Factors Predictive of Behavioural and Emotional Dysfunction in Adolescents in a Secure Children’s Home

Harris, Richard; Stubbings, Daniel Robert; Claire, Karen De

doi:10.1007/s40653-020-00329-7

Cited by 5 publications

(3 citation statements)

References 24 publications

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“…[46,47] Social/Emotional Impairment This can range from mild social interaction issues to trauma-associated body disassociation. [48,49] Elevated risk of suicide This often co-occurs with major depressive disorder. [50,51] HPA axis dysregulation This recent review describes a neuroimmune regulation model for the resulting HPA hyperactivity.…”

Section: Conditions/attribute Details Referencesmentioning

confidence: 99%

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

Dietert

Dietert²

2022

Microorganisms

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Adverse childhood experiences (ACEs), which can include child trafficking, are known to program children for disrupted biological cycles, premature aging, microbiome dysbiosis, immune-inflammatory misregulation, and chronic disease multimorbidity. To date, the microbiome has not been a major focus of deprogramming efforts despite its emerging role in every aspect of ACE-related dysbiosis and dysfunction. This article examines: (1) the utility of incorporating microorganism-based, anti-aging approaches to combat ACE-programmed chronic diseases (also known as noncommunicable diseases and conditions, NCDs) and (2) microbiome regulation of core systems biology cycles that affect NCD comorbid risk. In this review, microbiota influence over three key cyclic rhythms (circadian cycles, the sleep cycle, and the lifespan/longevity cycle) as well as tissue inflammation and oxidative stress are discussed as an opportunity to deprogram ACE-driven chronic disorders. Microbiota, particularly those in the gut, have been shown to affect host–microbe interactions regulating the circadian clock, sleep quality, as well as immune function/senescence, and regulation of tissue inflammation. The microimmunosome is one of several systems biology targets of gut microbiota regulation. Furthermore, correcting misregulated inflammation and increased oxidative stress is key to protecting telomere length and lifespan/longevity and extending what has become known as the healthspan. This review article concludes that to reverse the tragedy of ACE-programmed NCDs and premature aging, managing the human holobiont microbiome should become a routine part of healthcare and preventative medicine across the life course.

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Section: Conditions/attribute Details Referencesmentioning

confidence: 99%

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

Dietert

Dietert²

2022

Microorganisms

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“…Developments within the framework include embedding psychologically informed formulation across secure settings with young people (Taylor et al , 2018). Children and young people within the children’s secure estate often have complex backgrounds with histories of trauma, as well as forensic needs (Harris et al , 2020).…”

Section: Secure Stairs Frameworkmentioning

confidence: 99%

The SECURE STAIRS framework: preliminary evaluation of formulation developments in the Children and Young People’s Secure Estate

McKeown

Martin²,

Farooq³

et al. 2022

MHRJ

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Purpose The purpose of this paper is to evaluate pre- and post-formulation findings with multi-disciplinary staff within two secure children’s homes (SCHs) in the North East of England. Design/methodology/approach Multi-disciplinary staff teams involved in formulation across two SCHs were administered pre- and post-formulation questionnaires. The pre- and post-formulation questionnaires focused on five domains: knowledge; confidence; motivation; understanding; and satisfaction with treatment plan. Findings A total of 338 pre- and post-formulation questionnaires were administered across 43 formulation meetings. The highest proportion of formulation attendees were: residential staff (44%); mental health staff (17%); case managers (12%); and education staff (9%). Paired samples t-tests showed significant post-formulation improvements across all domains including: knowledge [t(337) = 22.65, p < 0.001]; confidence [t(337) = 15.12, p < 0.001]; motivation [t(337) = 8.27, p < 0.001]; understanding [t(337) = 19.13, p < 0.001]; and satisfaction [t(337) = 18.81, p < 0.001]. Research limitations/implications The SECURE STAIRS framework has supported formulation developments across the Children and Young People’s Secure Estate. Preliminary findings within two SCHs suggest multi-disciplinary staff teams find psychologically informed formulation beneficial. Future directions are considered including future evaluation of young person involvement in formulation meetings. Originality/value There is a notable lack of existing research within the child and young people secure estate evaluating the impact of SECURE STAIRS trauma-informed care developments including the impact of team formulation. This paper adds to the evidence base.

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“…Especially vulnerable are the individuals within Secure Children’s Homes (SCHs), who often have experienced more complex trauma than the general population, and on average over four adverse childhood experiences by the time they are referred to a SCH (Harris et al , 2020; Martin et al , 2021). These young people may also present with multiple and complex needs, insecure attachment styles and risk-taking behaviour (Chitsabesan et al , 2006; Finzi et al , 2000; Kroll et al , 2002).…”

Section: Introductionmentioning

confidence: 99%

Reduction in incidents during COVID-19 in a Secure Children’s Home: an opportunity for learning

McKeown

MacMillan

Watkins

et al. 2022

JACPR

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Purpose The COVID-19 pandemic is unprecedented for young people within the UK. The pandemic has presented particular challenges for vulnerable children and young people. For example, a recent study in the UK indicated that 83% of young people with existing mental health conditions said the pandemic had made their condition worse (Young Minds, 2020). To date, the impact upon populations such as young people in Secure Children’s Homes (SCHs) is unknown. This study aims to elucidate this area. Design/methodology/approach SCHs provide a safe, supportive environment for vulnerable young people who frequently present with multiple and complex needs. Young people residing within a SCH may be residing at the setting because of a Secure Accommodation Order under a Section 25 Order of the Children’s Act (1989) or for criminal justice reasons, i.e. serving a Remand period or custodial sentence. Preliminary research compared a baseline period to a follow-up period after the commencement of COVID-19 national lockdown measures within a SCH in the North of England to develop understanding of the impact for young people. Findings A significant decrease in overall incidents (t (5) = −6.88, p < 0.001), restraints (t (5) = −9.07, p < 0.001) and other incidents including assaults occurred during follow-up. The SECURE STAIRS framework supports trauma-informed care and enhances support within the setting. Consistent with the framework, provision of formulation meetings was significantly increased within the follow-up period (Welsh’s t (74) = −2.74, p < 0.001). Reflections and future recommendations are outlined. Originality/value The unanticipated results highlight the value of examining incident data within secure environments and could lead to effective practice changes for practitioners working within this domain. This research also demonstrates how frameworks such as SECURE STAIRS can be beneficial for vulnerable young people during periods of change and stress in mitigating some of the potential negative effects. The implementation of such frameworks within SCHs is still novel and thus evaluative research is valuable.

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Factors Predictive of Behavioural and Emotional Dysfunction in Adolescents in a Secure Children’s Home

Cited by 5 publications

References 24 publications

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

Using Microbiome-Based Approaches to Deprogram Chronic Disorders and Extend the Healthspan following Adverse Childhood Experiences

The SECURE STAIRS framework: preliminary evaluation of formulation developments in the Children and Young People’s Secure Estate

Reduction in incidents during COVID-19 in a Secure Children’s Home: an opportunity for learning

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