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Beverley Raphael

Bio: Beverley Raphael is an academic researcher from Australian National University. The author has contributed to research in topics: Mental health & Poison control. The author has an hindex of 50, co-authored 260 publications receiving 12009 citations. Previous affiliations of Beverley Raphael include Princess Alexandra Hospital & QIMR Berghofer Medical Research Institute.


Papers
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Journal ArticleDOI
TL;DR: The psychometric validity of criteria for prolonged grief disorder (PGD) is tested to enhance the detection and care of bereaved individuals at heightened risk of persistent distress and dysfunction.
Abstract: Background: Bereavement is a universal experience, and its association with excess morbidity and mortality is well established. Nevertheless, grief becomes a serious health concern for a relative few. For such individuals, intense grief persists, is distressing and disabling, and may meet criteria as a distinct mental disorder. At present, grief is not recognized as a mental disorder in the DSM-IV or ICD-10. The goal of this study was to determine the psychometric validity of criteria for prolonged grief disorder (PGD) to enhance the detection and potential treatment of bereaved individuals at heightened risk of persistent distress and dysfunction. Methods and Findings: A total of 291 bereaved respondents were interviewed three times, grouped as 0–6, 6–12, and 12– 24 mo post-loss. Item response theory (IRT) analyses derived the most informative, unbiased PGD symptoms. Combinatoric analyses identified the most sensitive and specific PGD algorithm that was then tested to evaluate its psychometric validity. Criteria require reactions to a significant loss that involve the experience of yearning (e.g., physical or emotional suffering as a result of the desired, but unfulfilled, reunion with the deceased) and at least five of the following nine symptoms experienced at least daily or to a disabling degree: feeling emotionally numb, stunned, or that life is meaningless; experiencing mistrust; bitterness over the loss; difficulty accepting the loss; identity confusion; avoidance of the reality of the loss; or difficulty moving on with life. Symptoms must be present at sufficiently high levels at least six mo from the death and be associated with functional impairment. Conclusions: The criteria set for PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction. The results support the psychometric validity of the criteria for PGD that we propose for inclusion in DSM-V and ICD-11. Please see later in the article for the Editors’ Summary.

1,437 citations

Journal ArticleDOI
TL;DR: Child and adolescent mental health problems are an important public health problem in Australia and the appropriate balance between funding provided for clinical interventions focusing on individual children and families and funding for interventions that focus on populations, requires careful study.
Abstract: Objective: To identify the prevalence of three mental disorders (Depressive Disorder, Conduct Disorder and Attention-Deficit/Hyperactivity Disorder), the prevalence of mental health problems, the health-related quality of life of those with problems, and patterns of service utilisation of those with and without mental health problems, among 4–17-year-olds in Australia. To identify rates of health-risk behaviours among adolescents with mental health problems.Method: The mental disorders were assessed using the parent-version of the Diagnostic Interview Schedule for Children Version IV. Parents completed the Child Behaviour Checklist to identify mental health problems and standard questionnaires to assess healthrelated quality of life and service use. The Youth Risk Behaviour Questionnaire completed by adolescents was employed to identify health-risk behaviours.Results: Fourteen percent of children and adolescents were identified as having mental health problems. Many of those with mental health problems ha...

913 citations

BookDOI
01 Jan 1993
TL;DR: Theoretical and conceptual foundations of Traumatic Stress Syndromes: From Hiroshima to the Nazi Doctors R.J. Lifton as discussed by the authors, and Trauma Related to Torture, Detention, and Internment: Torture of a Norwegian Ship Crew L. Weisaeth.
Abstract: Theoretical and Conceptual Foundations of Traumatic Stress Syndromes: From Hiroshima to the Nazi Doctors R.J. Lifton. Assement Methodology, and Research Strategies: Identifying Survivors at Risk B.L. Green. War Trauma and Civil Violence: Trauma and the Aging Process: War and Remembrance Z. Harel, et al. Research Post-World War II to the Present: The Vietnam P.O.W. Experience E.J. Hunter. Trauma Related to Disasters of Natural and Human Origen: Chernobyl T. Lundin. The Impact of Trauma on Children and Adolescents: Father Kills Mother D. Black, et al. Trauma Related to Torture, Detention, and Internment: Torture of a Norwegian Ship Crew L. Weisaeth. Intervention, Clinical Treatment, and Psychotherapy: Post-Traumatic Therapy F. Ochberg. Organizational, Social Policy Issues, and Critical Sress Incident Debriefing in Response to Victims of Trauma: Vet Centers A.S. Blank Jr. 75 additional articles. Index.

631 citations

Book
01 Jan 1983
TL;DR: The Anatomy of Bereavement as discussed by the authors describes all the stages of mourning and healing, and analyzes how the effects of loss differ at each stage of life, starting with the infant's loss of a parent, taking up the effects on adolescents of death in the family, and moving on to the losses people face in adult life and in old age, showing how the dynamics of grief and recovery vary over the course of time.
Abstract: Grief is a universal human experience, painful and inevitable. In this wise and compassionate book, a psychiatrist who has done extensive work and research with the bereaved shares her broad experience, revealing how people cope with, understand, and eventually adapt to many different bereavements in the course of human life. Those first few hours and days after a loved one has died may seem to pass like a dream, and only afterward does the real work of grieving and healing begin. In this comprehensive book, Beverley Raphael describes all the stages of mourning and healing, and analyzes how the effects of loss differ at each stage of life. Starting with the infant's loss of a parent, taking up the effects on adolescents of death in the family, and moving on to the losses people face in adult life and in old age, Raphael, with sensitivity and grace, shows how the dynamics of grief and recovery vary over the course of time. In describing the experience of loss, the author provides the reader with a rich understanding of how different people at different ages cope with grief, loss, and pain. The most thorough book on the subject ever written, The Anatomy of Bereavement is the standard work.

