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Biomedical subjects

Nancy Rappaport

Publications and source records attributed to Nancy Rappaport.

14 recordsLinked to original sources
PubMed2006

Beyond psychopathology: assessing seriously disruptive students in school settings.

OBJECTIVE: To obtain a demographic profile of aggressive students in an urban setting and discern psychiatric diagnoses, functional impairment, and psychosocial stressors. STUDY DESIGN: Participants were 33 students in an urban public school district referred for comprehensive psychiatric evaluation by school staff because they were viewed as a threat to school safety. Evaluations included a review of records, interviews with school and mental health professionals, and student and parent interviews. RESULTS: Students were characterized by severe and untreated or undertreated psychopathology together with high levels of psychosocial stressors and learning disorders. Thirty-two students received at least one Axis I diagnosis, and the mean number of diagnoses for each student was 3; 33% had substance abuse problems, and 30% had nonpsychiatric medical conditions. CONCLUSIONS: The sample is a chronically impaired group of students confronting serious adversity in their daily lives, whose psychosocial and psychiatric needs are not met by current educational and mental health programming. Necessary interventions include prevention and early identification, substance abuse and family treatment, and appropriate psychopharmacological treatment. A comprehensive psychiatric assessment can help change the outcomes for this group of aggressive students.

Achievement↗
PubMed2006

An overview of juveniles and school violence.

Despite the relative rarity of school shootings, targeted violence, and school-associated violent deaths, any youth who presents with words, gestures, or actions of a threatening or violent nature in a school setting should be assessed and referred for further evaluation by a mental health professional and, if clinically indicated, a forensic evaluator.The request for a juvenile risk assessment for future dangerousness requires careful delineation of role and agency; confidentiality issues; a comprehensive diagnostic evaluation of the youth; and a detailed assessment of the youth's perceived threat or problematic behavior. Various protective and risk factors and consideration of other individual, family, school/peer, and situational factors should also be explored.There is still much information that is unknown when considering school violence or targeted school violence. There is clearly a need for additional research on the identification of at-risk youths, the contributions and significance of various protective and risk factors, the impact of peer relationships, and perceived rejection, socioeconomic status, subtypes of aggression, and developmental stages. Examples of future research direction might include difference by gender, presence of affective or psychotic disorders, substance abuse, emerging characterologic disturbances, and physiologic markers, such as cortisol or serotonin. Additional research regarding best practices and the development of clinical guidelines or practice parameters is also needed.

Adolescent↗
PubMed2006

Developmental differences in risk factors for suicide attempts between ninth and eleventh graders.

In order to identify differences in risk factors for suicide attempts throughout adolescence, this study utilized a school-based survey of ninth (n = 1,192) and eleventh graders (N = 1,055). Suicide attempts were associated with cigarette and alcohol use, family violence, and depression for ninth graders and with illicit drug use, school violence, and sexual abuse for eleventh graders, while having friends was protective for both groups. Additionally, having more than one risk factor imparted an exponential risk for suicide attempts (ninth > eleventh graders). The differences detected are consistent with developmental changes of adolescence and represent important information for identification of at-risk youth.

Adolescent↗
PubMed2006

Developing systems interventions in a school setting: an application of community-based participatory research for mental health.

OBJECTIVES: The goal of this study was to develop systems interventions in a public school district using community-based participatory research (CBPR) methods to improve the social and academic functioning of children from racial and ethnic minority populations. DESIGN: The study used qualitative methods in the process of problem definition and intervention planning, including in-depth qualitative interviews and stakeholder dialogue groups. The study was conducted at three levels--the school system as a whole, two individual schools, and a multiple-stakeholder participatory group. SETTING: The study took place in a public school system in an urban city with a population of 101,355 and in two public schools located in this city. PARTICIPANTS: The CBPR team included two researchers, a researcher/consulting psychiatrist in the schools, the director of the special education office, her management team, four teachers, and two school-based administrators. INTERVENTIONS: The CBPR group engaged in a process of problem definition and intervention planning at all three levels of the system. In addition, both schools initiated systems interventions to target the needs of their school environments. RESULTS: The project led to system interventions at both schools, clarity about the policy constraints to effective collaboration, and increased awareness regarding the behavioral and academic needs of minority children in the schools. The process produced a series of questions to use as a framework in CBPR partnership development. CONCLUSIONS: The CBPR approach can expand the scope of mental-health services research, particularly related to services for racial and ethnic minorities.

Adolescent↗
PubMed2005

Case study: the internet as a developmental tool in an adolescent boy with psychosis.

The Internet has become an increasingly important part of teen culture; however, there still remains little in the medical/psychiatric literature pertaining to the impact of the Internet on adolescent development. Despite the potential problems associated with communication online, the Internet offers a variety of positive opportunities for teens. In this report, we present a case study that illustrates the Internet as a helpful tool in a 15-year-old adolescent boy with a history of chronic neurological illness accompanied by refractory psychosis. Although the case emphasizes some of the ways in which the Internet may have a positive impact on adolescent development, further research is indicated to evaluate the contexts in which the Internet serves healthy developmental processes and those in which its influence is potentially deleterious.

Adolescent↗
PubMed2004

Recent research findings on aggressive and violent behavior in youth: implications for clinical assessment and intervention.

Assessing children and adolescents for potential violent behavior requires an organized approach that draws on clinical knowledge, a thorough diagnostic interview, and familiarity with relevant risk and protective factors. This article reviews empirical evidence on risk factors, the impact of peers, developmental pathways, physiological markers, subtyping of aggression, and differences in patterns of risk behaviors between sexes. We explore these determinants of violence in children and adolescents with attention to the underlying motivations and etiology of violence to delineate the complexity, unanswered questions, and clinical relevance of the current research. Interventions, including cognitive behavioral therapy, psychopharmacological treatment, and psychosocial treatment, are reviewed with acute recognition of the need to use multiple modalities with, and to expand research to define optimal treatment for, potentially violent children and adolescents. The information considered for this review focuses on violence as defined as physical aggression toward other individuals. Other studies are included with wider definitions of violence because of their relevance to assessing the potential for violent behavior.

Adolescent↗
PubMed2002

Can advising lead to meaningful relationships?

Schools have increasingly implemented advising programs as a means of linking students with caring adults. Although this approach is promising, its success depends on adequate funding; the full commitment of administration, staff, and parents; and a thoughtful definition of the procedures for achieving the goals.

Adolescent↗