Identity Conflict in People with Intellectual Disabilities: What Role do Service-providers Play in Mediating Stigma?

Background Self-restraint often appears to be associated with self-injurious behaviour (SIB), and has been described as an attempt to prevent or escape from SIB. Research into the determinants of self-restraint is limited, and the present single case study assesses the environmental determinants of self-restraint and SIB, as well as describing the relationship between the two behaviours. Methods Observations in the natural environment were conducted for 16.5h and data were collected on SIB, self-restraint and environmental events. Results Sequential analysis showed that SIB and self-restraint were unrelated to environmental events and that the behaviours co-varied inversely. Self-injurious behaviour occurred at higher than chance levels immediately following self-restraint and also at high levels immediately prior to self-restraint. Conclusions Whilst these results would appear to support the hypothesis that self-restraint was negatively reinforced by escape from SIB, the data cannot be explained solely by this theory. The implications of these findings for the behavioural theory of SIB and the conceptualization of self-restraint are discussed.