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Biomedical subjects

Rosemary Purcell

Publications and source records attributed to Rosemary Purcell.

10 recordsLinked to original sources
PubMed2006

Identifying risk factors in stalking: a review of current research.

Stalking is a behaviour which can cause substantial damage to its victims, whether the perpetrator is violent or not. Victims face a range of risks including not only assault, but persistent or recurrent stalking and varying degrees of psychological and social damage. The responsibility for assessing and managing these risks often falls to the mental health professional, yet the emerging stalking risk assessment literature is at too early a stage to provide clinicians with empirically derived evidence upon which to base their clinical practice. This paper reviews existing research to identify those factors currently believed to be associated with increased risk of physical and sexual assault; with persistent and/or recurrent stalking; and, with psychological and social damage.

Crime↗
PubMed2006

Effectiveness of complementary and self-help treatments for depression in children and adolescents.

OBJECTIVE: To review the evidence for the effectiveness of complementary and self-help treatments for depression in children and adolescents. DATA SOURCES: Systematic literature search using PubMed, PsycINFO and the Cochrane Library for 131 treatments up to February 2006. STUDY SELECTION: There were 13 treatments that had been evaluated in intervention studies. DATA EXTRACTION: Studies on each treatment were reviewed by one author and checked by a second. A consensus was reached for level of evidence. DATA SYNTHESIS: Relevant evidence was available for glutamine, S-adenosylmethionine, St John's wort, vitamin C, omega-3 fatty acids, light therapy, massage, art therapy, bibliotherapy, distraction techniques, exercise, relaxation therapy and sleep deprivation. However, the evidence was limited and generally of poor quality. The only treatment with reasonable supporting evidence was light therapy for winter depression. CONCLUSIONS: Given that antidepressant medication is not recommended as a first line treatment for children and adolescents with mild to moderate depression, and that the effects of psychological treatments are modest, there is a pressing need to extend the range of treatments available for this age group.

Adolescent↗
PubMed2006

Evaluating brain activity in obsessive-compulsive disorder: preliminary insights from a multivariate analysis.

Obsessive-compulsive disorder (OCD) has been linked to a dysfunction of brain corticostriatal networks, although functional imaging studies of OCD rarely apply network-sensitive analysis methods. In this study, we compared a univariate and a multivariate analysis of PET data in OCD patients and healthy subjects; the latter approach was considered more suitable for characterizing functional networks of brain activity. Although both methods suggested there was abnormal corticostriatal activity in OCD patients, the nature, extent and magnitude of this activity was clearly enhanced by the multivariate approach. Implications for the analysis of such studies are discussed.

Adult↗
PubMed2006

Assessing and managing the risks in the stalking situation.

Stalking is a common social problem, often driven by psychiatric disorder in its perpetrators and productive of psychological and social damage in its victims. Assessing and managing the risks in the stalking situation is a task that frequently falls on the mental health professional. The concerns of risks in the stalking situation are not confined to violence but include psychosocial damage, chronicity, and recurrence, and, for the stalker, arrest and incarceration. This article outlines a structured approach to assessment and management involving domains based on the relationship between stalker and victim, the type of motivation driving the stalking, the stalker's risk profile, the victim's risk profile, and finally, the legal and mental health context. The assessment is closely linked to management strategies to counter specific ascertained risks and future hazards. These strategies will be limited, or facilitated, according to the current legal and mental health contexts that have a critical impact on the stalking situation.

Crime↗
PubMed2005

The relationship between duration of untreated psychosis and outcome: an eight-year prospective study.

Longer duration of untreated psychosis (DUP) prior to the initiation of treatment has been found to predict poorer short-term clinical and functional outcomes in patients with first-episode psychosis (FEP). The extent to which the relationship between DUP and outcome is maintained in the medium-to-long term however remains unclear. We examined the influence of DUP on clinical and functional outcomes in a prospective, naturalistic study of 318 FEP patients followed up 8 years after initial treatment at a specialist early psychosis service. Quality of life, social and occupational functioning, positive and negative symptoms at 8 years were assessed using standardized instruments. Multiple linear regression analyses indicated that, after controlling for the effects of other factors, shorter DUP correlated moderately with decreased severity of positive symptoms, and enhanced social and occupational functioning and quality of life. There was no uniform point associated with medium-to-long term impairment, with some domains of outcome more sensitive to treatment delay than others. However a consistent finding was that outcomes for these domains were significantly worse when DUP exceeded 3 months. Among those with a schizophrenia-spectrum diagnosis, DUP exceeding 1 year was associated with poorer outcome. No association was found between DUP and negative symptoms in either diagnostic group. As with short-term prognosis, DUP appears to be an independent predictor of prognosis in the medium-to-long term. Results support the need for assertive early detection strategies to facilitate the timely delivery of effective intervention programs to those with emerging psychotic illness in order to reduce the risk of long term deleterious outcomes.

