Restraint Procedure Research Articles

Adrenocortical response to mating, social interaction and restraint in the female Japanese quail

In some species, the act of mating may be the only occasion when a female judges the male and the course of the sexual encounter might influence forms of maternal investment that are mediated by hormonal pathways. Despite the growing interest in fitness consequences of acute adrenocortical responses, it has not been determined to what extent the act of mating provokes such responses in females. We used female Japanese quail (Coturnix japonica) to determine to what extent any increase in corticosterone (CORT) is specific to actually mating with a male compared to visual and auditory contact with a male, and compared to social interaction with a female. We also asked if greater mating experience decreases the CORT response. We assessed how body condition of the individuals and their behavior during testing contributed to the variation in CORT response. As an additional reference for CORT increase we used a restraint procedure which resulted in the highest CORT. Our results show that females mating with a male have plasma CORT concentrations significantly increased from the baseline, which is not the case in females interacting with a male without the possibility of mating. Greater previous mating experience does not affect the CORT change caused by sexual interaction. Interestingly, social interaction with a female elicited a similar CORT response as mating with a male, which suggests that the effect on CORT was due to direct social interactions per se and not specific to the act of mating. Behavior during social and sexual interactions did not predict the CORT response, but larger females exhibited lower baseline and response CORT concentrations. We suggest that the lesser adrenocortical response of larger females might be related to their better control of the course of mating and might help them to adjust their reproductive investment, as reported in earlier studies.

Effects of prenatal cocaine exposure on infant reactivity and regulation

The purpose of this study was to examine the role of prenatal cocaine exposure and associated risk factors on infant reactivity and regulation at 7 months of infant age. Participants consisted of 167 mother–infant dyads participating in an ongoing longitudinal study of prenatal cocaine exposure, who completed the arm restraint procedure at the 7-month assessment (87 cocaine exposed, 80 non-cocaine exposed). We hypothesized that cocaine exposed infants would display higher arousal or reactivity and lower regulation during a procedure designed to arouse anger/frustration. Results indicated that cocaine exposed infants were more reactive to increases in the level of stress from trial 1 to trial 2 but exhibited no change in the number of regulatory strategies as stress increased, unlike the control group infants. Infant birth weight moderated the association between cocaine exposure and infant regulation. Among cocaine exposed infants, those with lower birth weight displayed higher reactivity compared to those with higher birth weight. Contrary to expectations, there were no indirect effects between cocaine exposure and infant reactivity/regulation via environmental risk, parenting, or birth weight. Results are supportive of a teratological model of prenatal cocaine exposure for infant reactivity/regulation in infancy.

Therapeutic effects of a restraint procedure on posttraumatic place learning in fimbria-fornix transected rats

Restraint procedures have been shown to influence the neural processes in the brain (dendritic changes or changes in the expression of neurotrophines, etc.) as well as to alter the behavioural performance. While many report deleterious effects of this procedure in normal animals, there are also indications of positive effects in the context of brain injury. In order to address the issue from the perspective of functional posttraumatic recovery, we studied 6 experimental groups of rats—3 groups undergoing a fimbria-fornix transection, and 3 groups remaining neurally intact. Within the lesioned and intact groups, respectively, one group of animals was subjected to an 8-day long restraint procedure (2 h daily) that ended immediately prior to the infliction of trauma; another group was subjected to the same procedure starting immediately after the infliction of trauma; and one group was not subjected to the restraint procedure at all. After a brief period of postoperative pause, the animals were tested on their acquisition of an 8-arm radial maze based place learning task and the effects of the restraint procedure on the task acquisition were evaluated. The results show that within the neurally intact groups, the administration of this procedure had no effect at all. However, the lesioned groups that were subjected to the restraint procedure showed significantly improved acquisition of the studied task compared to the lesioned animals that did not undergo the restraint procedure. The improved task performance suggests a therapeutic effect of this manipulation on the functional recovery after a mechanical trauma.

