Risk factors and topographies for self‐injurious behaviour in a sample of adults with intellectual developmental disorders

Folch, Annabel; Cortés, Marta Haro; Salvador‐Carulla, Luis; Vicens, Paloma; Irazábal, Marcia; Muñoz, Silvia; Rovira, Lluís; Orejuela, Carmen; Haro, Josep María; Vilella, Elisabet; Martínez‐Leal, Rafael

doi:10.1111/jir.12487

Cited by 19 publications

(39 citation statements)

References 52 publications

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“…Only two studies reported prevalence of self-injury across different levels of autism. These studies found that severity of autism is associated with a higher prevalence of self-injury, and moreover, that severity of self-injurious behaviour is associated with more severe autism (Akram et al 2017 ; Folch et al 2018 ).…”

Section: Resultsmentioning

confidence: 99%

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The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study

Steenfeldt-Kristensen

Jones

Richards

2020

J Autism Dev Disord

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Self-injurious behaviour is purportedly common in autism, but prevalence rates have not yet been synthesised meta-analytically. In the present study, data from 14,379 participants in thirty-seven papers were analysed to generate a pooled prevalence estimate of self-injury in autism of 42% (confidence intervals 0.38-0.47). Hand-hitting topography was the most common form of self-injury (23%), self-cutting topography the least common (3%). Sub-group analyses revealed no association between study quality, participant intellectual disability or age and overall prevalence rate of self-injury. However, females obtained higher prevalence rates than males (p = .013) and hair pulling and self-scratching were associated with intellectual disability (p = .008 and p = .002, respectively). The results confirm very high rates of self-injury in autism and highlight within group risk-markers.

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Section: Resultsmentioning

confidence: 99%

“…Sample AUTISM ID:IQ ID:AF SIB/SH Folch et al, (2018) 37.3 31.6 -- Gulsrud et al, (2018) 29.1 9 .0 25 -2 . 0 0.…”

Section: Authormentioning

confidence: 99%

The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study

Steenfeldt-Kristensen

Jones

Richards

2020

J Autism Dev Disord

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“…Two studies 41 , 50 used the Diagnostic Assessment for the Severely Handicapped Part 2 (DASH-II) 65 . Two studies 43 , 53 used the Aberrant Behaviour Checklist-Community version (ABC-C) total score, 66 and another four 42 , 46 , 52 , 67 used ABC-C subdomain scores 68 . Three studies 37 , 38 , 69 used the Psychosocial Behaviour Scale (PBS) 70 .…”

Section: Resultsmentioning

confidence: 99%

“…The overall rate of challenging behaviour Of the total 19 controlled studies, 13 12,36,37,39,40,[43][44][45]47,[50][51][52][53] did not show any significant intergroup difference in the overall rate of challenging behaviour, three 38,42,48 showed a significantly higher rate of challenging behaviour in the epilepsy group and three 41,46,49 showed a higher overall rate of challenging behaviour in the non-epilepsy group (Table 1). Of these three, one 41 was at a significant level and the level of significance for other two 46,49 is not known.…”

Section: Outcome (Narrative Synthesis)mentioning

confidence: 97%

“…Another problem is that none of these specific behavioural types was defined using any standardised criteria (such as the Modified Overt Aggression Scale for rating aggression) 15,82 but were based on single-item scoring. Blickwedel et al, 2019 53 Chung & cassidy, 2001 42 Collacott, 1993 39 Deb, 1997 40 Deb et al, 1987 36 Deb et al, 2001 12 Espie et al, 1989 37 Espie et al, 2003 46 Fitzgerald et al, 2011 50 Folch et al, 2018 52 Gillies et al, 1989 38 Matson et al, 1999 41 Matthews et al, 2008 43 McGrother et al, 2006 48 O'Dwyer et al, 2018 51 Pawar & Akuffo, 2008 49 Prasher, 1995 45 Smith & Matson, 2010a 44 Turkistani, 2004 47 Random sequence generation (selection bias)…”

Section: Types Of Challenging Behaviourmentioning

confidence: 99%

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Association between epilepsy and challenging behaviour in adults with intellectual disabilities: systematic review and meta-analysis

