• Title/Summary/Keyword: Self-Injurious behavior

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THE DENTAL MANAGEMENT OF SELF-INFLICTED ORAL MUTILATION IN THE DISABLED : CASE REPORT (장애인의 자해로 인한 구강 내 손상의 치과적 조절: 증례 보고)

  • Lee, Hyeon-Heon;Lee, Sang-Ik;Lee, Hyeok-Sang;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.2
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    • pp.156-160
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    • 2006
  • Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, comatose status, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents some self-inflicted oral mutilation patients who were all treated successfully with several appliances.

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APPLICATION OF THE MODIFIED-MOUTHGUARD TO PREVENT SELF-INJURIOUS BEHAVIORS IN A CHILD WITH CEREBRAL PALSY : A CASE REPORT (뇌성마비 환아의 자해 방지를 위한 변형된 마우스가드의 적용)

  • Pak, Eun-Kyung;Kim, Kwang-Chul;Choi, Sung-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.351-356
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    • 2008
  • Cerebral palsy, a range of non-progressive syndromes of posture and motor impairment, is a common cause of disability in childhood. Self-injurious behavior(SIB) is deliberate harm to the body without suicidal intend, often involving repetitive actions that cause tissue damage. One of the most common orofacial self-injurious behavior is chewing tongue, lip or oral mucosa. This kind of SIB in children is not common in normal children. High occurrence rates are observered in cases of syndromatic, mentally retarded children, and children with congenital disease. Various methods such as behavior modification, behavior control by drugs, body restraints, application of dental appliance, surgery and extraction of teeth have been suggested to control those self-injurious behavior. Using mouthguard as one of dental applainaces is the most conservative and appropriate method in terms of reducing oral self-injurious habits and protection of tissue. This case report describes a child with cerebral palsy who presented with self-injurious ulceration of lip and buccal mucosa. A modified mouthguard was effective in preventing self-injurious oral trauma in a child with cerebral palsy.

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A CASE OF PERVASIVE DEVELOPMENTAL DISORDER NOS WITH REPETATIVE SELF-INJURIOUS BEHAVIOR (반복적으로 머리를 때리는 전반성발달장애 환아 1례)

  • Kim, Jeong-Lim;Chung, Bo-In;Cho, Soo-Churl;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.244-251
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    • 1999
  • Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.

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TREATMENT OF SELF-INJURIOUS BEHAVIOR WITH INTRAORAL APPLIANCE IN EPILEPSY PATIENTS (가철식 장치를 이용한 구강조직 자해 환자의 치료)

  • Kim, Ik-Hwan;Lee, Ko-Eun;Lee, Jae-Ho;Kang, Chung-Min
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.12 no.1
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    • pp.16-19
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    • 2016
  • Oral self-injurious behavior (SIB) can be defined as the intentional, direct injuring of oral tissue, most often done without conscious suicidal intent and most commonly associated with tongue or lip biting. Chronic biting of oral mucosa is an innocuous self inflicted injury, commonly seen in children suffering from developmental and psychological problems. The cases presented in this report discuss oral SIB due to epilepsy, quadriplegia and their treatments. This report documents a successful self-injurious behavior treatment of epilepsy patients within a short time by applying a removable intraoral device. Clinicians should notice the possibility of oral SIB in various disorders. Moreover, different treatment should be performed according to the causative disorders and symptoms.

THE DENIAL MANAGEMENT OF SELF-INFLICTED ORAL MUTILATION (자해로 인한 구강내 손상의 치과적 조절 : 증례 보고)

  • Lee, Sang-Ik;Kim, Young-Jae;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.244-250
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    • 2005
  • Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, coma, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents two self-inflicted oral mutilation patients who were all treated successfully with appliances such as modified activator without wire for retention, modified tongue-rake appliance and mouth guard.

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TREATMENT OF SELF-INJURIOUS LIP BITING WITH POSTERIOR BITE BLOCK APPLIANCE IN A BRAIN LESION PATIENT (교합 거상판을 이용한 뇌병변장애 환아의 자해성 구강 손상의 치료)

  • Jun, Hyelim;Song, Je-Seon;Lee, Jae-Ho;Lee, Hyo-Seol
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.2
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    • pp.93-96
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    • 2014
  • Brain disorder disability is assessed when organic brain lesion such as cerebral palsy, traumatic brain injury, or stroke causes physical impairment which limits daily activites substantially according to its level and range of paralysis or the presence of involuntary movement. According to the disabled person welfare law in Korea, grade I brain disorder is assessed when one is in continuous irreversible state of coma without the ability to prolong one's life without other's help. Self-injurious behavior is defined as the non-suicidal intentional or unintentional injury to one's own body which can occur repetitively temporarily or chronically. People with decreased consciousness often exhibit increased self-injurious behavior which is most commonly associated with tongue or lip biting. This report documents a successful self -injurious lip biting treatment of a brain lesion patient within a short time by applying a removable acrylic resin appliance including posterior bite block.