Infants’ responses to arm restraint at 2 and 6 months: A longitudinal study

This study examined the continuity, stability, and change of infants’ responses to a frustrating event (i.e., arm restraint) between 2 and 6 months in terms of both negative reactivity and its regulation. Fifty-two healthy, full-term infants and their mothers participated in an arm restraint procedure. Infant behaviors were observed and coded at 3-s intervals. The results showed that infants’ reactivity to frustration and their ability to regulate such reactivity significantly changed in level over time. Individual differences in frustration reactivity were stable across the two ages; two regulatory behaviors (i.e., orientation to mother and avoidance) could be observed in the same percentage of babies at both 2 and 6 months. At 6 months, several significant associations between frustration reactivity and infant regulatory behaviors emerged. These findings suggest that the arm restraint procedure may be usefully employed to study individual differences in infants as young as 2 months of age.

Analysis of the cold-water restraint procedure in gastric ulceration and body temperature

Analysis of the cold-water restraint procedure in gastric ulceration and body temperature

Analysis of the cold-water restraint procedure in gastric ulceration and body temperature

Gastric mucosal injury induced by body restraint can be enhanced when combined with cold-water immersion. Based on this fact, the present study had two main purposes: (i) to examine the contribution of each of these two forms of stress on the development of gastric ulceration and regulation of body temperature and (ii) to investigate the importance of the animal's consciousness on gastric ulceration induced by the cold-water restraint. Independent groups of animals were exposed for 3 h to one of the following stressful treatments: body restraint plus cold-water (20+1 °C) immersion, body restraint alone or cold-water immersion alone. Control animals were not exposed to any form of stress. Half of the animals submitted to each of the four treatments were anesthetized with thionembutal (35 mg/kg), whereas the other half was injected with saline. Results indicated that body restraint alone was not sufficient to induce gastric ulceration or changes in body temperature. On the other hand, cold-water exposure, either alone or in conjunction with body restraint, induced the same amount of stomach erosions and hypothermia. Therefore, it appears that body restraint does not play an important role on gastric ulceration induced by the cold-water restraint procedure. Present results also indicated that conscious and anesthetized animals immersed in cold water presented robust gastric ulceration and a marked drop in body temperature. However, conscious animals developed more severe gastric damage in comparison to anesthetized animals although both groups presented the same degree of hypothermia. These findings suggest that hypothermia resulting from cold-water exposure has a deleterious effect on gastric ulceration but the animal's conscious activity during the cold-water immersion increases the severity of gastric mucosal damage. It is concluded that cold-water restraint is a useful procedure for the study of the underlying mechanisms involved in stress-induced ulceration.

Restraint stress affects hippocampal cell proliferation differently in rats and mice

Granule cell neurogenesis occurs in the dentate gyrus of the mammalian hippocampus throughout adult life, and incorporation of bromodeoxyuridine (BrdU) into DNA can serve as a marker of cell division associated with such neurogenesis. We examined the effects of a stressor (3 h of restraint) on hippocampal cell proliferation in Sprague–Dawley rats and C57BL/6J mice. Animals were killed immediately following restraint stress and their brains were prepared for immunohistochemical studies. Restraint stress caused similar significant increases in c-Fos immunoreactivity among cells in the hypothalamic paraventricular nucleus of both species, indicating that the stress experienced was similar. The restraint procedure also caused a significant decrease in BrdU labeling in the dentate gyrus of rats, as previously reported, but a significant increase in the same region in mice. Hippocampal cell proliferation appears to respond differently to restraint stress in these species.

