This commentary critiques two papers by Curt Sandman, pointing out interpretive problems in models explaining self-injurious behavior in terms of opioids. Withdrawal effects are emphasized as an alternative to hypotheses asserting congenital opioid excess as a cause of sensory depression or an addiction to a relative excess of opioid activity in…

This paper answers criticism (EC 601 030) of the authors' work regarding opioid explanations of self-injurious behavior. Possible withdrawal effects are ruled out as an explanation, in favor of opioid excess leading to sensory depression and addiction to relative excesses of opioid activity in the brain. Alternative models of consequences of…

This reaction paper reviews a report on the use of carbamazapine for behavioral disorders. The paper translates the original report's data into percentages and concludes that carbamazapine has a more limited role in behavior disorder treatment. The original report's author then clarifies various points criticized in the reaction paper. (JDD)

B-endorphin and cortisol concentrations were examined in the plasma of mentally retarded adults who displayed symptoms of self-injurious behavior (SIB) (N=9), stereotypy (N=17), or SIB plus stereotypy (N=14). Compared to matched controls, patients with SIB plus stereotypy had elevated b-endorphin plasma, while cortisol levels were identical for…

Sensitivity theory divides the causes of challenging behavior into three categories, aberrant contingencies, aberrant environments, and aberrant motivation. This paper replies to criticism that sensitivity theory is circular and unsupported by empirical evidence by reporting on studies that support the theory and rejecting the idea that…

The incidence of medical and behavioral symptoms that could occur as side effects of psychotropic medication was assessed in a sample of 30 adults with developmental disabilities. Using a retrospective chart review method, we measured symptoms in six a priori classes of potential side effects over a 2-year period. The majority of side effects…

The efficacy of the serotonin uptake inhibitor clomipramine in treating stereotyped and related repetitive behavior disorders was tested in 10 adults (ages 18-42) with severe and profound mental retardation. Of the seven participants who tolerated the drug, six exhibited a clinically significant improvement in one or more repetitive behaviors.…

This paper describes current neurological knowledge regarding the recognition, diagnosis, and classification of frontal lobe seizures, and then critiques a study by A. Gedye which suggested that self-injury may be involuntary and related to frontal lobe seizure activity. (JDD)

Catamenial and behavioral records of nine women with mental retardation who exhibited self-injurious behavior (SIB) were analyzed for six months. Analysis confirmed that SIB was cyclic across the menstrual cycle, with the highest frequency occurring in the early follicular and late follicular phases. (Author/JDD)

Four adults with severe/profound mental retardation and self-injurious behavior (SIB) received naltrexone in a double-blind procedure. All patients exhibited decreased SIB when treated with naltrexone; three patients decreased SIB as naltrexone dose increased. There were no consistent effects of naltrexone on stereotypy, activity, or performance…

This article introduces this special issue focused on application of guidelines based on the consensus of experts to the treatment of psychiatric and behavioral problems in persons with mental retardation. It explains the method of developing the guidelines, the limitations and advantages of the guidelines, and the organization of the guidelines.…

This study investigated whether blood plasma levels of pro-opiomelanocortin-derived (POMC) peptides, beta-endorphin-like activity, adrenocorticotrophic hormone, and adrenal cortisol immediately after self injurious behavior (SIB) episodes predicted subsequent response to an opiate blocker in 10 patients with mental retardation. Results suggest…

Individuals (n=199) with mental retardation referred for behavioral and psychiatric crisis intervention services were studied to determine attributes differentiating physically aggressive behavior from other behavioral problems. Aggression was predicted by gender, level of mental retardation, and history of previous institutional placement; the…

The prevalence of compulsions in 210 adults with severe/profound mental retardation was studied. Prevalences were as follows: stereotypy (60.9 percent), self-injury (46.6 percent), and compulsion (40 percent). The occurrence of compulsions was positively associated with the occurrence of stereotypy, self-injury, and stereotypy plus self-injury.…

A comparison on the body-rocking of 21 college students and 22 individuals with mental retardation found a greater proportion of the people with mental retardation were less sensitive to situational factors, demonstrated atypical collateral behaviors, engaged in less leg-kicking, and executed their body-rocking with larger amplitudes. (Author/CR)