The Motivation for Self-Injury: Looking Backward to Move Forward

Abstract

Self-injurious behavior (SIB) is among the most disturbing, destructive, and costly behavior disorders among people with developmental, psychiatric, and neurological disorders. In people with intellectual or developmental disorders (IDD), there are numerous forms including self-hitting, pinching, scratching, and biting (Schroeder et al., 2001). In almost all cases of SIB, the etiology of the behavior disorder is unknown, and any underlying pathogenesis and pathophysiology is only partly understood. The field of behavior analysis has made enormous progress in understanding and treating SIB among individuals with IDD since the 1970s, but there is still much to do. This chapter will provide a selective review of clinical research findings and a synthesis of the underlying behavioral approach that has led to a better understanding of SIB, its forms, functions, and effective intervention. It is important to note that the review is focused almost exclusively on maintaining factors related to SIB. Discussion of the etiology of SIB is beyond the scope of the chapter. Clinical examples of SIB are used to illustrate practical applications of functional assessment technology and illustrate basic principles of behavior in relation to behavioral mechanisms (e.g., positive, negative reinforcement) as well as the intersection of behavior and biology. (PsycINFO Database Record (c) 2014 APA, all rights reserved). (chapter)