Adult↗
PubMed2005

Functional connectivity during Stroop task performance.

Using covariance-based multivariate analysis, we examined patterns of functional connectivity in rCBF on a practice-extended version of the Stroop color-word paradigm. Color-word congruent and incongruent conditions were presented in six AB trials to healthy subjects during 12 H2(15)O PET scans. Analyses identified two reproducible canonical eigenimages (CE) from the PET data, which were converted to a standard Z score scale after cross-validation resampling and correction for random subject effects. The first CE corresponded to practice-dependent changes in covarying rCBF that occurred over early task repetitions and correlated with improved behavioral performance. This included many regions previously implicated by PET and fMRI studies of this task, which we suggest may represent two "parallel" networks: (i) a cingulo-frontal system that was initially engaged in selecting and mapping a task-relevant response (color naming) when the attentional demands of the task were greatest; and (ii) a ventral visual processing stream whose concurrent decrease in activity represented the task-irrelevant inhibition of word reading. The second CE corresponded to a consistent paradigmatic effect of Stroop interference on covarying rCBF. Coactivations were located in dorsal and ventral prefrontal regions as well as frontopolar cortex. This pattern supports existing evidence that prefrontal regions are involved in maintaining attentional control over conflicting response systems. Taken together, these findings may be more in line with theoretical models that emphasize a role for practice in the emergence of Stroop phenomena. These findings may also provide some additional insight into the nature of anterior cingulate- and prefrontal cortical contributions to implementing cognitive control in the brain.

Arousal↗
PubMed2005

Association between stalking victimisation and psychiatric morbidity in a random community sample.

BACKGROUND: No studies have assessed psychopathology among victims of stalking who have not sought specialist help. AIMS: To examine the associations between stalking victimisation and psychiatric morbidity in a representative community sample. METHOD: A random community sample (n=1844) completed surveys examining the experience of harassment and current mental health. The 28-item General Health Questionnaire (GHQ-28) and the Impact of Event Scale were used to assess symptomatology in those reporting brief harassment (n=196) or protracted stalking (n=236) and a matched control group reporting no harassment (n=432). RESULTS: Rates of caseness on the GHQ-28 were higher among stalking victims (36.4%) than among controls (19.3%) and victims of brief harassment (21.9%). Psychiatric morbidity did not differ according to the recency of victimisation, with 34.1% of victims meeting caseness criteria 1 year after stalking had ended. CONCLUSIONS: In a significant minority of victims, stalking victimisation is associated with psychiatric morbidity that may persist long after it has ceased. Recognition of the immediate and long-term impacts of stalking is necessary to assist victims and help alleviate distress and long-term disability.

Adult↗
PubMed2002

Patients who stalk doctors: their motives and management.

The prevalence of stalking is increasing and healthcare professionals are overrepresented among stalking victims. The most common motivations for stalking are patients' developing a romantic attachment, due to delusional beliefs (as in erotomania) or misplaced expectations (often by socially inept patients), and patients' developing a resentment for some supposed injury. Strategies to prevent victimisation and minimise the impact of stalking include: taking care to preserve privacy and security, making clear to patients that the relationship will always be professional and what the boundaries are, informing colleagues and other relevant parties, transferring the patient's care to another doctor, and considering legal action.

Adaptation, Psychological↗
PubMed2002

The prevalence and nature of stalking in the Australian community.

OBJECTIVE: This study examines the extent and nature of stalking victimisation in a random community sample. METHOD: A postal survey was distributed to 3700 adult men and women selected from the electoral roll in the State of Victoria. Outcome measures included the lifetime and annual cumulative incidence of stalking, the duration and methods of harassment, rates of associated violence and responses to victimisation. RESULTS: Almost one in four respondents (23.4%;432) had been stalked, the unwanted behaviour they were subjected to being both repeated and fear-provoking. One in 10 (197) had experienced a protracted course of stalking involving multiple intrusions spanning a period of at least one month. Women were twice as likely as men to report having been stalked at some time in their lives, though the rates of victimisation in the 12 months prior to the study did not differ significantly according to gender. Younger people were significantly more likely than older respondents to report having been stalked. Victims were pursued by strangers in 42% of cases. The most common methods of harassment involved unwanted telephone calls, intrusive approaches and following. Associated threats (29%) and physical assaults (18%) frequently arose out of the stalking. Significant social and economic disruption was created by the stalking for 63% of victims. Most sought assistance to manage their predicament (69%). CONCLUSIONS: The experience of being stalked is common and appears to be increasing. Ten percent of people have been subjected at some time to an episode of protracted harassment. Assaults by stalkers are disturbingly frequent. Most victims report significant disruption to their daily functioning irrespective of exposure to associated violence.

Adolescent↗