1/12. hyperphagia and self-mutilation in prader-willi syndrome: psychopharmacological issues.This study focused in the treatment of two major Prader-Willi symptoms: hyperphagia and self-injurious behavior (SIB). Four patients participated in a four-year study with monthly follow-ups. patients lived in a behaviorally structured environment, and were treated with selective serotonin reuptake blockers and phenothiazines. Psychopharmacological intervention improved SIB symptoms, but was ineffective to control appetite satiation.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/12. Amputee fetishism and genital mutilation: case report and literature review.A case is presented of a 49-year-old man who amputated his penis following instructions that he had obtained from the internet. The patient had a long-standing amputee fetish, which evolved into eroticized genital mutilation. The transformation of the preferred fetish occurred in a setting of depression due to environmental stressors. The literature about amputee fetishism, also called "apotemnophilia," is reviewed, and possible connections with the genital mutilation are discussed.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/12. factitious disorders encountered in patients with the diagnosis of reflex sympathetic dystrophy.reflex sympathetic dystrophy (RSD) may be a misdiagnosis or at least not descriptive enough in patients with atypical hand posture and atypical edema. Seven patients with the previous diagnosis of RSD were investigated further because of inconsistent clinical picture with the underlying pathology and bizarre course of the disease. Four patients had clenched fist and three had factitious edema. These seven patients underwent psychological examination, and mmpi was applied to all. In two of these no psychological disorder was obtained according to DSM-IV. One patient could not adapt to mmpi. In two anxiety disorders, in one depression, and in one patient conversion disorder was diagnosed. We suggest that these patients are not motivated enough to improve their conditions and expectations of such patients may show some differences depending on the environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/12. Effects and side effects of DRO as treatment for self-injurious behavior.A three-part controlled case study is presented in which severe and longstanding self-injurious behavior exhibited by a 9-year-old-boy was treated successfully with differential reinforcement of other behavior. In Phase 1, an experimental analysis demonstrated that the boy's scratching was not maintained by environmental contingencies; instead, it appeared that the self-injurious behavior was a stereotypic (automatically reinforced) response. In Phase 2, the effects of an escalating differential-reinforcement-of-other-behavior schedule mediated through token reinforcement (pennies) were evaluated in a reversal design. Results showed that differential-reinforcement-of-other-behavior eliminated self-injurious behavior very quickly and for periods of time as long as 30 min. A noteworthy side effect observed during Phase 2 was the occurrence of crying behavior following the nondelivery of reinforcement. In Phase 3, the token program was gradually extended in 30-min increments throughout the day. Additionally, results of a brief multielement manipulation showed that the effects of token reinforcement were superior to those of a more easily administered differential reinforcement of other behavior based on social reinforcement, which differed little from baseline.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/12. Reducing severe aggressive and self-injurious behaviors with functional communication training.Functional communication training is a behavioral intervention that incorporates a comprehensive assessment of the communicative functions of maladaptive behavior with procedures to teach alternative and incompatible responses. In two studies severe aggressive and self-injurious behaviors exhibited by two adult men with mental retardation were reduced through the implementation of functional communication training. In both studies, these reductions came after years of less successful nonaversive and aversive interventions and generalized across staff, new environments, and increasing task demands. The role of this training as a refinement of the traditional differential reinforcement of other behavior and as an alternative to the use of aversive interventions was discussed.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/12. Self-induced subcutaneous air mimicking a gas-forming infection.We describe three cases of self-induced soft-tissue gas among inmates at a prison. This behavior was specifically designed to gain hospitalization and relied on the simulation of a necrotizing soft-tissue infection. Two cases were treated by surgical exploration only. The third case was treated non-surgically after the etiology was suspected. The possibility of self-induced injury or manufactured physical signs is high in the prison population, and the presence of isolated physical signs or symptoms should be cause for suspicion. The inmates in these cases used manufactured signs and professed symptoms to extract themselves successfully from a prison environment.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/12. Behavior analysis, program development, and transfer of control in the treatment of self-injury.This case study illustrates an empirical approach to the diagnosis, treatment, and controlled follow-up of self-injurious clients. Following an assessment period, during which environmental factors associated with a severely retarded adolescent's self-injury were identified, the contingent application of protective equipment was combined with a differential reinforcement procedure (DRO) and implemented in a multiple baseline design across two hospital settings. Results showed a marked decrease in the rate of self-injury. Upon discharge from the hospital, the program was successfully replicated at the adolescent's residential center, again using a multiple baseline design across settings.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/12. Reduction of eye gouging using a response interruption procedure.A profoundly retarded male with severe congenital impairment of vision and hearing was treated for self-inflicted eye gouging. Prior to intervention, continuous mechanical restraint was required to prevent the response, precluding participation in educational and play activities. The response topography, the nature of the client's deficits, and a preliminary behavioral and medical assessment suggested that the response functioned as a source of sensory self-stimulation. Presentation of toys plus differential reinforcement of other behavior (DRO) as alternate sources of stimulation during baseline had no impact on eye gouging. The introduction of a contingent response interruption procedure reduced eye gouging and decreased the amount of time spent in restraints. Treatment effects were replicated in a group setting, and in the natural environment. parents and school personnel were trained to use the treatment, and eye gouging remained infrequent at a 9-month follow-up.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/12. behavior therapy for a child with lesch-nyhan syndrome.The behavioural symptoms in a 10-year-old boy with lesch-nyhan syndrome were effectively ameliorated by the behavior therapy techniques of systematic desensitization and extinction. Therapy was undertaken in a highly controlled environment. The hypothesis that the self-destructive behaviours in this syndrome were voluntary and maintained through continuous reinforcement was confirmed. Characteristic biting and other maladaptive behaviours were extinguished. Over a period of time it was possible to remove all the physical restraints previously used to prevent the boy injuring himself. During treatment his anxiety, associated with phobic reaction to being unrestrained, was reduced by nitrous oxide. At 1 1/2 years follow-up the boy continues to be symptom-free. He attends a special class at school and is learning to walk with crutches. It is emphasied that a trained and experienced therapist and a controlled environment are essential for the success of this form of behaviour therapy, and the dangers inherent in this method of treatment are discussed.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
10/12. head injury and mental handicap.A clinical and pathological study of head injury and the implications in mental handicap are outlined. Non-accidental injury as a form of child abuse is suspected as contributing considerably to the cause of mental handicap in populations resident in long-stay hospital, but this is unlikely to be the best environment for such patients. A number of mentally handicapped epileptic patients who injure their heads during fits and patients who repeatedly bang their heads as a feature of self-injurious behaviour are exposed to progressive neurological deficits associated with lesions in the brain which could further impair the efficiency of brain function.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
| | Next -> |