Social-Environmental Factors Contribute to Self-Injury Behavior in Fragile X, Study Finds

Social-Environmental Factors Contribute to Self-Injury Behavior in Fragile X, Study Finds

Social-environmental variables can influence self-injury behavior in a large proportion of boys with fragile X syndrome, according to researchers.

Their study, “Examining the influence of social-environmental variables on self-injurious behaviour in adolescent boys with fragile X syndrome,” was published in the Journal of Intellectual Disability Research.

Fragile X syndrome is the most common form of inherited intellectual disorder. A significantly high number of fragile X patients display behavior intended to harm themselves, such as self-hitting and self-biting.

Studies have shown that as many as 60-80% of fragile X patients show this type of behavior, sometimes causing minor injuries to themselves and substantially affecting their well-being.

In addition to self-injury behavior, many patients also demonstrate aggression.

While several studies have focused on the connection between genetic factors associated with fragile X and an increased occurrence of self-injuries, few have looked at the role of social-environmental factors and their influence on these types of behaviors.

Some studies suggest that fragile X patients try to hurt themselves as a way to escape social interaction with others, task demands, and unexpected transitions (when a patient has to stop an activity and move to another one).

Here, 22 adolescent boys ages 10-18 with fragile X were exposed to seven environmental conditions in a functional analysis of self-injury behavior conducted over two days at a Stanford University research center.

Functional analysis is widely used as a method of identifying variables that contribute to self-harming behavior. It involves repeatedly exposing an individual to several specific tests and control conditions that simulate the natural environment, including being ignored, or given attention.

Fourteen participants (63.6%) engaged in self-injury behavior during the functional analysis.

Eight (36.4%) boys showed aggressive behavior in the functional analysis, and three (13.6%) showed aggressive and self-harming behavior together.

Ten participants (45.5%) engaged in self-injury behavior that was maintained by social-environmental variables. This included getting attention and highly preferred tangible items, escaping from social interactions, task demands, and transitions from one activity to another.

For two boys, self-harming occurred regardless of whether they were in a test or control condition.

For two other boys who were hurting themselves, their behavior appeared to be maintained by automatic reinforcement — when a participant is left alone or ignored with nothing to do.

“Social-environmental variables appeared to maintain SIB [self-injurious behavior] in a significant proportion of boys with FXS [fragile X syndrome],” the researchers wrote.

“Given that pharmacological treatments for SIB have limited efficacy in this population, the potential role of social-environmental factors on SIB should be examined before pharmacological treatments are implemented for these behaviors.

“It is important, therefore, not to discount the significant role that social-environmental variables may play in the maintenance of these behaviors, even in populations of individuals with known genetic risk for SIB,” they added.

Iqra holds a MSc in Cellular and Molecular Medicine from the University of Ottawa in Ottawa, Canada. She also holds a BSc in Life Sciences from Queen’s University in Kingston, Canada. Currently, she is completing a PhD in Laboratory Medicine and Pathobiology from the University of Toronto in Toronto, Canada. Her research has ranged from across various disease areas including Alzheimer’s disease, myelodysplastic syndrome, bleeding disorders and rare pediatric brain tumors.
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Iqra holds a MSc in Cellular and Molecular Medicine from the University of Ottawa in Ottawa, Canada. She also holds a BSc in Life Sciences from Queen’s University in Kingston, Canada. Currently, she is completing a PhD in Laboratory Medicine and Pathobiology from the University of Toronto in Toronto, Canada. Her research has ranged from across various disease areas including Alzheimer’s disease, myelodysplastic syndrome, bleeding disorders and rare pediatric brain tumors.
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