The use of applied behavior analysis in traumatic brain injury rehabilitation
Mark J. Ashley, David A. Hovda in Traumatic Brain Injury, 2017
An antecedent event is followed by the occurrence of a behavior. If the behavior has been chosen for modification, to either increase or decrease, it is referred to as the target behavior. People with TBI can exhibit a wide variety of behaviors that require intervention. A target behavior must be observable and immediately recordable. The target behavior must also be very clearly defined in terms of observable actions.196 This is known as an operational definition. Two therapists, for instance, can have very different ideas about what constitutes a behavior. For example, take the behavior of physical aggression. Does it include spitting or threatening? What about self-injurious behavior? Should throwing or breaking objects be included? Clear and concise definitions of target behaviors are critical to identifying the behaviors and to implementing programs consistently.
Hepatorenal tyrosinemia/fumarylacetoacetate hydrolase deficiency
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop in Atlas of Inherited Metabolic Diseases, 2020
Neurologic crises of pain and paresthesia are a result of peripheral neuropathy [42–45]. These may occur in as many as 42 percent of patients. Crises may be mistaken for porphyria [43]. There may be extensor hypotonus or the patient may have hypertonia. Systemic, autonomic signs include hypertension, tachycardia, and ileus. Pain usually begins in the legs. The patient may position the head and trunk in extreme hyperextension and may be thought to have opisthotonus or meningismus [29]. Muscular weakness may progress to paralysis requiring artificial ventilation [42]. Self-injurious behavior has been observed. Some patients have had seizures [43], some of them associated with hyponatremia [8]. Death may occur during a neurologic crisis [44, 45]. During most crises, consciousness is normal. These crises are not associated with hepatic relapse. Most crises subside in 1–7 days and resolve slowly, but there may be residual weakness. Intelligence is usually normal.
Mental Health: Clinical Issues
Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar in Handbook of Refugee Health, 2021
In many refugee settings, suicide attempts and self-harm are an issue of significant concern. Anecdotal reports about high levels of suicidal behaviour have been described, particularly when refugees get stuck in protracted situations and, not seeing any concrete perspectives for positive changes, lose hope for the future and feel trapped.9–12 Refugee populations resettled in high-income countries also have increased risk of suicidal behaviour, which can be attributed to various factors such as socio-economic disadvantage, exposure to potentially traumatic events, prevalence of mental disorders, and lack of appropriate and accessible care.13 Given the potentially lethal consequences and the huge psychosocial consequences of a suicide attempt for the person, family and helpers, it is important to monitor the incidence of such events, but very limited data are as yet available.14 It is relevant to distinguish between self-harm without suicidal intention (such as intentional self-inflicted poisoning or injury without the intent to die) and suicide attempts that are self-directed, potentially injurious behaviour with an intent to die as a result of the behaviour but that have a non-fatal outcome.
Assessing Non-Suicidal Self-Injury in the Laboratory
Published in Archives of Suicide Research, 2018
Brooke A. Ammerman, Mitchell E. Berman, Michael S. McCloskey
The search targeted published papers between July 1984 and November 2016. An electronic search on the following databases was carried out: PsycINFO, PsycARTICLES, ERIC, CINAHL, and MEDLINE. The following search terms were included: (a) self-injury or self-injurious behavior or non-suicidal self-injury or self-harm or deliberate self-harm or self-mutilation or self-aggression, and (b) experimental or laboratory or behavioral or real-time. Studies had to be in English and meet the following three inclusion criteria: (1) included a task that was an analogue of intentional self-injury (e.g., directly assessing an NSSI-proxy behavior). Examples of tasks that did not meet the proxy for self-injury criterion included EMA/daily diary designs, behavioral measures of impulsivity, and assessments of only pain tolerance; (2) the study was conducted in a controlled laboratory setting (e.g., no case studies); and (3) the sample was not specific to those with intellectual disabilities, autism spectrum disorder, or traumatic brain injury.
The incidence and economic impact of aggression in closed long-stay psychiatric wards
Published in International Journal of Psychiatry in Clinical Practice, 2021
Nienke J. de Bles, Andreia W. P. Hazewinkel, Jan P. A. M. Bogers, Wilbert B. van den Hout, Constant Mouton, Albert M. van Hemert, Nathaly Rius Ottenheim, Erik J. Giltay
We categorised aggression incidents into four categories, based on the Overt Aggression Scale (OAS) (Yudofsky et al. 1986). First, we defined ‘verbal aggression’ as yelling, shouting, using obscenities or swearwords, sexual remarks, and threatening others (with or without a threatening posture). Second, we defined ‘physical aggression towards an object’ as kicking, hitting, throwing objects (e.g., chairs, dishes, or cups), and slamming doors. Third, we defined ‘self-harm’ as any act of physical aggression towards the self, such as hitting, cutting, burning, strangulation, overdosing on medication, and jumping from heights (with or without suicidal intent). Fourth, we defined ‘physical aggression towards others’ as a physical assault on another person by means of hitting, pushing, pulling, holding, scratching, kicking, biting, spitting, touching inappropriately, strangulating, and/or attacking someone with an object (e.g., a chair or a knife). We did not categorise incidents based on severity. Case vignettes illustrating each of the categories are presented in Supplement 1.
A psychometric analysis of the Ottawa self-injury inventory-f
Published in Journal of American College Health, 2018
Joshua Travis Brown, Fred Volk, Gabrielle L. Gearhart
College campus counseling centers are challenged to deal with a wide range of mental health issues. The development of tools that facilitate the improved efficiency of psychological intake processes is essential for colleges and universities given that they simultaneously possess limited resources but must also increase accessibility in order to adequately meet the mental health needs of students. The purpose of this study was to evaluate the psychometric properties and validate the use of a measure of self-injurious behavior in a clinical setting for the diagnosis of NSSI according to the DSM-5. Self-injurious behavior is an increasing issue and is especially prevalent within the adolescent and young adult populations. We see concerning trends within this study, as 36.4% of the 1,064 students who visited the student counseling center indicated a history of self-injurious behavior and 11% indicated having self-injured or thought about self-injuring in the past 30 days. This suggests the importance of awareness regarding NSSI for counselors of young adults and adolescents. Thus, a validated and reduced measure of self-injurious behavior is necessary for the evaluation of NSSI among a set of mental health issues presently being addressed by university mental health professionals.
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