Papers by Barry Rosenfeld
Issues in Palliative Care Research, 2003
... and euthanasia brought these questions squarely into the forefront of public and political de... more ... and euthanasia brought these questions squarely into the forefront of public and political debate. Although numerous journal articles, books, and newspaper editorials have been written about such issues, few have attempted to integrate this rapidly growing literature into a ...
The Fordham urban law journal, 2002
Oncology nursing forum, 1999
To determine the degree to which nurses recognize levels of depressive symptoms in their patients... more To determine the degree to which nurses recognize levels of depressive symptoms in their patients with cancer and to describe patient characteristics that influence the accuracy of nurses' perceptions of depressive symptoms. Descriptive, prospective correlational design. 25 community-based ambulatory oncology clinics affiliated with Community Cancer Care of Indiana. 40 clinic nurses rated the depression levels of 1,109 patients. Patients completed the Zung Self-Rating Depression Scale (ZSDS) prior to their medical oncology clinic appointment. Nurses rated their patients' level of depressive symptoms, anxiety, and pain on a 0-10 numerical scale along with determining a performance status score. Patient-rated depression and the nurse depression rating. The most frequent agreement between nurses and patients was observed when patients reported little or no depressive symptoms. They were only concordant 29% and 14% of the time in the mild and moderate/severe ranges, respectively...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 1998
This study was performed as part of a large depression screening project in cancer patients to de... more This study was performed as part of a large depression screening project in cancer patients to determine the degree of physician recognition of levels of depressive symptoms in cancer patients and to describe patient characteristics that influence the accuracy of physician perception of depressive symptoms. Twenty-five ambulatory oncology clinics affiliated with Community Cancer Care, Inc of Indiana enrolled and surveyed 1,109 subjects treated by 12 oncologists. Subjects completed the Zung Self-Rating Depression Scale (ZSDS) and physicians were asked to rate their patients' level of depressive symptoms, anxiety, and pain using numerical rating scales. Subjects' sex, age, primary tumor type, medications, primary caregiver, and disease stage at diagnosis were also recorded. Physician ratings of depression were significantly associated with their patients' levels of endorsement of depressive symptoms on the ZSDS. However, agreement between physicians and patients is most fr...
Journal of forensic sciences, 1998
As research strategies for studying competence to stand trial evolve, interest in the decision-ma... more As research strategies for studying competence to stand trial evolve, interest in the decision-making process of clinicians and the factors that may influence the clinical process has grown. This study assesses the reliability of clinical opinions regarding the basis for competence decisions and the influence that severity of the offense has upon the clinical determinations of competence. One-hundred eighty-eight criminal defendants in an outpatient forensic clinic were evaluated by pairs of clinicians (psychiatrists and clinical psychologists). Each clinician was asked to complete a questionnaire regarding the defendant's overall degree of competence on a 0 to 10 rating scale, ability to understand charges and proceedings and ability to assist in one's defense, and the likelihood that the defendant was malingering. Results demonstrated a high degree of reliability not only in clinical determinations of competence (agreement in 187 of 188 cases), but in estimates of overall ...
Hospital & community psychiatry, 1993
The Bulletin of the American Academy of Psychiatry and the Law, 1994
A preliminary investigation of the impact of pretrial evaluations of trial competence and legal i... more A preliminary investigation of the impact of pretrial evaluations of trial competence and legal insanity, and the variables that mediate case outcomes is reported. Twenty-four percent of defendants evaluated as incompetent to stand trial were found competent by the court or were tried without the question of competence being adjudicated. Charges were dropped in more than half of the cases in which an evaluator considered a defendant incompetent, most frequently in cases involving misdemeanor charges and/or the clinician considered it unlikely that the defendant could be restored to competence. One third of defendants considered to meet criteria for legal insanity subsequently were acquitted NGRI; more than half did not present an insanity defense and were ultimately convicted or plea bargained a guilty verdict. The defendants considered to meet the criteria for legal insanity were more likely than their mentally ill but not insane counterparts to have treatment ordered in lieu of in...
