Showing papers by "Beverley Raphael published in 1993"

International Handbook of Traumatic Stress Syndromes

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.

Emotional Lability after Stroke

Abstract: The aims of this study were (i) to determine the frequency of emotional lability following first ever stroke, and (ii) to identify factors associated with this condition. Sixty-six consecutive inpatients with first ever stroke were surveyed two months post stroke for the presence of emotional lability. Demographic, clinical, psychiatric and stroke lesion characteristics were also assessed. Emotional lability was present in 12 of the 66 patients (prevalence: 18%). Emotional lability occurred independently of post stroke depression. Single lesions located in anterior regions of the cerebral hemispheres had four times the odds of emotional lability than lesions located anywhere else (p<0.05). Emotional lability is a common emotional-behavioural syndrome following stroke and is probably a separate condition from post stroke depression. The aetiology of this condition is possibly related to the consequences of injury to anterior regions of the cerebral hemispheres.

Domestic violence victims in a hospital emergency department.

Abstract: OBJECTIVE: To determine the prevalence and predictors of domestic violence victims among attenders at the emergency department at Royal Brisbane Hospital in 1991. DESIGN: Cross-sectional study in which randomly selected nursing shifts were used to screen attenders. RESULTS: Of all attenders at the emergency department, 14.1% disclosed a history of domestic violence. Women were more likely than men to disclose domestic violence ("raw" relative risk, 2.31; 95% confidence interval CI., 1.83-2.91; relative risk adjusted for age and history of child abuse, 4.50; 95% CI, 3.02-6.71). The greatest risks for being an adult victim of domestic violence were being female and having experienced abuse as a child. Most of those who had experienced domestic violence within the last 24 hours (1.1% of attenders) came to the department after-hours when social work staff were unavailable for referral. CONCLUSIONS: The prevalence and risk factors have implications for the training of doctors and nurses in domestic violence problems and for the provision of adequate resources to deal with the psychosocial aspects of domestic violence. Language: en

An international perspective on bereavement related concepts

Abstract: This paper reports on part of a study which was aimed at assessing the views of leading researchers, theorists or clinicians working in the field of bereavement on key issues including, as reported here, concepts of different forms of grief as well as favoured theoretical orientations. Of a range of conceptual models the most favoured, by a large margin, were attachment theory and the psychodynamic model. The views of the “experts’ were canvassed with respect to the use of seven selected terms used to denote some variant of the grieving process. There was, on the part of the respondents, reasonable support for the syndromes of “delayed’, “chronic’, “anticipatory’ and “absent’ grief. “Inhibited’ and “unresolved’ grief tended to be described using one of the four terms already supported, while the use of the term “distorted grief’ attracted little support.

An international perspective on bereavement related concepts

Abstract: This paper reports on part of a study which was aimed at assessing the views of leading researchers, theorists or clinicians working in the field of bereavement on key issues including, as reported here, concepts of different forms of grief as well as favoured theoretical orientations. Of a range of conceptual models the most favoured, by a large margin, were attachment theory and the psychodynamic model.The views of the “experts’ were canvassed with respect to the use of seven selected terms used to denote some variant of the grieving process. There was, on the part of the respondents, reasonable support for the syndromes of “delayed’, “chronic’, “anticipatory’ and “absent’ grief. “Inhibited’ and “unresolved’ grief tended to be described using one of the four terms already supported, while the use of the term “distorted grief’ attracted little support.

Theoretical and Intervention Considerations in Working with Victims of Disaster

Abstract: Compassionate and humanitarian concerns have dictated the intense response that occurs following most major disasters throughout the world. Such catastrophes are evocative, fill the onlookers with vicarious dread, and, at the same time, provide a focus for the altruism and good will that will strengthen and sustain those affected throughout the crisis period. Although the shock, horror, and grief that may follow have long been recognized, the more profound psychological consequences that will affect significant numbers of people are only now being systematically and consistently quantified (Raphael, 1986).

Images of Trauma: From Hysteria to Post-Traumatic Stress Disorder

Abstract: Inevitably, reading is one of the requirements to be undergone. To improve the performance and quality, someone needs to have something new every day. It will suggest you to have more inspirations, then. However, the needs of inspirations will make you searching for some sources. Even from the other people experience, internet, and many books. Books and internet are the recommended media to help you improving your quality and performance.

The evolution of mental health responses and research in Australian disasters

Abstract: This paper overviews the development of Australian mental health services during disasters as well as recording research conducted and outcomes published. A comprehensive review of disaster research conducted on the Australian continent over the past 15 years has been undertaken. This includes “natural disasters” of flood, bushfire, cyclone, and earthquake; as well as “man-made” disasters of rail accident, bus crash, shipwreck, and mass shootings. The Australian mental health response to disasters has evolved progressively through a changing focus from broad evaluations in early studies to systematic exploration of the mental health impact. Ongoing research should consider prevention at every level, further exploration of etiology, and the issues of service provision across the diverse nature of Australian society.

Further evidence that scopolamine can improve verbal fluency.