Brizard¹,

Limbu

2020

BJPsych open

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Background Previous systematic reviews showed no significant association between epilepsy and challenging behaviours in adults with intellectual disabilities. Aims To identify whether there is an association between epilepsy and challenging behaviour in adults with intellectual disabilities by carrying out a systematic review of published data. PROSPERO registration number: CRD42020178092. Method We searched five databases and hand-searched six journals. Two authors independently screened titles, abstracts and full articles using a standardised eligibility checklist. Several meta-analyses were carried out. Results The narrative analysis of data from 34 included articles (14 168 adults with intellectual disabilities, 4781 of whom also had epilepsy) showed no significant association between epilepsy and challenging behaviour. Meta-analysis was possible on data from 16 controlled studies. This showed no significant intergroup difference but after sensitivity analysis meta-analysis of 10 studies showed a significantly higher rate of overall challenging behaviour in the epilepsy group (effect size: 0.16) compared with the non-epilepsy group. Aggression and self-injurious behaviour both showed a statistically significant higher rate in the epilepsy group, with very small effect sizes (0.16 and 0.28 respectively). No significant intergroup difference was observed in the rate of stereotypy. Conclusions The findings are contradictory and must be interpreted with caution because of the difficulty in pooling data from varied studies, which is likely to introduce confounding. Where significant differences were found, effect sizes are small and may not be clinically significant, and there are major methodological flaws in the included studies, which should be addressed in future large-scale properly controlled studies.

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Risk of Self-harm in Children and Adults With Autism Spectrum Disorder

et al. 2021

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IMPORTANCE Multiple studies have reported that people with autism spectrum disorder (ASD) are at a higher risk for self-injurious behavior and suicide. However, the magnitude of this association varies between studies. OBJECTIVE To appraise the available epidemiologic studies on the risk of self-injurious behavior and suicidality among children and adults with ASD.DATA SOURCES PubMed, Embase, CINAHL, PsycINFO, and Web of Science were systematically searched for epidemiologic studies on the association between ASD and self-injurious behavior and suicidality. Databases were searched from year of inception to April through June 2020. No language, age, or date restrictions were applied.STUDY SELECTION This systematic review and meta-analysis included studies with an observational design and compared self-injurious behavior (defined as nonaccidental behavior resulting in self-inflicted physical injury but without intent of suicide or sexual arousal) and/or suicidality (defined as suicidal ideation, suicide attempt, or suicide) in children (aged <20 years) or adults (aged Ն20 years) with ASD. DATA EXTRACTION AND SYNTHESISInformation on study design, study population, ASD and selfharm definitions, and outcomes were extracted by independent investigators. Study quality was assessed using the Newcastle-Ottawa Scale. Overall summary odds ratios (ORs) and 95% CIs were estimated using DerSimonian-Laird random-effects models. MAIN OUTCOMES AND MEASURESThe ORs for the associations of ASD with self-injurious behavior and suicidality were calculated. Analyses were stratified by study setting and age groups as planned a priori. RESULTSThe search identified 31 eligible studies, which were of moderate to high quality. Of these studies, 16 (52%) were conducted in children, 13 (42%) in adults, and 2 (6%) in both children and adults. Seventeen studies assessed the association between ASD and self-injurious behavior and reported ORs that ranged from 1.21 to 18.76, resulting in a pooled OR of 3.18 (95% CI, 2.45-4.12).Sixteen studies assessed the association between ASD and suicidality and reported ORs that ranged from 0.86 to 11.10, resulting in a pooled OR of 3.32 (95% CI, 2.60-4.24). In stratified analyses, results were consistent between clinical and nonclinical settings and between children and adults. CONCLUSIONS AND RELEVANCEThis study found that ASD was associated with a substantial increase in odds of self-injurious behavior and suicidality in children and adults. Further research is (continued) Key Points Question What excess risk of self-harm, including self-injurious behaviors and suicidality, is associated with autism spectrum disorder (ASD)? Findings This systematic review and meta-analysis of 31 studies found that the pooled odds of self-harm in people with ASD was more than 3 times the odds in people without ASD. The excess odds of self-harm were found in both children and adults (although a slightly higher risk was identified in adults) across geographic regions and regardless of study designs, methods, and settings. Mea...

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Risk factors and topographies for self‐injurious behaviour in a sample of adults with intellectual developmental disorders

Cited by 19 publications

References 52 publications

The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study

The Prevalence of Self-injurious Behaviour in Autism: A Meta-analytic Study

Association between epilepsy and challenging behaviour in adults with intellectual disabilities: systematic review and meta-analysis

Risk of Self-harm in Children and Adults With Autism Spectrum Disorder

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