American Journal of Psychiatry, 1999
As physician-assisted suicide is debated, a need for standardized measurement of desire for death... more As physician-assisted suicide is debated, a need for standardized measurement of desire for death among medically ill individuals has emerged. The authors present preliminary validation data for a new self-report instrument, the Schedule of Attitudes Toward Hastened Death. The participants were 195 patients with HIV/AIDS from two sites: 148 ambulatory patients and 47 patients who had been recently admitted to a facility for end-of-life care. The ambulatory participants completed the 20-item Schedule of Attitudes Toward Hastened Death and several other instruments, including the Beck Depression Inventory and Brief Symptom Inventory. The terminally ill patients also completed the Schedule of Attitudes Toward Hastened Death, along with other measures, and were assessed by clinicians with the Hamilton Depression Rating Scale and the Desire for Death Rating Scale, a global clinician rating of the patient's desire for death. The Schedule of Attitudes Toward Hastened Death demonstrated high reliability. The total score significantly correlated with the clinician rating on the Desire for Death Rating Scale and with ratings of depression and psychological distress. In addition, the Schedule of Attitudes Toward Hastened Death score significantly correlated with pain intensity and physical symptom distress. Factor analysis supported a single factor structure for the instrument. These results indicate that the Schedule of Attitudes Toward Hastened Death is a reliable, valid measure of desire for death among patients with HIV/AIDS. Further research with this measure may help address many of the unanswered questions emerging from the ongoing debates regarding legalization of assisted suicide.
Assisted suicide and the right to die: The interface of social science, public policy, and medical ethics., 2004
Palliative & Supportive Care, 2004
The faithful translation of the English version of the Schedule of Attitudes toward Hastened Deat... more The faithful translation of the English version of the Schedule of Attitudes toward Hastened Death (SAHD) into Greek and its validation as an assessment tool in terminally ill cancer patients receiving palliative treatment. 120 terminally ill cancer patients attending a Palliative Care Unit, at the University of Athens, Greece, between June 2003 and November 2003 for palliative treatment. SAHD would be a useful instrument for measuring desire for hastened death with valid psychometric properties in a Greek cancer population. The SAHD demonstrated high reliability. Desire for hastened death was significantly associated with Hospital Anxiety and Depression Scale (HAD) depression (r = 0.607, p < 0.0005) and substantially correlated with HAD anxiety (r = 0.502, p < 0.0005). "Pain intensity" had a moderate correlation with SAHD scores (r = 0.28, p = 0.01) and SAHD scores correlated significantly with "pain interference in mood" (r = 0.38, p = 0.01) and in "enjoyment of life" (r = 0.34, p = 0.03). SAHD correlation with quality of life was statistically significant (r = -0.38, p < 0.01) as was health status (r = -0.36, p < 0.01). Patients with a Poor Performance Status (from Eastern Cooperative Oncology Group scale) correlated significantly with high scores in SAHD (p = 0.038). Factor analysis supported the unidimentionality of the measurement. SAHD could be a useful and valid instrument for measuring desire for hastened death in Greek terminally ill cancer patients.
Valutazione e gestione della violenza, 2014
Journal of Ambulatory Care Management, 2003
Asylum seekers arriving in the United States are often imprisoned for months or years while their... more Asylum seekers arriving in the United States are often imprisoned for months or years while their asylum claims are processed. Recently, Physicians for Human Rights and the Bellevue/New York University Program for Survivors of Torture released the findings of the first systematic study examining the health of detained asylum seekers. The study found that the mental health of asylum seekers interviewed was extremely poor, including high levels of symptoms for anxiety, depression, and posttraumatic stress disorder, which worsened the longer individuals were in detention. The study also raises concerns about the manner in which asylum seekers are treated upon arrival in the United States and then while in detention. These findings support assertions that detention has a harmful effect on the health and well-being of asylum seekers. Policies regarding the long-term detention of asylum seekers should be reconsidered.