475 citations

Journal ArticleDOI
TL;DR: Although this study is the first to collect psychological distress data from an affected population during such a disease outbreak, it has limited generalisability and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.
Abstract: In 2007 Australia experienced its first outbreak of highly infectious equine influenza. Government disease control measures were put in place to control, contain, and eradicate the disease; these measures included movement restrictions and quarantining of properties. This study was conducted to assess the psycho-social impacts of this disease, and this paper reports the prevalence of, and factors influencing, psychological distress during this outbreak. Data were collected using an online survey, with a link directed to the affected population via a number of industry groups. Psychological distress, as determined by the Kessler 10 Psychological Distress Scale, was the main outcome measure. In total, 2760 people participated in this study. Extremely high levels of non-specific psychological distress were reported by respondents in this study, with 34% reporting high psychological distress (K10 > 22), compared to levels of around 12% in the Australian general population. Analysis, using backward stepwise binary logistic regression analysis, revealed that those living in high risk infection (red) zones (OR = 2.00; 95% CI: 1.57–2.55; p < 0.001) and disease buffer (amber) zones (OR = 1.83; 95% CI: 1.36–2.46; p < 0.001) were at much greater risk of high psychological distress than those living in uninfected (white zones). Although prevalence of high psychological distress was greater in infected EI zones and States, elevated levels of psychological distress were experienced in horse-owners nationally. Statistical analysis indicated that certain groups were more vulnerable to high psychological distress; specifically younger people, and those with lower levels of formal educational qualifications. Respondents whose principal source of income was from horse-related industry were more than twice as likely to have high psychological distress than those whose primary source of income was not linked to horse-related industry (OR = 2.23; 95% CI: 1.82–2.73; p < 0.001). Although, methodologically, this study had good internal validity, it has limited generalisability because it was not possible to identify, bound, or sample the target population accurately. However, this study is the first to collect psychological distress data from an affected population during such a disease outbreak and has potential to inform those involved in assessing the potential psychological impacts of human infectious diseases, such as pandemic influenza.

409 citations


Cited by
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Journal ArticleDOI
TL;DR: A review of the psychological impact of quarantine using three electronic databases is presented in this article, where the authors report negative psychological effects including post-traumatic stress symptoms, confusion, and anger.

10,370 citations

Journal ArticleDOI
TL;DR: Evidence is reviewed that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience.
Abstract: Many people are exposed to loss or potentially traumatic events at some point in their lives, and yet they continue to have positive emotional experiences and show only minor and transient disruptions in their ability to function. Unfortunately, because much of psychology’s knowledge about how adults cope with loss or trauma has come from individuals who sought treatment or exhibited great distress, loss and trauma theorists have often viewed this type of resilience as either rare or pathological. The author challenges these assumptions by reviewing evidence that resilience represents a distinct trajectory from the process of recovery, that resilience in the face of loss or potential trauma is more common than is often believed, and that there are multiple and sometimes unexpected pathways to resilience. M ost people are exposed to at least one violent or life-threatening situation during the course of their lives (Ozer, Best, Lipsey, & Weiss, 2003). As people progress through the life cycle, they are also increasingly confronted with the deaths of close friends and relatives. Not everyone copes with these potentially disturbing events in the same way. Some people experience acute distress from which they are unable to recover. Others suffer less intensely and for a much shorter period of time. Some people seem to recover quickly but then begin to experience unexpected health problems or difficulties concentrating or enjoying life the way they used to. However, large numbers of people manage to endure the temporary upheaval of loss or potentially traumatic events remarkably well, with no apparent disruption in their ability to function at work or in close relationships, and seem to move on to new challenges with apparent ease. This article is devoted to the latter group and to the question of resilience in the face of loss or potentially traumatic events. The importance of protective psychological factors in the prevention of illness is now well established (Taylor, Kemeny, Reed, Bower, & Gruenewald, 2000). Moreover, developmental psychologists have shown that resilience is common among children growing up in disadvantaged conditions (e.g., Masten, 2001). Unfortunately, because most of the psychological knowledge base regarding the ways adults cope with loss or potential trauma has been derived from individuals who have experienced significant psychological problems or sought treatment, theorists working in this area have often underestimated and misunderstood resilience, viewing it either as a pathological state or as something seen only in rare and exceptionally healthy individuals. In this article, I challenge this view by reviewing evidence that resilience in the face of loss or potential trauma represents a distinct trajectory from that of recovery, that resilience is more common than often believed, and that there are multiple and sometimes unexpected pathways to resilience.

5,415 citations

Journal ArticleDOI
TL;DR: The effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.
Abstract: Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.

4,488 citations

01 Jan 1988
TL;DR: The role of attachment in personality development is discussed in this paper, where the origins of attachment theory are discussed and a discussion of the role of communication and attachment in the development of personality is discussed.
Abstract: * Caring for children * The origins of attachment theory * Psychoanalysis as art and science * Psychoanalysis as a natural science * Violence in the family * On knowing what you are not supposed to know and feeling what you are not supposed to feel * The role of attachment in personality development * Attachment, communication, and the therapeutic process * Developmental psychiatry comes of age

4,257 citations

Journal ArticleDOI
TL;DR: In this article, the authors present a conceptual model of how social networks impact health, and argue that networks operate at the behavioral level through four primary pathways: (1) provision of social support; (2) social influence; (3) on social engagement and attachment; and (4) access to resources and material goods.

4,033 citations