Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-26T17:00:47.878Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-injurious behaviour and the serotonin link: two case illustrations and theoretical overview

Published online by Cambridge University Press:  13 June 2014

Syed Hasan Jawed ,
Vallepur HR Krishnan  and
Géraldine Cassidy
Syed Hasan Jawed
Affiliation:
Weston Hospital, Weston-under-Wetherley, Leamington Spa, Warwickshire, CV33 9AJ, England
Géraldine Cassidy
Affiliation:
University of Birmingham, Edgbaston, Birmingham, B15 2TT, England
Get access Rights & Permissions [Opens in a new window]

Abstract

Self-injurious behaviour (SIB) is one of the challenging behaviours that is exhibited by people with severe learning disabilities. Various current aetiological theories of SIB have failed to provide a feasible model of care for this complex clinical problem. Recent advances in the understanding of serotonin neurotransmitter function may provide a way forward in the management of SIB. Case histories of two people whose SIB responded to antidepressant medication are described. Possible implication of serotonin neurotransmitter function in the causation of SIB is explored and relevant recent literature is reviewed.

Keywords

Mental retardationSelf-injurious behaviourSerotonin neurotransmittersManagement
Type
Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 11 , Issue 4 , December 1994 , pp. 165 - 168
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Tate, BG, Baroff, GS. Aversive control of self injurious behaviour in a psychotic boy. Behav Res Ther 1966; 4:281–7.CrossRefGoogle Scholar
2.Emerson, E. Self-injurious behaviour: an overview of recent trends in epidemiological and behavioural research. Ment Hand Res 1992; 5:49–81.CrossRefGoogle Scholar
3.Schroeder, SR. Self injury and stereotypy. In: Matson, JL, Mulick, JA (Eds). Handbook of mental retardation. New York: Pergamon Press 1991.Google Scholar
4.Oliver, C, Murphy, GH, Corbett, JA. Self-injurious behaviour in people with mental handicap: a total population survey. J Ment Def Res 1987; 31:147–62.Google Scholar
5.Mikkelsen, EJ. Low dose haloperidol for stereotypic self injurious behaviour in the mentally retarded. New Engl J Med 1986; 316:398–9.Google Scholar
6.Schroeder, SR, Mulick, JA, Rojahn, J. The definition, taxonomy, epidemiology and ecology of self injurious behaviour. J Autism Dev Dis 1980; 10:417–32.CrossRefGoogle Scholar
7.Freud, A. Self mutilative behaviour. The Psycho-analytic study of the child 1954; 8:9–19.CrossRefGoogle Scholar
8.Zuk, GH. Psycho-dynamic implications of self-injury in defective children and adults. J Clin Psychol 1960; 16:58–60.3.0.CO;2-6>CrossRefGoogle Scholar
9.Bachman, JA. Self injurious behaviour; a behavioural analysis. J Ab Psychol 1972;80:211–24CrossRefGoogle Scholar
10.Iwata, BA, Dorsey, MF, Slifer, KF, Bauman, KE, Richman, GS. Towards a functional analysis of self-injury. Analysis and intervention in developmental disabilities 1982; 2:3–20.CrossRefGoogle Scholar
11.Steege, MW, Wacker, DP, Berg, WK, Cigrand, KK, Cooper, LJ. The use of behavioural assessment to prescribe and evaluate treatment for severely handicapped children. J Applied Behav Analysis 1989; 22:23–33.CrossRefGoogle ScholarPubMed
12.Bernstein, GA, Hughes, IR, Mitchell, JE, Thompson, T. Effects of narcotic antagonists on self injurious behaviour: a single case study. J Am Acad Child Adolesc Psychiatr 1987; 26:886–9.Google ScholarPubMed
13.Goldstein, M, Kuga, S, Kusand, N. Dopamine agonist induced self mutilative biting behaviour in monkeys with unilateral ventromedial tegmental lesions of the brain stem: possible pharmacological model for Lesch Nyhan Syndrome. Brain Res 1986;367:114–9CrossRefGoogle ScholarPubMed
