Stereotyped behaviors predicting self-injurious behavior in individuals with intellectual disabilities

https://doi.org/10.1016/j.ridd.2014.08.017Get rights and content

Highlights

  • BPI-01stereotyped behavior subscale scores predicted BPI-01 SIB subscale scores.

  • Two groups of individuals emerged from mixture modeling.

  • One group emerged where stereotyped behavior was a strong significant predictor of SIB.

  • Another group emerged in which stereotyped behavior was not a predictor of SIB.

Abstract

We examined the relation between stereotyped behavior and self-injurious behavior (SIB) for 1871 individuals with intellectual disabilities who had a score of >0 on the Behavior Problem Inventory (BPI-01; Rojahn et al., 2001). We report three main findings: First, structural equation modeling techniques (SEM) revealed that the BPI-01stereotyped behavior subscale scores predicted BPI-01 SIB subscale scores. Second, when stereotyped behavior was modeled as a predictor of SIB, mixture-modeling techniques revealed two groups of individuals: one in which stereotyped behavior was a strong, statistically significant predictor of SIB (69% of the sample), and another one in which stereotyped behavior was not a predictor of SIB (31%). Finally, two specific stereotyped behavior topographies (i.e., body rocking and yelling) were identified that significantly predicted five different SIB topographies (i.e., self-biting, head hitting, body hitting, self-pinching, and hair pulling). Results are discussed in terms of future research needed to identify bio-behavioral variables correlated with cases of SIB that can, and cannot, be predicted by the presence of stereotyped behavior.

Section snippets

Participants and data collection

The data set consisted of a total 1871 cases. Data sets from five different regions of the world were collated (Within USA: Rojahn et al., 2010; Rojahn et al., 2011, Zaja et al., 2011; Outside of USA: Hastings et al., 2005, Mircea et al., 2010, Owen et al., 2004). Participants were selected to be part of the sample studied if they had a total score greater than 0 on the Behavior Problem Inventory (Rojahn et al., 2001). Data were cross-sectional though collected in a period from 2004 to 2010.

Measures

The long form of the Behavior Problem Inventory (BPI-01; Rojahn et al., 2001, Rojahn et al., 2012a, Rojahn et al., 2012b) is a 49-item measure consisting of three subscales: Self-injurious Behavior (k = 14), Stereotyped Behavior (k = 24), and Aggressive/Destructive Behavior (k = 11). For the current study, we focused on the Self-injurious Behavior and Stereotyped Behavior subscales. A score of 1 indicated the presence of SIB or stereotyped behavior. Zeros indicated no reported presence of SIB.

Procedure

For our first research question (Was stereotyped behavior a significant predictor of SIB?), structural equation modeling techniques were utilized to examine the relationship between stereotyped behavior as predicting SIB via MPlus (v. 7.0; Muthén & Muthén, 2012). The exogeneous variables of age and level of intellectual disability (ID) were statistically controlled in examining this relationship in view of the relationship of the rest of the endogenous variables. The latent variable of

Was stereotyped behavior a significant predictor of SIB?

To test the predictive relationship between stereotyped behavior and SIB, a path model was established using structural equation modeling techniques where we statistically controlled for level of ID and chronological age. Model fit was evaluated via values for root mean square error of approximation (RMSEA), Tucker–Lewis index (TLI), Comparative fit index (CFI), and chi-square (χ2) for statistical significance (Byrne, 2011). Based upon the pre-existing item to factor structure of the BPI-01,

Discussion

The primary purpose of this study was to examine the viability of a model of stereotyped behavior predicting SIB among individuals with ID. Utilizing a large, international dataset, findings from this study indicate that stereotyped behavior is a significant predictor of SIB for some, but not all, individuals with ID. Specifically, stereotyped behavior was a strong, statistically significant predictor of SIB for approximately 69% (n = 1291) of the sample, but stereotyped behavior did not predict

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