Academic journal article International Journal of Psychology Research

Treatments for the Deliberate Ingestion of Objects for a Person with an Intellectual Disability

Academic journal article International Journal of Psychology Research

Treatments for the Deliberate Ingestion of Objects for a Person with an Intellectual Disability

Article excerpt

Introduction

Despite deliberate self-ingestion of objects being exhibited in various populations, there is a paucity of studies within the population of persons with a developmental disability who deliberately ingest objects. Deliberate ingestion can be defined as intentionally ingesting objects for the purpose of some anticipated outcome. Overall, studies of deliberate ingestion within the population of persons with developmental disabilities appears to be limited to only one study presenting a profile of characteristics that accompanied deliberate ingestion. The purpose of this case study is to present another profile of person with a developmental disability, and the effectiveness of various environmental precautions and therapies.

In one of the only studies of someone with a lower IQ, Soong, Harvey and Doherty (1990) presented a case study of a 37 year old single man of below average intelligence (WAIS Full Scale IQ score of 74), without any mental illness but with a diagnosis of a personality disorder. The study stated that his clinical presentation was characterized by dependence, attentionseeking behavior, and poor tolerance for stress.

In regard to the connection between deliberate ingestion and auditory hallucinations, Han et al. (1984) and Tsai (1997) both identified that deliberate ingestion was engaged in response to auditory hallucinations. Furthermore, Karp, Whitman and Convit (1991) reported that for individuals admitted to a prison ward of a hospital, the most frequent diagnoses included schizophrenia with a personality disorder or just having a personality disorder.

In regard to characteristics or risk factors for ingestion, such factors as a heightened sense of dependency (Karp et al. 1991), poor problem solving and self-concept (Martinez 1980), and a history of substance misuse and inadequate socialization have been identified. Furthermore, Martinez (1980) also identified difficulties with delaying reinforcement, and trying to exert control by deliberate ingestion which yielded such benefits as increased attention from staff or even being sent to a hospital. Other functions for deliberate ingestion have also agreed with Martinez (1980) in that O'Sullivan et al. (1996) identified being transferred to a hospital, access to analgesia (Lee et al. (2007), and inmates being able to impose their will on a restrictive environment especially because of limited problem solving skills (Smit and Kleinhans, 2010).

In regards to treatment for deliberate ingestion, Martinez (1980) proposed the interventions of removing potential objects to ingest, including person and prisoner's cell searches, and providing no cutlery during meals. In addition, decreased attention for the instances of the deliberate ingestion was also incorporated into treatment. In terms of pharmacological treatment, both Naltrexone and Clonidine have been associated with a decrease in impulsivity and the frequency of self-harm, of which deliberate ingestion was regarded a as a variant (Roth et al. 1996; Philipsen et al. 2004). Gitlin et al. (2007) related an account of one of his psychiatric patients whom when admitted to a Dialectical Behavior Therapy (DBT) treatment unit, evidenced an "extended remission." Furthermore, he argued that since DBT was effective with other self-harmful behaviors, it could potentially be effective with deliberate ingestion.

This particular case study is noteworthy in that detailed background and diagnostic information is presented, functions for the deliberate ingestion identified, and the efficacy of different interventions are also presented for the same individual with an Intellectual Disability. In particular, it is noteworthy that while other longstanding maladaptive behaviors were no longer exhibited, when the individual entered secure care, deliberate ingestion began and was learned through contagion.

Case Study

Mr. R had been institutionalized for a significant portion of his entire life. …

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