Studying Self Injury
An interview with CLAS psychology professor Brian Iwata
Originally published in the February 1999 issue of CLASnotes.
Iwata, who studies self-injurious behavior, originated the Florida Center on Self Injury with a NIH grant he brought with him when he came to UF in 1986 [the Center has been funded by the Department of Children and Families since 1990].
Cn:
What is self-injurious behavior?
BI: Self-injurious behavior or SIB is a disorder involving repeated self-infliction of physical damage, including face hitting, head banging, biting, scratching, eye poking, chronic vomiting and the ingestion of dangerous materials. The prevalence of SIB is highest among individuals with mental retardation and related developmental disabilities.
Cn: What causes SIB?
BI: Thus far, most research suggests that SIB is a learned behavior disorder.
Cn: So the behavior is a response to reinforcers, negative or positive?
BI: Exactly. When you look at an individual who is bleeding, you have to do something. So if that individual doesn't have, say, language to communicate, but learns that every time s/he is hurt a caring adult will come attend, then that behavior takes on communicative properties, just as raising a hand would...only in this case, it's fairly dramatic. Similarly, if one finds oneself in a very demanding situation like a work situation, which many individuals with mental retardation are required to participate in, one may start to engage in a variety of what we call "escape behaviors," including disruption, aggression, or SIB.
Cn: Is there a profile for the typical person who engages in SIB?
BI: No. There are no reliable predictors. It occurs across the age span and the developmental span. Usually SIB begins by late adolescence, and we've seen it in children younger than a year.
Cn: With the behavior arising so early in some children, do scientists think there might be a neurochemical imbalance associated with SIB?
BI: One current hypothesis about the origins of some SIB cases is based on possible brain disorder involving neurotransmitters, an area in which one of our new faculty members, Darragh Devine, specializes. A lot of interesting research is being done in that area, but a great deal more is needed before any conclusions can be made about the role of neurotransmitters in the development or maintenance of SIB.
Cn: Describe the Florida Center on Self Injury and your work there.
BI: We are one of very few research programs funded by the state (most state-funded programs are service oriented), and as a result we are given a fairly wide latitude for how to conduct our mission. We have a residential day training component and a community component. We've been treating SIB residents at Tacachale [here in Gainesville] for more than nine years and have treated almost all of the residents there with that problem.
We will now begin working more in the community because prevention or treatment of mild SIB may significantly reduce the likelihood of institutionalization in the first place. We are currently negotiating with the Association for Retarded Citizens (ARC), which offers a variety of services, for example, pre-school, vocational, and small-group residential programs, to individuals living in the community.
Part of our mission is the clinical-research program, which blends service and research, and also provides a context for training. Seven doctoral students currently work with me, and the program also forms the nucleus of an undergraduate lab course, in which we have provided a combination of academic, clinical, and research experience to over 300 undergraduate students during the last six to seven years.
We also serve as a state-wide resource center. If someone in Pensacola is treating a person with SIB, for example, that person can call or e-mail us, and we can provide them with information from our computerized data base, which contains about 2500 references to research on behavior disorders. So if we receive an inquiry about cigarette butt ingestion (Pica) or chronic vomiting as behavior problems, we can give that caller an in-depth list of references, saving him/her weeks or months of research.
Our other component is consultation. When very serious SIB cases are identified in the State—usually involving problems related to outplacement recommendations, jurisdiction, or funding—we are asked to evaluate the case and make recommendations.
Cn: The Florida Center on Self Injury is widely considered the best program of its kind in the country. What are your long-term goals for the Center?
BI: One certain goal is to have a direct impact through the service we provide, but our larger goal is to produce and disseminate new knowledge regarding the assessment and treatment of SIB, which will benefit not only those individuals we serve directly, but others also. For example, we developed the assessment procedures that are now considered to be standard in the field. All of the major clinical research programs in the country who conduct assessment of SIB use the procedures we developed, which puts us in a position to be at the forefront in developing and evaluating new treatment procedures also.
Cn: Sounds exciting.
BI: It is, but it keeps us busy [laughs].
