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The present case study was an effort to determine the relative effectiveness of two variant treatment modalities, and to provide an exploratory study of the hypothesis that therapy with naltrexone might increase the effectiveness of an aversive stimulus in controlling self-injury. Data are presented for a man who was treated for severe self-injury with the Self-Injurious Behavior Inhibiting System (SIBlS) and naltrexone, conducted under open-trial conditions utilizing fixed doses of 50 mg, 75 mg, and 100 mg per day. The effects of naltrexone on SIB were evaluated alone, and paired with SIBIS. When used alone, lower dosages of naltrexone produced moderate decrements in sell-injury. However, the rate of SIB increased in a dose-dependent manner when naltrexone was paired with SIBIS. The data also suggested that naltrexone may have caused a generalized blunting of both positive and negative affect. [ABSTRACT FROM AUTHOR]

The article discusses the treatment strategies for self-injurious behavior in a large service-delivery network. Psychoactive drugs continue to be utilized with institutionalized mentally retarded persons, despite pressures in recent years to discourage reliance upon pharmacological interventions. The scope of the study were examined, including the pattern of psychoactive drug usage within the a state-wide institutional service-delivery network.