Self-injurious behavior (SIB) by individuals with intellectual and developmental disabilities including autism (I/DD) is among the most clinically disturbing, socially costly, and scientifically challenging behavior disorders. Forty years of clinical research has produced a knowledge base supporting idiographic behavioral assessment and treatment approaches. Despite the treatment progress, from a public health and population perspective, we argue it is less clear that we have reduced the disorder's burden. The developmental course of the disorder is mostly unknown and empirically informed population-level models of risk are absent. In this review, we systematically examined the published scientific literature specific to risk for SIB in the I/DD population. We reviewed study methodology in detail intentionally informed by an epidemiological perspective with a set of questions intended to test the quality of the inferences about risk. Results are discussed in terms of conceptual, methodological, and translational issues with respect to what needs to be done to create credible and useful clinical models for SIB risk in the I/DD population.

包括自闭症 (I/DD) 在内的智力和发育障碍人士的自残行为 (SIB) 是临床上最令人不安、社会成本最高且在科学上最具挑战性的行为障碍之一。四十年的临床研究已经产生了支持具体行为评估和治疗方法的知识库。尽管治疗取得了进展，但从公共卫生和人口的角度来看，我们认为尚不清楚我们是否已经减轻了这种疾病的负担。这种疾病的发展过程大多是未知的，并且缺乏基于经验的人群水平风险模型。在这篇综述中，我们系统地审查了已发表的 I/DD 人群 SIB 风险的科学文献。我们从流行病学角度有意详细审查了研究方法，并提出了一系列旨在测试风险推论质量的问题。结果从概念、方法和转化问题的角度进行了讨论，涉及如何为 I/DD 人群中的 SIB 风险创建可靠且有用的临床模型。