Adolescents' Experiences of Non-Suicidal Self-Injury: An Interpretative Phenomenological Analysis Study (청소년의 비자살적 자해 경험: 해석 현상학적 분석)

  • Ko, Jung A;Kim, Ji Young
    • Journal of Korean Academy of Nursing
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    • v.53 no.5
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    • pp.538-555
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    • 2023
  • Purpose: This qualitative study used interpretative phenomenological analysis and photovoice methods to explore the meaning of non-suicidal self-injury experienced by adolescents. Methods: Participants were adolescents enrolled in middle and high schools in Gyeonggi-do and Jeollabuk-do who were selected through snowball sampling. Six participants had repeatedly engaged in self-injurious behavior for over a year. Data were collected through in-depth interviews and the photovoice method between November 2020 and July 2021. The collected data were analyzed using six steps of interpretative phenomenological analysis. Results: The results yielded 5 main themes and 18 subthemes. The main themes were 'a silent cry to an indifferent world', 'a heartache that one endures with scars', 'an inescapable cycle', 'filling the space in one's heart', and 'healing the wounds'. The study findings revealed that the self-injurious behavior of adolescents began as a consequence of feeling lost and struggling with conflicts at home and school, which helped them relieve tension and pain. Nonetheless, inflicting self-injury only left signs of regret and remorse, which became a trace that the participants wanted to hide. However, the wounds healed after receiving attention and support from others. They were determined to stop engaging in repeated self-injurious behaviors and made efforts to do so. Conclusion: This study can be used as a basis for the development of educational programs to prevent non-suicidal self-injury in adolescents. Additionally, it can inform nursing interventions that focus on building support systems to help adolescents who attempt self-injury.

SELF-INJURIOUS BEHAVIOR IN A PATIENT WITH AUTISM : A CASE REPORT (자폐 환자의 자해로 인한 구강 내 손상 : 증례 보고)

  • Ji, Eun-Hye;Lee, Hyo-seol;Choi, Hyung-Jun;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.1
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    • pp.10-14
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    • 2012
  • Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.

A Systematic Review on Non-Medication Intervention for Self- Injurious Behavior of Individuals With Autism Spectrum Disorders (자폐스펙트럼장애의 자해행동 중재에 관한 체계적 고찰 : 비약물치료 중심으로)

  • Kim, Seul-kee;Choi, Jeong-sil
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.1
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    • pp.30-42
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    • 2019
  • Objective : The purpose of this study is to analyze non-medication interventions for self-injurious behavior of individuals with autism spectrum disorders, using a systematic review, and to provide evidence of appropriate services for individuals with autism spectrum disorders with self-injury behaviors in the clinical practice of occupational therapy. Methods : Using the electronic databases PubMed, Medline (ProQuest), DBpia, RISS, KISS, and NDSL, we searched for articles published in Korean and international journals from December 2004 to November 2018. The main search term were "Autism OR Autism Spectrum Disorder AND Therapy OR Treatment Or Intervention AND Self Injurious Behavior." Qualitative analysis was performed, and the results are presented in the PICO format. Results : A total of 12 articles were selected. The quality of the evidence was highest in level IV and level V. Single studies with an experimental design were the most common. Behavior therapy was the most common type of intervention. The next most common interventions were behavioral therapy, brain stimulation and control, and sensory integration therapy with behavioral therapy. The self-injury behaviors of individuals autism spectrum disorders were decreased, and was statistically significant. Conclusion : This study investigated the use of non-medication interventions for children with autism spectrum disorders who showed self-injury behavior. Future research should use higher-level designs, and investigate differences between various non-medication interventions.

The Mediating Role of Depression Severity on the Relationship Between Suicidal Ideation and Self-Injury in Adolescents With Major Depressive Disorder

  • Kang, Byungjoo;Hwang, Jaeuk;Woo, Sung-il;Hahn, Sang-Woo;Kim, Minjae;Kim, Younggeun;Jin, Hyeonseo;Jeon, Hong Jun;Lee, Yeon Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.4
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    • pp.99-105
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    • 2022
  • Objectives: Suicide is the leading cause of death among adolescents in South Korea, and depression and personality profiles have been identified as significant risk factors for self-injurious behavior. This study examined the influence of depressive mood and temperament/character on self-injury in adolescents. Methods: A total of 116 adolescents (aged 12-18 years) with a primary diagnosis of major depressive disorder (MDD) and their parents were enrolled in this study. The participants were divided into three groups based on adolescent's self-injury frequency, and their Children's Depression Inventory (CDI), Youth Self-Report (YSR), and Temperament and Character Inventory (TCI) scores were compared. Finally, mediation analysis was conducted to investigate the relationship between suicidal ideation and self-injury. Results: Of study participants, 75.9% answered that they had suicidal ideation, and 55.2% answered that they had engaged in self-injurious behavior in the last six months. There were significant differences in CDI and suicidal ideation among the groups. After adjusting for age and sex, mediation analysis indicated that depressive mood mediated the relationship between suicidal ideation and self-injury. Conclusion: This study emphasizes the importance of evaluating and managing depressive mood severity in adolescents with MDD as these factors partially mediate the transition from suicidal ideation to self-injury.