Behavioral and physiological adaptation to repeated chair restraint in rhesus macaques

Physical restraint is a commonly used procedure when working closely with nonhuman primates. Nonhuman primates show rapid behavioral changes when learning the restraint procedure, and these changes have been taken to reflect behavioral and physiological habituation to the procedure. This study examined the behavioral and adrenocortical responses to repeated physical restraint in a large sample of adult male rhesus monkeys. Subjects showed a decline in behavioral agitation and cortisol concentrations across seven consecutive days of restraint. The changes in adrenocortical responsiveness were also coincident with an increased sensitivity to dexamethasone and a change in early morning basal cortisol secretion. The subjects were restrained for a single session 6 months later, and while the reduction in behavioral agitation was still present, the majority of changes in adrenocortical responsiveness were no longer present. These data show that behavior is not necessarily an indicator of underlying physiological processes and that the reduction of hypothalamic–pituitary–adrenal (HPA) activity with repeated restraint is due to physiological adaptation to high glucocorticoid concentrations and not to psychological habituation to the restraint procedures.

Restraint procedures and dementia sufferers with psychological trauma.

Restraint is an extreme response to an emergency situation in which there is imminent harm to self or others. Although some restrained patients become calm, others may become even more behaviorally disorganized. In some of these latter cases, the restrained patients may be victims of violence for whom the restraint procedure acts as a symbolic reminder of the past victimization. Elderly dementia sufferers may also be among these victims of violence. This paper provides a brief review of psychological trauma, research findings on psychological trauma in the elderly, and an approach to modifying restraint procedures that may be needed for dementia sufferers with a past history of victimization to minimize the disquiet associated with the needed restraint.

Contribution of sex and genetics to neuroendocrine adaptation to stress in mice.

Male and female C57BL/6 (B6) and DBA/2 (D2) mice were subjected to either acute or 5 days of repeated restraint in ventilated, 50 ml centrifuge tubes. Control animals were not disturbed. The acute restraint animals were killed immediately following 15, 30 or 60 min of restraint and blood collected for corticosterone (CORT) analysis. The results of the acute restraint procedure revealed a strain difference in time to peak CORT in plasma with D2 animals showing an earlier peak. The males of both strains evinced similar maximum response and similar to B6 females; however, the D2 females showed a 2-fold greater CORT response than did the B6 females. Repeated restraint consisted of 5 days of 12 h in the tubes. At the end of 5 days, the animals were weighted and adrenalectomized in preparation for determination of brain corticosteroid receptors. Upon sacrifice, brains, thymus, adrenals and blood were harvested, the last for corticosteroid binding globulin (CBG). Five days of repeated restraint produced body weight loss in both strains, with B6s less affected than D2s. Repeated restraint reduced the mass of the adrenals in the B6s only. Restraint also reduced the mass of the thymus in both strains and sexes, but to a greater extent in the B6s. Plasma CBG densities were also sensitive to restraint, but only in females, showing a restraint-related decrease. Repeated restraint had no effect on hippocampal glucocorticoid or mineralocorticoid receptors; however for the latter, we observed significant strain and sex effects with D2 having higher Bmax than B6 and females having higher Bmax than males. In the pituitary, glucocorticoid receptors (GR) were reduced by repeated restraint in males, but increased in females, especially in the B6. These findings lend preliminary evidence for involvement of sex and genetics as sources of individual differences in bioadaptation to stress.

Developmental factors modify stress ulcer incidence in a stress-susceptible rat strain

Our multifactor theory of stress ulcer assumes that environmental factors that operate during early growth stages influence the elaboration of stress ulcer in adult rats. The theory would predict that rats exposed to either neonatal handling, or raised in a stimulus enriched environment, would reveal differences in stress ulcer susceptibility. In study 1, some Wistar rats and ulcer-susceptible Wistar Kyoto (WKY) rats were handled daily from birth to day 21, whereas other rats from each strain were not disturbed. In study 2, Wistar and WKY rats were raised (3 months) in a large stimulus-dense enriched environment, whereas other rats from each strain were raised in standard rat cages where visual and auditory stimuli were minimized. At 3 months all rats were observed in the open field test (OFT), a test of emotionality, as well as the Porsolt forced swim test (FST), a test of behavioral depression, and subsequently exposed to the ulcerogenic water restraint procedure. Neonatal handling produced results suggesting increased wall climbing activity in the FST, reduced response latency in the OFT, increased body weight and reduced ulcer severity, but these differences were not significant. Rearing in an enriched environment produced similar results but these difference were more pronounced and significant in the Wistar rats as compared to the WKY rats. Thus early environmental manipulations can influence adult behavior and the elaboration of stress ulcer disease, but the impact of these manipulations is less salient in an organism with an endogenous susceptibility to the disease.

