Stereotypy II: a review of neurobiological interpretations and suggestions for an integration with behavioral methods

doi:10.1016/j.ridd.2004.11.006

Research in Developmental Disabilities

Volume 26, Issue 6, November–December 2005, Pages 548-564

https://doi.org/10.1016/j.ridd.2004.11.006 Get rights and content

Abstract

Stereotypy is a relatively common behavioral disorder displayed by individuals with developmental disabilities, including autism. In this paper, we review selected studies on neurobiological interpretations of stereotypy and pharmacological interventions for stereotypy. Specifically, we review studies that evaluated the effects of serotonin uptake inhibitors (e.g., clomipramine) or opioid antagonists (e.g., naltrexone) on stereotypy displayed by humans. Throughout, suggestions are made for the incorporation of behavioral methods into this area of research.

Section snippets

Pharmacological and neurobiological interpretations

Although behavioral researchers have made little reference to the etiology of repetitive behavior, other researchers have implicated neurobiological mechanisms as the originating and maintaining source(s) of stereotyped behavior. Hypotheses concerning neurobiological chemical systems and repetitive behavior evolved from basic research with nonhumans (e.g., rodents, primates). Models of stereotypy (displayed by humans) have been developed through basic research with nonhumans using impoverished

Pharmacological interventions

Several classes of psychotropic medication have been used to treat stereotypy displayed by individuals with DD. Studies involving serotonin reuptake inhibitors and opiate antagonists are the focus of discussion in the following sections. Although several studies have also evaluated the effects of antipsychotic or neuroleptic medication for treating stereotypy, research involving this class of medication has been limited during the past decade. Prior literature reviews on the efficacy of

Discussion

Historically, behavioral and pharmacological studies have differed on two general dimensions. Behavioral studies have tended to involve fewer participants (e.g., one to five) wherein direct observation (e.g., via rate of response or percentage of time measures) of the target behavior was employed and treatment effects were evaluated using single-subject experimental designs. Furthermore, due to the small number of participants in a typical behavioral study, the generality of treatment results

Acknowledgements

Portions of the manuscript preparation were funded by NICHD Grant #HD38698 to the second author. We would like to extend our thanks to Jennifer Elder, Timothy Hackenberg, Brian Iwata, and Mark Lewis for their comments on an earlier draft of this manuscript.

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Existing evidence indicates that activity of midbrain dopamine (DA) system is likely to play a role in regulating repetitive, stereotypic behaviors. Enhancing DA release by psychostimulants increases repetitive behavior [1,71]. We have shown that psychostimulants that augment DA transmission reduces habituation to sensory reinforcers [23,46,51,72].
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It is reported that high doses of METH-induced stereotypy (i.e. repetitive and compulsive behavior) are regulated by pharmacological manipulations of μ opioid receptors in rats; intrastriatally infused DAMGO ([D-Ala2-N-Me-Phe4-Gly5-ol]-enkephalin, a synthetic opioid peptide with high μ opioid receptor specificities) and CTAP (D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2, a somatostatin analog with μ opioid receptor antagonist property) augment and attenuate METH-induced stereotypy, respectively (Horner et al., 2010; Horner et al., 2012). Overall, endogenous opioid systems have been proposed to play a critical role in behavioral sensitization, stereotypy, and drug reward, and opioid receptor antagonists are candidates for the treatment of drug abuse (Gianoulakis, 2004), as well as for the treatment of other impulse control disorders or symptoms, including self-injurious behavior (SIB) (Odlaug and Grant, 2010; Rapp and Vollmer, 2005). However, the involvement of specific opioid receptor subtypes in the adverse effects of acute METH injections (resulting from higher doses of METH) has not been fully investigated.
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Stereotypy II: a review of neurobiological interpretations and suggestions for an integration with behavioral methods

Abstract

Section snippets

Pharmacological and neurobiological interpretations

Pharmacological interventions

Discussion

Acknowledgements

Behavioural Processes

Journal of the American Academy of Child and Adolescent Psychiatry

Research in Developmental Disabilities

Research in Developmental Disabilities

Behavioral and Neural Biology

Journal of the American Academy of Child and Adolescent Psychiatry

Research in Developmental Disabilities

Behavioral and Neural Biology

Physiology and Behavior

Brain Research

Research in Developmental Disabilities

The effectiveness of naltrexone in treating task attending, aggression, self-injury, and stereotypic mannerisms of six young males with autism or pervasive developmental disorders

Journal of Developmental and Physical Disabilities

Placebo, doublie-blind evaluation of long-term naltrexone treatment effects of adults with mental retardation and self-injury

Journal of Developmental and Physical Disabilities

Blink rate as an index of dopamine function in adults with mental retardation and repetitive behavior disorders

American Journal on Mental Retardation

B-endorphin levels in peripheral blood mononuclear cells and long-term naltrexone treatment in autistic children

European Neuropsychopharmacology

Change in a multiple-response repertoire during response-contingent punishment and response restriction: Sequential relationships

Journal of the Experimental Analysis of Behavior

Schedules of reinforcement

Rate of stereotyped body rocking of severe retardates as a function of frustration of goal-directed behavior

Journal of Abnormal Psychology

Body rocking and activity level as a function of prior movement restraint

American Journal of Mental Deficiency

Neuropsychiatry and behavioral pharmacology

Comprehensive school-based behavioral assessment of the effects of methylphenidate

Journal of Applied Behavior Analysis

Structural and environmental characteristics of stereotyped behaviors

American Journal on Mental Retardation

Toward a functional analysis of self-injury

Journal of Applied Behavior Analysis

Clomipramine treatment for stereotypy and related repetitive movement disorders associated with mental retardation

American Journal on Mental Retardation

Plasma HVA in adults with mental retardation and stereotyped behavior: Biochemical evidence for a dopamine deficiency model

American Journal on Mental Retardation