Self-injurious behaviour and self-restraint in individuals with a learning disability

Forman, Debbie J. (2003). Self-injurious behaviour and self-restraint in individuals with a learning disability. University of Birmingham. Ph.D.

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Abstract

Background: Self-restraint is a behaviour that has been reported to be uniquely associated with self-injurious behaviour and has been described as an attempt to prevent or escape from SIB. The following studies investigated the phenomenology and potential parameters of self-restraint, assessed the environmental determinants of and further explored alternative theories of self-restraint.

Methods: 56 Individuals exhibiting SIB were identified and information on self-injury, self-restraint, compulsive behaviour, stereotypies, age, gender, autism and degree of learning disability was collected using valid and reliable measures. For ten participants identified as engaging in self-restraint, observations in the natural environment were conducted for a minimum of eight hours and data collected on SIB, self-restraint and environmental events. Odds ratios were calculated and sequential analysis conducted in order to identify any associations between SIB, self-restraint, social contact and other variables.

Results: A lower prevalence of self-restraint (34.9%)was obtained using a multi-parameter definition of self-restraint compared to previous studies where topographical definitions were used. Three parameters of self-restraint were identified in the literature review (initiation, preference and association with a reduction in SIB) and all three parameters were present in some but not all participants. Furthermore, self-restraint in some participants was significantly associated with environmental variables, and the sequential analysis in three participants was consistent with the hypothesis that self-restraint is negatively reinforced by escape or avoidance of SIB

Conclusions: The results suggest that there is a need for a multi-parameter definition of self-restraint that takes into account both present and historical factors. Further research into the determinants of self-restraint should be conducted using experimental methods and self-restraint should be studied within a developmental as opposed to a static model. The implications of these findings for the behavioural theories of self-injury are discussed.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):