EXCITATION Study: Unexplained In-Custody Deaths: Evaluating Biomarkers of Stress and Agitation

This award was competitively made in response to a proposal submitted by the University of California, San Diego Medical Center to an NIJ FY2012 solicitation "Determining the Relationship Between Stress and Unexplained In-Custody Deaths." This project is part of a larger NIJ-funded research effort looking into the potential for the physiologic and metabolic effects of stress to be a cause for otherwise unexplained in-custody deaths. This research effort seeks to: (1) clarify the fatal mechanisms that might be associated with stress resulting from being subdued or restrained, by any means and not limited to CEDs; and, if such mechanisms can be demonstrated, (2) identify post-mortem markers that can inform death investigations. This particular project examines the question of whether one type of unexplained in-custody death that has been termed excited delirium because of its manifestation as manic behavior on the part of the detainee is in fact a severe stress reaction. It will do so by examining a panel of seven stress-related biomarkers to determine if these biomarkers are associated with excited delirium. The proposed research will utilize four study populations. Comparison of physiologic and biomarker results across cohorts will permit 1) hypothesis testing of the role of stress in excited delirium and 2) demonstrate the sensitivity and specificity of the biomarker panel for identifying abnormal stress mediators in excited delirium. ca/ncf