Psycho-Oncology, 1998
The feasibility, utility and reliability of the Zung Self-Rating Depression Scale (ZSDS) was exam... more The feasibility, utility and reliability of the Zung Self-Rating Depression Scale (ZSDS) was examined in a large sample of ambulatory cancer patients. This tool and a brief 11-item version of the ZSDS (excluding nine items concerning somatic symptoms), which was developed during the course of the survey, were used to estimate the prevalence of self-reported depressive symptoms. Patient characteristics that may be associated with an increased risk of clinically significant depressive symptoms were also explored. Twenty-five ambulatory oncology clinics affiliated with Community Cancer Care, Inc. enrolled and surveyed 1109 subjects. The alpha coefficients for the ZSDS (0.84) and the Brief ZSDS (0.84) indicated high levels of internal consistency. The overall prevalence of clinically significant depressive symptoms as defined by the ZSDS was 35.9% and by the Brief ZSDS was 31.1%. The ZSDS and the Brief ZSDS were highly correlated (r = 0.92). The medical and demographic variables most associated with clinically significant depressive symptoms were more advanced stage of disease at time of diagnosis, lung cancer as primary tumor type, higher ECOG rating (greater degree of physical disability), and having been prescribed antidepressant medications. The high prevalence of depressive symptoms observed in this study is consistent with rates found in other studies of self-report depression instruments in cancer patients. The initial indicators of internal consistency and validity suggest that the Zung SDS or the brief version may be useful screening tools to identify depressive symptoms in oncology patients.
Psychology, Public Policy, and Law, 2000
The debate surrounding the legalization of assisted suicide continues despite a limited body of e... more The debate surrounding the legalization of assisted suicide continues despite a limited body of empirical research. Relatively few studies have addressed interest in assisted suicide or the desire for hastened death (rather than approval of legislation) among medically ill patients, and this literature is plagued by methodological limitations. In general, this research has demonstrated a significant association between depression and desire for death; however, the magnitude of this association is unclear. Nevertheless, psychological and social factors have typically appeared more influential in determining patients' desire for death than physical symptoms such as pain. The impact of these findings on future legislative efforts to legalize assisted suicide is discussed.
Professional Psychology: Research and Practice, 2012
Immigration trends are rapidly increasing the diversity present in individuals who require psycho... more Immigration trends are rapidly increasing the diversity present in individuals who require psychological evaluation. Forensic psychologists in particular are often faced with evaluatees from diverse backgrounds, about which they may have little or no prior knowledge. Furthermore, the measures commonly used in forensic assessment have rarely been developed for, or validated in, individuals from nonmajority cultural backgrounds, let alone in languages other than English. This article examines a range of topics that impact cross-cultural validity in psychological assessments more generally, with particular attention to the issues most relevant for forensic assessment (e.g., clinical interviewing, diagnostic assessment, and psychological testing). Additionally, recommendations for best practice in forensic assessment with culturally diverse evaluatees are offered.
Law and Human Behavior, 1997
Forensic mental health evaluation systems have undergone major changes during the past two decade... more Forensic mental health evaluation systems have undergone major changes during the past two decades, and the variability of service delivery systems across states is significant. We compared assessments of competence to stand trial and criminal responsibility in three states with different systems for forensic mental health evaluations: Michigan, Ohio, and Virginia. Although all three states use comparable legal criteria to judge competence and criminal responsibility, we found large, statistically significant differences among the states in the proportion of defendants referred for evaluation who were assessed as incompetent or not criminally responsible. In addition, significant differences were found in the diagnostic and offense categories of defendants referred for evaluation. Our findings suggest that the structure of a system for providing forensic evaluation services may significantly affect both the group of individuals referred for evaluation as well as evaluation outcome.
Uploads
Papers by Barry Rosenfeld