The self-organization of self-injurious behavior as revealed through temporal pattern analyses

Abstract

Intentional acts of harm to self are among the most dramatic and disturbing behaviors exhibited by human beings and frequently exact a heavy toll in terms of the emotional and economic burden that must be borne by affected individuals, families, caregivers, and society. One major obstacle to understanding and treating self-injurious behavior (SIB) is the absence of adequate tools and methodologies to identify distinctive behavioral phenotypes or to quantify the complex presentation of SIB across varying time scales and environmental settings. Granted, there are increasingly sophisticated analytic techniques available to study behavior, but the vast majority of existing studies on SIB still rely on measures of frequencies or rates of SIB linked to a single environmental condition or other presumed contingencies. In contrast, our recent investigations of SIB among individuals with severe intellectual and developmental disabilities have employed temporal pattern analyses using the Theme™ program to explore the complex organizational dynamics underlying the presentation of SIB as recurrent patterns across time. Comprehensive behavioral and environmental events were recorded in situ, in real time, by trained, unobtrusive observers using The Observer®. The event codes and their associated times were then imported into Theme™, which was used to identify highly significant (i.e., nonrandom), recurrent, temporal patterns that were not constrained by implicit assumptions about the sequential ordering or hypothesized relations among the constituent events. Principal among our findings are that transitions to episodes of SIB are characterized by greater overall behavioral complexity and order within individuals; that self-injuring acts may serve as singular points that increase coherence within self-organizing patterns of behavior; that temporal patterns associated with SIB are highly correlated with basal beta-endorphin and adrenocorticotropic hormone levels across individuals; and that treatment with the opiate antagonist naltrexone may reduce the temporal patterning of SIB. The implication of these findings is that SIB can never be fully understood within a strictly linear conceptualization of “cause-and-effect” sequential dependencies. Instead, we suggest that SIB is dynamically regulated by “internal” processes which contribute to the emergence of complex, selforganizing patterns. If confirmed, these results may portend the development of innovative new behavioral or pharmacologic interventions designed to disrupt self-organizing regulatory processes, rather than simply focusing on putative antecedents or consequences.