Reducing restraint use in the acute care setting.

A Massachusetts hospital with a significant geriatric population initiated a pilot program to reduce use of restraints on an inpatient medical-surgical unit. A task force developed and implemented a successful program that included identification of alternatives to restraint use, policy and procedure development, staff education and evaluation.

Stimulation of the lateral septum attenuates immobilization-induced stress ulcers

Rats with electrodes implanted in their dorsolateral septal area underwent a cold-immobilization restraint procedure during which the experimental group received electrical stimulation while the control group did not. Electrical stimulation of the dorsolateral septal region clearly reduced the number of gastric ulcers formed during the cold-immobilization stress procedure. The pattern of results with septal stimulation contrasts with that seen by other investigators after stimulation of the central amygdaloid nucleus. The mitigation of stress-induced ulceration after lateral septal stimulation is consistent with the proposed function for the lateral septal area in relief from aversive emotional states.

Physical restraint procedures for managing challenging behaviours presented by mentally retarded adults and children

This paper reviews the published research literature on the use of physical restraint with mentally retarded adults and children. Research on three types of restraint is included. One type involves one or more person(s) holding another. A second method is where a mechanical device is fitted to limit movement or reduce injury. The third type is where the person voluntarily applies a personal or mechanical restraint. The following conclusions emerged: (a) there are numerous processes which contribute to the outcomes associated with restraint, and these are poorly understood; (b) different processes mediate the outcomes for contingent and noncontingent restraint; (c) both noncontingent and contingent restraint can result in long-term reductions in target behaviours, especially when fading procedures are employed (noncontingent restraint) and where staff or carers are involved in the treatment plan (contingent restraint); (d) self-restraint seems to be maintained by the reinforcing effects of the restraint procedure or by escape from the aversive consequences of self-injury; (e) there are (negative) reinforcing consequences for staff who use restraint procedures in service settings; (f) and both staff and clients risk injury, especially from emergency or unplanned restraint.

The regulation of negative reactivity in infancy: Function and development.

This study examined the function and effectiveness of certain behaviors in regulating negative arousal in 5- and 10-month-old infants. Infants participated in an arm restraint procedure at 5 months (N=87) and a toy removal task at 10 months (N=82). Negative reactivity and regulatory behaviors ― avoidance, orienting, self-comforting, and communicative behaviors (10-month only) ― were coded and sectioned into 10-s epochs. Results showed that self-comforting behaviors were preferred at both 5 and 10 months of age. A comparison of changes in negative reactivity across every 2 consecutive 10-s epochs (decreasers vs. increasers vs. no change) revealed self-conforting behaviors to be exhibited most often during periods of decreasing negative arousal. Orienting behaviors also appeared to serve a regulatory function but in a more limited way. Finally, under these circumstances, avoidance and communicative behaviors were exhibited most often during increasing distress

Differential effect of restraint procedure on incidence of restraint-stress-induced rib fusion in CD-1 mice