Abstract: Scopolamine usually is found to impair various aspects of human cognitive performance. Recently, however, a significant (though modest) improvement in verbal fluency has been reported following scopolamine hydrobromide (0.6 and 1.2 mg p.o.). This study replicated that effect, finding significantly better FAS letter fluency in contrast to poorer performance on other neuropsychological measures following sub cutaneous injection of 0.4 mg scopolamine. Data are discussed in terms of a functional state model of drug action.

Young women and alcohol: psychosocial factors associated with their own drinking, their fathers' drinking, and both

Abstract: Psychosocial factors associated with young women's own alcohol consumption, and that of their fathers, were assessed in a sample of 231 females (mean age: 18.0 years) from the Hunter Region, NSW, Australia. Consistent with prior research, we found some evidence of poorer adjustment in girls who drank heavily and among daughters of high drinkers. In addition, we found that the 'psychosocial profiles' associated with girls' and fathers' drinking were quite different, which argues against a simple additive model which might predict poorer adjustment in high drinking daughters of high drinking men. One interesting finding was that discordance between girls' and fathers' drinking patterns was independently related to some psychosocial problems.

Earthquakes and Traumatic Stress

Abstract: There have been few studies of immediate reactions to earthquakes and devastating disasters in many parts of the world. Historically, Japan suffers earthquakes and these have had severe effects on communities, as in the earthquake of 1923 when at least 200,000 died. In this chapter, we will report preliminary findings on two separate earthquakes that occurred 10 years apart.

Images of Trauma

Abstract: ymages of Trauma is an intelligent and challenging book and one that is difficult to review: it sweeps across a wide canvas of theoretical constructs to examine the relation between environmental factors and neuroses. The issues covered range from hysteria to post-traumatic stress disorder; from psychoanalysis as a "theory of everything" to a dynamic psychology of consciousness; from the meaning of hypnosis to the psyche as distinct from the mind. It is at times irritating when, in such a vast panorama, generalisations appear as if truths, evidence to the contrary view is but briefly considered, the exciting and stimulating ideas are not explored or taken through to their conclusions. Nevertheless, these irritations in a way add to the challenge and engage the reader intensely throughout the book. Healy starts with an exploration of ideas about neurosis and early theories of hysteria and the role of trauma and "degeneracy" in causation. He reviews the emerging understanding of the psyche and also the role of psychoanalysis. Rightly challenging the ideas of "degeneracy" which created a stereotype of the individual's inadequacies leading to the development of neurosis, he also later challenges the failure adequately to take into account other environmental influences in the aetiology of neurosis; but perhaps here he does not give due credit to the developments of social psychiatry in recent decades. He goes on to discuss consciousness and its vicissitudes, challenging Freud's concept of repression and emphasising dissociation, which he claims has "re-emerged to the point where it has replaced repression." This renewed interest in dissociation is timely because of current awareness of the morbidity of post-traumatic stress disorder and related conditions, in which trauma has been acknowledged as a necessary but not sufficient factor in aetiology. As Healy also points out, recognition, even though justified, could lead to "epidemic" diagnoses of traumatic disorders, especially if such a diagnostic pattern was supported by vested interests. Interests such as these may, he believes, have led to a denial of the role of trauma in precipitating psychological disorder-for instance, in times ofwar. After a discussion of neurobiology Healy examines the nature of internal imagery, emotions, and consciousness, including the unconscious dynamic. He draws also on the biological basis of a dynamic unconscious in circadian and other physiological rhythms. He reviews psychotherapeutic treatments from the context of these theoretical frameworks, and the special role'of imagery and cognitive interventions. Finally, he draws together these conceptualisations in a framework theorising on the genesis and significance of the neuroses. In attempting to draw together a vast number of theoretical frameworks, Healy perhaps does not give appropriate coverage to some-for example, Bowlby's work on attachment and loss, which also covers environmental stressors and the powerful role of internal imagery. There is little recognition either of the potent role of culture as it imprints on human society, individual "authenticity," and images of trauma. There are also many doubtful facts and interpretations, although Healy is obviously in touch with contemporary data on major topics such as autobiographical memory. He pays no attention to the serious view that images are propositional rather than pictorial; and credits trance logic (mistakenly) to its originators as neuropsychological change. He suggests that psychoanalysis put paid to "introspection and a psychology ofconsciousness." Despite these shortcomings the book is worth its purchase price for what the author himself describes as a "joyride through a hundred years of psychiatric history." It has a creative sweep that would be stimulating to the knowledgeable and inquiring practitioner. It is liberally sprinkled with case histories that will interest therapists, and readers will be able to extract innovative ideas on the "joyride." There are, for example, insightful speculations about transference, a distinctive discussion of rhythmicity as a key feature of cognition, and a thoughtful appreciation of the role of uncertainty in psychological functioning. This is an exciting book-stimulating the reader to know more and more of its author's work. It is to be hoped Healy will develop many of his ideas and take them further with the scholarly depth of which he is obviously capable.-BEVERLEY RAPHAEL, professor ofpsychiatry, and PETER SHEEHAN, professor in psychology, University of Queensland, Australia