In 1977, Ted Carr described five major hypotheses regarding the motivation for self-injurious behavior (SIB) and provided a comprehensive review related to each hypothesis. What followed was the development and evolution of a robust technology for examining the influence of the first two hypotheses Carr described, namely, operant mechanisms. Functional analysis technology can be effective for specifying positive and negative social reinforcers, and in turn, effective intervention for socially maintained SIB. Far less is known about the third and fourth hypotheses, namely the sensory and neurobiological bases of chronic SIB among individuals with intellectual and developmental disabilities (IDD). In behavioral models of SIB, sensory mechanisms function as putative positive or negative automatic reinforcers but there is little evidence directly linking behavioral and biological mechanisms. Evidence from both clinical and animal studies of chronic pain and its behavioral sequelae support the hypothesis that some forms of SIB may be regulated by altered pain mechanisms. We know that pain can lead to SIB in individuals with IDD, but we do not know whether chronic SIB leads to pain and the resulting neurobiological cascade of effects. This talk will describe several sets of recent findings pertaining to the relationship between pain and SIB.
Review Jennifer McComas’s biographical statement.