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Section 16
Sleep & Cyclical Variables in Self-Mutilating Clients

Question 16 found at the bottom of this page
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Epidemiological research has identified both environmental and biological correlates of severe (Self-Injurious Behavior) SIB or aggression that may greatly influence the development, course, maintenance, and severity of these disorders. Sleep and cyclical variables represent two potentially important biological factors related to destructive behavior, which include certain mood disorders and other biological processes that are periodic and influence behavior (e.g., the menstrual cycle). In this chapter, we have summarized a line of research on relations between destructive behavior and sleep and cyclical variables. One study showed that children with severe behavior disorders were much more likely to have markedly disturbed sleep than typically developing peers. Another study showed that day-to-day fluctuations in sleep and SIB are often inversely correlated, with decreased sleep (sleep deprivation) often followed by increased SIB. A series of studies showed that behavioral interventions designed to entrain sleep patterns in synchrony with the individual's biological clock could effectively treat sleep disorders in this population and, in rare cases, sleep treatment may significantly reduce SIB. With regard to cyclical variables in SIB, we have developed a set of procedures for detecting and testing hypotheses about cyclical SIB in nonverbal individuals and for identifying the biological processes that may be responsible for periodicity in this disorder. Further research is needed to identify treatments that will more effectively manage individuals with treatment-resistant cyclical behavior disorders.
- Schroeder, Stephen, Oster-Granite, Mary, & Travis Thompson, Self-Injurious Behavior, American Psychological Association: Washington DC, 2002.

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Personal Reflection Exercise #2
The preceding section contained information about sleep and cyclical variables in self-mutilating clients. Write three case study examples regarding how you might use the content of this section in your practice.

QUESTION 16
What are two potentially important biological factors related to destructive Self-Injurious Behavior (SIB) behavior? Record the letter of the correct answer the Answer Booklet.