Seclusion of children and adolescents: Psychopathological and family factors

Gullick, Karen; McDermott, Brett; Stone, P.; Gibbon, Peter

doi:10.1111/j.1440-0979.2005.00353.x

Cited by 28 publications

(31 citation statements)

References 14 publications

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“…After applying the inclusion criteria, 13 publications were excluded: 6 did not meet the time-frame [2,10,20,23,31,35]; 2 papers did not report original research [8,13] and 5 did not present prevalence data for seclusion or restraint use [8,19,28,26,33] Four of the 7 included studies had a pre-intervention/post-intervention design (n=1,302) [6,17,18,21], two were descriptive studies (n=590) [9,15], and the last one was a cross-sectional survey (n=504) [32] (Table 1). …”

Section: Search Resultsmentioning

confidence: 99%

“…Gullick et al only provided data on mechanical fixation during episodes of seclusion; in 92 of 97 (94%) episodes mechanical fixation were used (94%) [15] 8 In 4 studies, authors evaluated the effect of specific interventions to reduce rates of SRU.…”

Section: Description Of Specific Resultsmentioning

confidence: 99%

“…The reference lists of identified papers were used to find additional publications. We restricted our search to English language papers published between 2000 and 2010 because review papers on earlier research up until 1999 were already available [1,4,10,15,23]. Both the title and abstract of retrieved papers were screened.…”

Section: Methodsmentioning

confidence: 99%

“…Studies were conducted in the US (n=4) [9,17,18,21], Australia (n=2) [6,15], and only one study was conducted in Europe [32]. One study (n=442) reported on two consecutive time points, and 4 studies (n=1,302) reported on SRU rates before and after a specific intervention.…”

Section: Summary Of the Included Studiesmentioning

confidence: 99%

“…The literature prior to the year 2000 reports rates ranging from 28% to 60% [1,4,10,15,23]. A survey of 25 US child and adolescent units found 6-fold higher SRU rates compared to adult services in the same state [18].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Prevalence and correlates of seclusion and restraint use in children and adolescents: a systematic review

Hert

Dirix

Demunter

et al. 2011

Eur Child Adolesc Psychiatry

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Seclusion and restraint are frequent procedures to intervene in aggressive and potentially dangerous patients in psychiatric settings. However, little is known about their utilization and effectiveness in paediatric populations. We aimed to examine the prevalence and determinants of seclusion and restraint utilisation in children and adolescents in psychiatric settings. Using PubMed, PsychInfo and Cinahl, we performed a systematic literature review of studies published in the last 10 years reporting on the prevalence of seclusion and restraint use in psychiatrically ill youth (<21 years old) treated in psychiatric settings. Only seven publications addressed the topic. Primary outcomes were prevalence rates, reported either as the proportion of patients restrained/secluded or as the number of restraints/seclusions per number of patient days. All studies found relatively high baseline rates of seclusion (26% of patients; 67/1.000 patient days), and restraints (29% of patients; 42.7/1,000 patient days). In four studies an intervention, implemented to reduce seclusion and restraints, resulted in a dramatic weighted mean reduction in the more restrictive use of restraints by 93.2%, with a 54.2% shorter duration. There was a small, weighted mean reduction in the use of less restrictive seclusions (-0.6%), but results were heterogeneous (-97.2% to +71.0%), with the only increase in seclusions being reported in one study in which the intervention-based padded seclusion room was utilized more frequently instead of more restrictive measures.Otherwise, seclusion episodes reduced by 74.7%, including a 32.4%. shorter duration. Few studies reported on risk-factors and predictors, consisting of past or current aggression and/or violence, suicidal behaviour, more severe psychopathology, non-White ethnicity, emergency admissions, out-of-home placement, and poorer family functioning, while findings regarding age were inconsistent Except for duration, data about the effectiveness of seclusion and restraints were missing, although there is some indication that seclusion and restraints can lead to severe psychological and physical consequences. Future research should focus on indications, predictors, preventive and alternative strategies, as well as on clinical outcomes of seclusion and restraints in psychiatrically ill youth. In addition, there is a clear need for transparent policies and guidelines.

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Section: Search Resultsmentioning

confidence: 99%

Section: Description Of Specific Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Summary Of the Included Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence and correlates of seclusion and restraint use in children and adolescents: a systematic review

Hert

Dirix

Demunter

et al. 2011

Eur Child Adolesc Psychiatry

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Prediction of restraints among youth in a psychiatric hospital: application of translational action research

2011

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This study extends a translational action research program by applying a theoretically based measure of risk in predicting incidents of restraint among children and adolescents in a secure psychiatric hospital. Youth inpatients (N=149, ages 5-17) were assessed at intake for the presence of selected individual and contextual risk factors, and their involvement in critical incidents was tracked (i.e., number of episodes in which restraint was applied) for the remainder of their hospitalization. Models including history of aggression or history of previous placements as well as a combined model including several individual and contextual factors significantly predicted the likelihood of a youth becoming involved in at least one restraint. Unique predictors of restraint involvement included history of aggression against adults and history of previous psychiatric hospitalizations. None of the variables assessed predicted the extent of a youth’s restraint involvement. The implications of these findings are discussed with respect to future research and empirically informed practice with high-risk youth.

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Traumatic stress symptoms predict restraint incidents in children and adolescents in psychiatric residential treatment

Brown

Nedelman

Phillips

et al. 2022

Journal of Traumatic Stress

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The early identification of youth at risk for restraint incidents is an important next step to reducing the likelihood of such incidents. Yet, the extant research has not comprehensively investigated the idiographic factors that contribute to the restraint of youth in psychiatric residential treatment facilities (PRTFs). The current study investigated client-level predictors of restraint incidents, with specific emphasis on youth client trauma history and traumatic stress symptoms as assessed at admission. Participants were children and adolescents (N = 150; 55.3% female, 66.7% White, 33.3% Black or biracial) aged 6-17 (M = 11.8 years) admitted to a PRTF in the northeastern United States. A negative binomial regression with maximum likelihood estimation was conducted to examine the relative contributions of age, gender, length of stay, number of psychiatric diagnoses, body mass index (BMI), and traumatic stress symptoms at intake to the frequency of restraint incidents. The model was significant, χ 2 (6, N = 150) = 30.326, p < .001, and both length of stay, β = .005, p < .001, IRR = 1.005, and traumatic stress symptoms at intake, β = .072, p = .007, IRR = 1.074, were identified as significant 694

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Seclusion of children and adolescents: Psychopathological and family factors

Cited by 28 publications

References 14 publications

Prevalence and correlates of seclusion and restraint use in children and adolescents: a systematic review

Prevalence and correlates of seclusion and restraint use in children and adolescents: a systematic review

Prediction of restraints among youth in a psychiatric hospital: application of translational action research

Traumatic stress symptoms predict restraint incidents in children and adolescents in psychiatric residential treatment

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