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PubMedDate not supplied

Factors associated with the seclusion of psychiatric patients.

Records of adult psychiatric patients in a university hospital revealed 116 patients had been secluded on 263 occasions during one year. Seclusion was more frequent in winter and spring, and during the late night and early morning, but there was no relationship between seclusion and lunar cycle, week day, weather, menstrual cycle, or month of birth. More males than females were secluded, but females had more multiple seclusions. A control group matched for ward, sex, and within ten years of age consisted of 108 patients. The most common diagnoses for both groups were the major affective disorders and schizophrenia.

Acting Out↗
PubMed1996

Novelty-seeking in rats--biobehavioral characteristics and possible relationship with the sensation-seeking trait in man.

A behavioral trait in rats which resembles some of the features of high-sensation seekers in man has been characterized. Given that the response to novelty is the basis of the definition of sensation-seeking, individual differences in reactivity to novelty have been studied on behavioral and biological levels. Certain individuals labeled as high responders (HR) as opposed to low responders (LR) have been shown to be highly reactive when exposed to a novel environment. These groups were investigated for free-choice responses to novel environments differing in complexity and aversiveness, and to other kinds of reinforcement, i.e. food and a drug. The HR rats appeared to seek novelty, variety and emotional stimulation. Only HR individuals have been found to be predisposed to drug-taking: they develop amphetamine self-administration whereas LR individuals do not. They also exhibit a higher sensitivity to the reinforcing properties of food. On a biological level, compared to LR rats, HR animals have an enhanced level of dopaminergic activity in the nucleus accumbens both under basal conditions or following a tail-pinch stress. HR and LR rats differ in reactivity of the corticotropic axis: HR rats exposed to a novel environment have a prolonged secretion of corticosterone compared to LR rats. The association of novelty, drug and food seeking in the same individual suggests that these characteristics share common processes. Differences in dopaminergic activity between HR and LR rats are consistent with results implicating these dopaminergic neurons in response to novelty and in drug-taking behavior. Given that rats self-administer corticosterone and that HR rats are more sensitive to the reinforcing properties of corticosteroids, it could be speculated that HR rats seek novelty for the reinforcing action of corticosterone. These characteristics may be analogous to some for the features found in human high-sensation seekers and this animal model may be useful in determinating the biological basis of this human trait.

Animals↗
PubMed2003

An analysis of successful efforts to reduce the use of seclusion and restraint at a public psychiatric hospital.

OBJECTIVE: The author reviews and evaluates a variety of interventions that were considered to have contributed to the successful reduction of reliance on the use of seclusion and restraint in a public psychiatric hospital for adult patients with severe and persistent psychiatric impairments. METHODS: A multiple regression analysis was applied to monthly seclusion and restraint data covering the period from 1997 to 2002. The independent variables were each of the component efforts to reduce reliance on seclusion and restraint at the hospital: changes in the criteria for administrative review of incidents of seclusion and restraint, changes in the composition of the case review committee, development of a behavioral consultation team, enhancement of standards for behavioral assessments and plans, and improvements in the staff-patient ratio. RESULTS: The use of seclusion and restraint was 75 percent lower during the final year of the five-year study period than it was during the first year. The only variable that was significantly associated with reduction in the use of seclusion and restraint was changes in the process for identifying critical cases and initiating a clinical and administrative case review. CONCLUSION: The results of this analysis underscore the importance of clinical and administrative priorities in efforts to reduce the use of seclusion and restraint in public psychiatric hospitals.

Behavioral Medicine↗
PubMed1992

A national survey on the use of seclusion in the psychiatric treatment of children.

Officials in 36 states responded to a survey of state policies, procedures, and regulations for the use of seclusion in the psychiatric treatment of children. Thirty-five of the states permit its use in emergencies, and 18 allow its use as part of a therapeutic treatment program. Only six states responding have regulations specifically addressing the use of seclusion with children. The authors summarize state regulations, including duration and frequency of seclusion episodes; orders required to implement seclusion and who may authorize it; rules about observation, documentation, and termination of episodes and breaks during episodes; design of seclusion rooms; and staff training. The authors present a model policy and procedure statement based on clinical and developmental considerations.

Child↗
PubMed1989

Disciplining handicapped students: legal issues in light of Honig v. Doe.

Court decisions interpreting the effect of the education for All Handicapped children Act on traditional forms of public school discipline have raised many question. This article reviews these decisions and confirms that most forms of minor disciplinary remedies remain available to educators so long as they are also used with nonhandicapped students. However, many legal problems arise with expulsion and long-term, or indefinite, suspensions of handicapped students, especially in the light of the recent Supreme court ruling regarding the expulsion of handicapped students.

Child Behavior Disorders↗
PubMed2003

Adult sexual offenders:current issues and future directions.

Sex offender research is still in its infancy, but our knowledge about adult sex offenders has increased in the last several decades. However, public interest in the issues of assessment, treatment, and recidivism with respect to risk and safety has increased substantially during this time. This article provides an introduction to the significant issues involved in the assessment, treatment, and current state-of-the-science for adult sex offenders. Prevalence rates are discussed, but these are more difficult to narrow down due to definitional problems. In addition, controversial issues involving diagnoses, classification, public notification, and risk assessment are introduced, and the goals of this volume are described. The purpose of this volume is to provide current information regarding what is known about sex offenders so that appropriate assessment, treatment, and prevention techniques can be developed and utilized.

Adult↗
PubMed1980

Industrial safety hazard reduction through performance feedback.

A "feedback package" system, designed to prevent occupational accidents and to fit directly into the normal operations of an industrial organization, was analyzed. Eighteen hazardous conditions in six production departments were assessed during seven observation sessions over a 12-week period, plus four follow-up observations over 4 months. The "feedback package" was presented in multiple baseline fashion, across subjects (department supervisors). It consisted of presenting the supervisor with copies of observational data, accompanied by a note which congratulated good practices and suggested ways for improving safety conditions, along with occasional comments from a senior executive. The results indicated that during the feedback phase, hazard rates were lower and less variable than during the baseline phase. Baseline data were highly variable with peaks ranging from 20 to 55 hazards per department. Following intervention, hazard frequencies dropped by 60%, averaged across departments, with decreases ranging from 29% to 88%. During treatment, data stabilized, with the highest frequency reaching 33. A modified feedback system was implemented by the organization following termination of the study, validating the assumption that such a system would tend to maintain.

Accidents, Occupational↗
PubMed1993

Weapon carrying among inner-city junior high school students: defensive behavior vs aggressive delinquency.

OBJECTIVES: The purpose of this study was to estimate associations between beliefs and experiences hypothesized to be related to weapon carrying among youths. METHODS: Students in two inner-city junior high schools completed anonymous questionnaires. Logistic regression models were fit for having ever carried a weapon for protection or use in a fight and were stratified by sex and weapon type. RESULTS: Among males, 47% had carried knives and 25% had carried guns. Key risk factors for knife carrying were being threatened with a knife, getting into fights, and disbelief that having a weapon increases the carrier's risk of injury. Gun carrying was associated with having been arrested, knowing more victims of violence, starting fights, and being willing to justify shooting someone. Among females, 37% had carried a knife; knowing many victims of violence and being willing to justify shooting someone predicted knife carrying. CONCLUSIONS: Knife carrying was associated with aggressiveness but did not appear to be related to serious delinquency. Gun carrying within this nonrandom sample appeared to be a component of highly aggressive delinquency rather than a purely defensive behavior.

Adolescent↗