In an investigation of the effects of specific maternal Stressors on development of the conceptus, pregnant mice were exposed to restraint stress on gestation day 9 (plug = day 1). Mated females were either unrestrained (C), unrestrained and food/water deprived (FWD), or restrained with surgical tape in a supine position for 12 h by one of two methods: I. 1-inch wide tape reaching from each shoulder across the body to the opposite thigh, or II. 1-inch wide tape placed over one shoulder, across the thorax, and over the opposite shoulder and similar tape placed over each thigh and across the intervening pelvic area. For both methods, an additional tape was placed across the tail and a 2-inch wide tape secured the upper abdominal area. There were 32 to 62 litters in each treatment group, and all fetuses were examined on day 18 for gross and skeletal defects. With regard to rib fusion, the percentage of affected fetuses and litters was increased ( P ≤ 0.05) by Method I (3.5% and 27%, respectively) vs. Method II. (0.5% and 4%), C (0.1% and 1%), or FWD (0%). Incidences of supernumerary ribs, however, did not differ between the restrained groups but were higher in both such groups than in the FWD and C groups. These results suggest that different methods of restraint may result in differences in incidence of rib fusion. Such data suggest that development of the offspring of stressed dams may be significantly influenced by what might appear to be minor differences in the stress techniques used.

Patient and family perceptions of restraints.

Based on a holistic philosophy that aging persons' most primary need is that of autonomy and freedom, this qualitative descriptive study examined patients' and their family members' perceptions of the restraint procedure. Twenty-five restrained patients were interviewed, and 19 of their family members completed mailed surveys to describe their perceptions about restraints. Results indicated that the majority of patients (52%) expressed negative feelings about being restrained. Family members expressed a wide variety of feelings and were ambivalent about seeing a loved one restrained. Implications are that nursing needs to become committed to the philosophy of autonomy and freedom for elderly persons.

Effects of housing, restraint and chronic treatments with mCPP and sertraline on behavioural responses to mCPP.

The effects of pretreatments on behavioural responses to activation of 5-HT1C receptors by m-chlorophenylpiperazine (mCPP) were investigated. The hypo locomotor and anxiogenic effects of mCPP (social interaction test) were influenced neither by previous housing (single versus grouped) nor by restraint (2 h, 24 h previously). In the absence of mCPP, 24 h group housing led to decreased social interaction and the restraint procedure led to significant decreases of feeding and locomotion. The hypophagic effect of mCPP was unaffected by previous restraint. However, chronic pretreatment with mCPP (2.5 mg/kg per day IP x 14) or with the antidepressant 5-HT reuptake inhibitor sertraline (5 mg/kg per day SC x 14) attenuated all three behaviours. The above findings are discussed with respect to published data on effects of pretreatments on responses to the activation of 5-HT1C receptors.

The Relations among Infant Temperament, Security of Attachment, and Behavioral Inhibition at Twenty-Four Months

The purpose of this study was to examine the relations among infant temperament, attachment, and behavioral inhibition. 52 infants were seen at 2 days, 5, 14, and 24 months of age. Assessments were made of temperament at 2 days and 5 months of age, and attachment and behavioral inhibition were assessed at 14 and 24 months, respectively. EKG was recorded at each assessment, and measures of heart period and vagal tone were computed. Distress to pacifier withdrawal at 2 days of age was related to insecure attachment at 14 months. 2 types of distress reactivity at 5 months, reactivity to frustration and reactivity to novelty, were identified and related to high vagal tone. Attachment classification at 14 months was directly related to inhibited behavior at 24 months. Infants classified as insecure/resistant were more inhibited than those classified as insecure/avoidant. In addition, an interaction of infant reactivity to frustration and attachment classification was found to predict inhibition at 24 months. Infants classified as insecure/resistant and who had not cried to the arm restraint procedure at 5 months were the most inhibited at 24 months. These findings are discussed in terms of hypotheses regarding multiple modes of distress reactivity and regulation in early infancy and their different social and behavioral outcomes.

Japanese and American infants' responses to arm restraint.

Five- and 12-month-old Japanese and American infants participated in a nonpainful arm restraint procedure. Facial responses were scored with an anatomically based coding system (Baby FACS, an adaptation for infants of Ekman and Friesen's, 1978, Facial Action Coding System, or FACS). Nonfacial body activity (struggling) and negative vocalizations also were scored