Ambulatory physiological stress measurements prior to aggression incidents in residential youth care

Aggression incidents are common in residential youth care, and impede treatment progress and the possibility of evolving into an independent healthy individual. Aggression incidents can lead to feelings of anxiety and unsafety in others, and can have major physical and/or traumatic impact for everyone involved. Current methods to prevent incidents are based on observations of increasing tension by professionals or adolescents themselves, however, they both might have difficulties recognizing these signals. A complementary and promising alternative might be the measurement of physiological reactivity to observe the stress response or increasing tension in adolescents. The present study used a wearable wireless device to examine patterns of physiological reactivity prior to aggression incidents in residential youth care. A total of 19 adolescents in residential youth care participated, who were involved in 87 aggression incidents during study participation. Participants wore a wearable wireless device to measure physiological stress response parameters (peaks per minute (PPM) , skin conductance (SCL), heart rate (HR)) during three, preferably consecutive, weeks, in which aggression incidents were accurately registered. Longitudinal multilevel models showed that PPM rose preceding incidents, but we failed to replicate previous SCL and HR findings in relation to incidents, as there was no significant effect for time, although both slopes did rise preceding aggression incidents. In sum, this study supports the idea that wearable devices measuring physiological stress reactivity might help in the prevention of aggression incidents. There is, however, high within-subject variation, which suggests that future studies should examine more personalized feedback and interventions to take this within-subject variation into account. To date, only a few tools adjusted the interface to this young (clinical) population, and store the data locally on the users’ phone.