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Biomedical subjects

Beverley Raphael

Publications and source records attributed to Beverley Raphael.

14 recordsLinked to original sources
PubMed2005

Comorbidity: cannabis and complexity.

Cannabis is one of the most commonly used illicit drugs, and its effects have traditionally been seen as less harmful than outcomes associated with the highly prevalent use of alcohol and other illicit substances (e.g., cocaine and amphetamines), and injecting drugs. Consequently, less attention has been focused on developing and evaluating interventions in this area. However, current research supports the idea that cannabis does pose a number of acute and chronic health risks to the individual and to society. The authors review findings concerning the physiological and neurological effects of cannabis, prevalence of use, and studies concerning its possible role as a "gateway" drug. Diagnostic criteria for cannabis dependence and abuse are discussed, with a focus on whether a cannabis withdrawal syndrome exists and if so how it can be diagnosed. There is strong support for a link between cannabis and the development and exacerbation of psychosis and other mental health conditions (e.g., anxiety, depression). Further research is needed to determine the underlying neurochemical processes and their possible contribution to etiology, as well as the social factors that contribute to the increasing use of cannabis by young people. In addition there is a need for systematic evaluation using randomized controlled trials to determine effective prevention and treatment strategies. A number of public health programs that address cannabis use are reviewed along with available evidence for their effectiveness.

Adolescent↗
PubMed2004

Debriefing: its evolution and current status.

Debriefing, like trauma counseling, and even grief counseling, has been taken up as an instant solution. Some suggest it is a part of the trauma industry. It may be seen as something to hold onto in the face of disaster or other chaos, because it offers the security of a structure, some sense of control over what to do to help when one wishes to undo what has happened, help others and the self, to make meaning of a horrific or shocking experience. The need to pursue a way of responding suggests that those who would offer help fear being overwhelmed, or do not trust their normal compassionate, protecting, and comforting responses. It would be sad if these spontaneous, caring, and altruistic reactions that so bind human society in times of tragedy were devalued or put aside, for they, ultimately are the beginning of the healing process.

Adaptation, Psychological↗
PubMed2004

Changeability, confidence, common sense and corroboration: comprehensive suicide risk assessment.

OBJECTIVE: The authors, in collaboration with NSW Health, have recently developed a comprehensive suicide risk assessment framework. The present paper describes key concepts in the assessment of suicide risk by mental health professionals. METHODS: A framework for conducting a comprehensive suicide risk assessment was derived from the literature, incident analysis and clinical experience. The framework underwent a consultation process involving clinicians in NSW area mental health services. The aim was to provide clinicians with a standardized conceptual map for the assessment of suicide risk. A MEDLINE search was conducted for publications dealing with 'suicide' and 'suicide risk assessment' from 1980 to 2002. The recommendations from sentinel event reviews conducted in a NSW area mental health service in the period 1999-2002 were reviewed. The lessons from a visit to a coroner's relatives support group for people who had been bereaved by suicide also informed the development of the guidelines. RESULTS: A framework is proposed for the assessment of suicide risk. The framework promotes a reflective style of practice, encouraging clinicians to evaluate their assessment and its limitations. Risk assessment is always undertaken as part of a full clinical assessment and an evaluation of the person's current predicament and psychosocio-cultural context. The concepts of changeability, assessment confidence, common sense and the importance of corroboration are incorporated in the framework. CONCLUSIONS: Mental health clinicians can be guided by a framework in suicide risk assessment and documentation. The assessment of suicide risk can generate a suicide risk rating for which minimum standards of care can be mandated.

Clinical Competence↗
PubMed2002

Mental health of teenagers who use cannabis. Results of an Australian survey.

BACKGROUND: There is concern in the community about increasing cannabis use and its potential effect on health. AIMS: To ascertain the prevalence of cannabis use among Australian adolescents, associations with mental health problems, risk behaviours and service use. METHOD: Examination of data from a national representative sample of households comprising 1261 adolescents aged 13-17 years. Parents completed a psychiatric interview and questionnaires while adolescents completed questionnaires. RESULTS: One-quarter of the adolescents in the sample had used cannabis. There were no gender differences. Use increased rapidly with age, was more common in adolescents living with a sole parent and was associated with increased depression, conduct problems and health risk behaviours (smoking, drinking) but not with higher use of services. CONCLUSIONS: Cannabis use is very prevalent. The association with depression, conduct problems, excessive drinking and use of other drugs shows a malignant pattern of comorbidity that may lead to negative outcomes.

Adolescent↗
PubMedDate not supplied

Psychological impact of disasters and terrorism on children and adolescents: experiences from Australia.

Recent acts of terrorism have emphasised the need for research to further establish not only the nature of the impact of disaster and terrorism on the population, but also further define methods of effective intervention. Those affected, and often overlooked, include children and adolescents, yet, our knowledge of the impact upon the younger members of our community is limited. The literature is evolving, and there are a small number of valuable studies that can inform a response to the mental health needs of this younger population. This article reviews some of the psychological impacts of disaster and terrorism upon children and adolescents, and considers both risk and protective factors. The importance of a developmental approach to children's understanding of disaster, particularly death and the nature of grief and loss are discussed as is the distinction between the phenomenology of bereavement and trauma. Family and community support are highlighted as protective factors, and a number of recent, valuable recommendations for intervention including psychological first aid and cognitive-behavioral therapy are described. Finally, the complex role of the media and the degree that children should be exposed to images of violence and disaster is considered. Disasters, whether they are natural or human-made always will be with us. It is necessary that a public-health approach that not only prepares for such scenarios, but responds by maximising the use of existing systems and agency linkages, is taken.

Adaptation, Psychological↗