with SIB may respond preferentially to pharmacological treatments that modify either serotonin or endorphin mechanisms. The findings also suggest that some cases of SIB may represent a type of obsessive-compulsive disorder or body grooming disorder. Additional clinical studies are needed before fluoxetine can be considered for routine use in treating SIB.

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“…Endogenous opiates released during cutting may lead to a rewarding sense of euphoria and decreased distress. However, this explanation appears incomplete since many individuals do not experience pleasure while cutting, and clinical trials of opioid antagonists have had mixed results (Barrett, Feinstein, & Hole, 1989;Szymanski, Kedesdy, Sulkes, Cutler, & Stevens-Our, 1987). Antagonists may be helpful only for a smaller subgroup of cutters whose endorphin levels increase after episodes (Sandman, Touchette, Marion, & Chicz-DeMet, 2008).…”

mentioning

confidence: 99%

Magical thinking in narratives of adolescent cutters

Gregory

Mustata

2012

Journal of Adolescence

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Adolescents sometimes cut themselves to relieve distress; however, the mechanism is unknown. Previous studies have linked self‐injury to deficits in processing emotions symbolically through language. To investigate expressive language of adolescent cutters, the authors analyzed 100 narratives posted on the Internet. Most narratives (n = 66) displayed idiosyncratic use of language indicating poor differentiation between the real and the symbolic, such as blood substituting for negative emotions, which can then be released from the self; or emotional pain magically transforming into physical pain, which can then be managed. This kind of magical thinking correlated with cutting to relieve distress, to see blood, and to feel pain, but negatively correlated with complex representation of people, understanding social causality, and self‐esteem. The results suggest that magical thinking represents a pre‐symbolic mental state that processes and organizes distressing emotions through body schema. Magical thinking thus provides a plausible mechanism for why cutting works.

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Naltrexone in treatment of self injurious behavior: A clinical study

Cited by 58 publications

References 16 publications

A Functional Analysis of Self Injurious Behaviour

A Functional Analysis of Self Injurious Behaviour

Therapeutic Effect of Fluoxetine on Naltrexone-Resistant Self-Injurious Behavior in an Adolescent with Mental Retardation

Magical thinking in narratives of adolescent cutters

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