A prospective clinical analysis of pain behavior and self-injurious behavior

Frank J. Symons, Stacy E. Danov

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


It is a widely assumed but rarely tested proposition that the experience and expression of pain is altered among individuals with self-injurious behavior and disabilities. As a preliminary test of this proposition, the purpose of this case study was to apply a validated pain measure to examine ratings of pain behavior in relation to ratings of self-injurious behavior (SIB). A prospective correlational design was used with maternal ratings completed three times/day for 9 days using two item independent rating scales specific to pain and SIB. The participant was a 6-year-old boy with severe SIB secondary to midbrain tumor (pilocytic astrocytoma) resection and post-operative sequelae. Measures were taken in the child's home. Pain behavior was measured using the Non-Communicating Children's Pain Checklist Revised (NCCPC-R). Self-injury was measured using the Self-Injury Trauma Scale (SITS). Time intervals associated with elevated ratings of SIB were associated with elevated pain ratings. There was a significant difference (P<0.05) for pain ratings between time intervals with and without self-injury. It is suggested that additional empirical work is needed to clarify the relation between pain and self-injury to improve assessment and treatment outcomes.

Original languageEnglish (US)
Pages (from-to)473-477
Number of pages5
Issue number3
StatePublished - Oct 1 2005


  • Pain
  • Self-injurious behavior
  • Traumatic brain injury

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