14.Breese, GR, Baumeister, AA, McCowan, TL. Behavioural difference between neonatal and adult 6-OHDA treated rats to dopamine agonists. J Pharmacol Exper Therap 1984;231:343–54.Google ScholarPubMed
15.Goldstein, M, Anderson, LT, Reuben, R. Self mutilation in Lesch-Nyhan disease is caused by dopaminergic denervation (Letter). Lancet 1985; 1:338–9.CrossRefGoogle Scholar
16.Richardson, MA, Haugland, G, Pass, R, Craig, TL. The prevalence of tardive dyskinesia in a mentally retarded population. Psychopharmacol Bull 1986; 22:243–9.Google Scholar
17.Oliver, C. Self injurious behaviour, the lost cause. In: Cowie, V, Harten-Ash, VL (Eds). Current approaches: mental retardation. Southampton, (UK): Duphar Medical Relations, 1989.Google Scholar
18.Winchel, RM, Stanley, M. Self Injurious Behaviour: A review of the behaviour and biology of self-mutilation. Am J Psychiatry 1991; 148:306–17.Google ScholarPubMed
19.Mizuno, T, Yugari, Y. Prophylactic effect of L-5HTP on self mutilation in the Lesch-Nyhan syndrome. Neuropaediatrics 1975; 6:13–23.CrossRefGoogle Scholar
20.Patel, H, Bruza, D, Yeragani, VK. Treatment of self abusive behaviour with trazadone. Can J Psychiatry 1988; 33:331–2.CrossRefGoogle Scholar
21.Primeau, F, Fontaine, R. Obsessive disorder with self-mutilation: a sub-group responsive to pharmacotherapy. Can J Psychiatry 1987; 32:699–701.CrossRefGoogle ScholarPubMed
22.Markowitz, PI. Fluoxetine treatment of self injurious behaviour in mentally retarded patients. J Clin Psychopharmacol 1990; 10:299–300.Google ScholarPubMed
23.Markowitz, PI. Effects of fluoxetine on self injurious behaviour in the developmentally disabled: A preliminary study. J Clin Psychopharmacol 1992; 12:27–31.CrossRefGoogle ScholarPubMed
24.Dichiara, G, Camba, R, Spand, PF. Evidence for inhibition by brain serotonin of mouse killing behaviour in rats. Nature 1971; 233:272–3.CrossRefGoogle Scholar
25.Kantak, KM, Hegstrand, LR, Eichelman, BR. Facilitation of shock induced fighting following intraventricular 5,7 Hydroxyllyptamine and 6 Hydroxy Dopa. Psychopharmacol 1981; 74:157–60.CrossRefGoogle Scholar
26.Brown, GL, Ebert, ME, Goyer, PF, Jimerson, DC, Klein, WJ, Bunney, WE, Goodwin, FK. Aggression, suicide and serotinin: relationship to CSF amine metabolites. Am J Psychiatry 1982; 139:741–6.Google Scholar
27.Schroeder, SR, Schroeder, C, Smith, B, Dalldorf, J. Prevalence of self injurious behaviour in a large state facility for the retarded. J Autism Childhood Schizophrenia 1978; 8:261–9CrossRefGoogle Scholar
28.Baumeister, AA, Forehard, R. Stereotyped acts. In: Ellis, NR (Ed). International review of research in mental retardation (Vol 6). New York: Academic Press, 1973.Google Scholar
29.Schain, RJ, Freedman, DX. Studies on 5-hydroxyindole metabolism in autistic and other mentally retarded children. J Paediatrics 1961; 58:315–20.CrossRefGoogle ScholarPubMed
30.McBride, PA, Anderson, GM, Hertzig, ME, Sweeney, JA, Kream, J, Cohen, DJ, Mann, JJ. Serotonin responsivity in male young adults with autistic disorder. Arch Gen Psychiatry 1989; 46:213–21.CrossRefGoogle ScholarPubMed
31.Barron, J, Sandsman, C. Am J Ment Def 1983; 88:177–86Google Scholar
32.Sovner, R, Pary, RJ. Affective disorders in developmentally disabled people. In: Matson, JL, Barrett, RP (Eds). Psychopathology in the mentally retarded. Boston: Allyn & Bacon, 1992.Google Scholar
33.Lowry, MA, Sovner, R. Severe behaviour problems associated with rapid cycling bi-polar disorder in two adults with profound mental retardation. J Int Dis Res 1992; 36:269–81.CrossRefGoogle ScholarPubMed
34.Jawed, SH, Krishnan, VHR, Prasher, VP, Corbett, JA. Worsening of pica as a symptom of depressive illness in a person with severe mental handicap: a case report. Br J Psychiatry 1993; 162:835–7.CrossRefGoogle Scholar