Predictors of the Use of Seclusion on an Inpatient Child Psychiatric Unit

Abstract

Characteristics of 102 children admitted to a child psychiatry unit were analyzed to determine predictability of seclusion use. A subgroup of 36 children was rated using the Zeitlin Coping Inventory. Results showed that frequently secluded children were significantly more likely to have a history of physical abuse, neurological impairment, relatively weaker verbal ability, assaultive behavior, and a suicide attempt in the 6 months prior to admission. They shared a profile of coping behavior, such as more need for environment structure, less ability to successfully meet needs, and more activity and rigidity in their unsuccessful attempts. Three items on the Coping Inventory related to frustration tolerance, response to external controls, and knowledge of what is expected in situations were highly predictive of seclusion use. Results suggest that seclusion may meet specific needs for children and may not always be an indicator of inadequate institutional policies and programs. © 1990, The American Academy of Child and Adolescent Psychiatry. All rights reserved.