β-Endorphin and ACTH are Dissociated After Self-Injury in Adults With Developmental Disabilities

Sandman, Curt A.; Touchette, Paul E.; Lenjavi, Mohammed R.; Marion, Sarah; Chicz-DeMet, Aleksandra

doi:10.1352/0895-8017(2003)108<414:eaaada>2.0.co;2

Cited by 35 publications

(32 citation statements)

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“…Indeed, numerous studies from many laboratories have shown that the functioning, relations, and processing of the POMC system are uncoupled or perturbed in subgroups of self-injuring individuals, resulting in different ratios of βE and ACTH, particularly under conditions of stress (Leboyer et al, 1994(Leboyer et al, , 1999Gillberg, 1995;Cazzullo et al, 1999;Sandman et al, 1990aSandman et al, , 1990bSandman et al, , 1995Sandman et al, , 1997Sandman et al, , 1999Sandman et al, , 2000aSandman et al, , 2002Sandman et al, , 2003.…”

Section: Discussionmentioning

confidence: 99%

Temporal patterns of self-injurious behavior correlate with stress hormone levels in the developmentally disabled

Kemp

Fillmore

Lenjavi

et al. 2008

Psychiatry Research

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While the origins and developmental course of self-injurious behavior (SIB) remain relatively unknown, recent studies suggest a biological imbalance may potentiate or provoke the contagious recurrence of SIB patterns in individuals with severe developmental disabilities (DD). Evidence from several laboratories indicates that functioning, relations, and processing of a stress-related molecule, proopiomelanocortin, (POMC), may be perturbed among certain subgroups of individuals exhibiting SIB. The current investigation employed a unique time-pattern analysis program (THEME) to examine whether recurrent temporal patterns (T-patterns) of SIB were related to morning levels of two POMC-derived hormones: β-endorphin (βE) and adrenocorticotropic hormone (ACTH). THEME was used to quantify highly significant (nonrandom) T-patterns that included SIB within a dataset of in-situ observational recordings spanning 8 days (~40 hours) in 25 subjects with DD. Pearson's product-moment analyses revealed highly significant correlations between the percentage of T-patterns containing SIB and basal levels of both βE and ACTH, which were not found with any other "control" T-patterns. These findings support the hypothesis that the recurrent temporal patterning of SIB represents a unique behavioral phenotype directly related to perturbed levels of POMC-derived stress hormones in certain individuals with severe DD.

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Section: Discussionmentioning

confidence: 99%

Temporal patterns of self-injurious behavior correlate with stress hormone levels in the developmentally disabled

Kemp

Fillmore

Lenjavi

et al. 2008

Psychiatry Research

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“…elevated transitional probability for SIB). Based on procedures employed in our previous studies (Sandman et al, 1997; Sandman, Touchette, Lenjavi, Marion, & Chicz-DeMet, 2003; Sandman et al, 1993) each subject was administered one of three doses of naltrexone (NTX; 0.5, 1.0 or 2.0 mg/kg, QOD) on separate weeks. Each positive treatment week was separated by a week of placebo treatment.…”

Section: Methodsmentioning

confidence: 99%

The role of proopiomelanocortin (POMC) in sequentially dependent self‐injurious behavior

Sandman

Touchette

Marion

et al. 2008

Developmental Psychobiology

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Self-injuring behavior (SIB) is a life-threatening behavior exhibited by many species, including humans, and has no known cause and no agreed upon treatment. The role of the stress axis in the maintenance of this mysterious behavior was examined in subjects with life-long SIB. Over a sixyear period, forty hours of direct observations of behavior and the environment were recorded on palmtop computers while 36 residential subjects (28 target and 8 control subjects) conducted their daily activities. Blood samples were collected in morning and evening for all subjects and within minutes after a self-injuring act in 28 target subjects who exhibited SIB to determine levels of ACTH and B-endorphin (BE). Self-injuring events in the patient group were significantly sequentially dependent (i.e. the only predictor of a self-injuring act was an antecedent self-injuring act). Higher morning levels of BE relative to ACTH predicted [r df=27 =0.57, p<.001] the sequentially dependent pattern of SIB. This effect was validated in a subgroup re-tested several months later [r df=22 =0.60, p<.001]. A subgroup of seven subjects exhibiting sequentially dependent patterns were administered an opiate blocker (naltrexone) in a double-blind, crossover design with an additional 14 hours/week of observation for seven weeks. Naltrexone challenge interrupted the sequential pattern (improved behavior) in subjects with elevated BE immediately following SIB (r=0.85, p<0.01). The pattern of results supported the conclusion that the stress axis played a significant role in the maintenance of complex episodes of self-injury.

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“…After a SIB episode, plasma β-endorphin levels increase and uncouple from adrenocorticotropic hormone (ACTH; Sandman et al 1997; Sandman et al 2003). Under normal circumstances, ACTH and β-endorphin levels are highly correlated, as they are both derived from the parent peptide proopiomelanocortin (Guillemin et al 1977).…”

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confidence: 99%

“…In addition, individuals with IDD exhibiting SIB have also been found to have elevated saliva cortisol levels, and cortisol levels were correlated with SIB severity (Symons et al 2003). Both the β-endorphin-ACTH uncoupling and altered cortisol levels among individuals with IDD and SIB suggest that the HPA stress axis is altered in individuals with IDD exhibiting SIB (Sandman et al 1997; Sandman et al 2003; Symons et al 2003). It is unlikely that these alterations in the stress response are generalizable to all persons exhibiting SIB.…”

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confidence: 99%

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Salivary biomarkers of HPA axis and autonomic activity in adults with intellectual disability with and without stereotyped and self-injurious behavior disorders

Symons

Wolff

Stone

et al. 2011

J Neurodevelop Disord

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Salivary levels of biomarkers for the hypothalamic–pituitary–adrenal axis (HPA; cortisol) and sympatho-adreno-medullary system (SAM; α-amylase) were measured in 51 adults (57% male) with neurodevelopmental disorders associated with intellectual disability (i.e., mental retardation) and chronic self-injurious behavior (SIB) and compared with matched controls without SIB. Cortisol levels differed significantly (p < 0.01) between the SIB and control group (SIB > control). Within-group analyses showed significant differences (p < 0.05) in levels of salivary α-amylase between individuals with SIB and those with SIB meeting criteria for stereotyped movement disorder (SMD; SIB + SMD > SIB). Salivary α-amylase was significantly correlated with frequency of stereotypy among the SIB group (r = 0.36, p < 0.05). These preliminary findings warrant further exploration into the role of the SAM system in the pathophysiology of SIB and related repetitive behaviors among individuals with neurodevelopmental disorders associated with intellectual disability.

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β-Endorphin and ACTH are Dissociated After Self-Injury in Adults With Developmental Disabilities

Cited by 35 publications

References 48 publications

Temporal patterns of self-injurious behavior correlate with stress hormone levels in the developmentally disabled

Temporal patterns of self-injurious behavior correlate with stress hormone levels in the developmentally disabled

The role of proopiomelanocortin (POMC) in sequentially dependent self‐injurious behavior

Salivary biomarkers of HPA axis and autonomic activity in adults with intellectual disability with and without stereotyped and self-injurious behavior disorders

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