Publications by authors named "Paul Rosenfield"

Adverse childhood experiences (ACEs) are associated with poor mental health in adulthood. Comprehensive prevalence data encompassing all 10 ACE questionnaire items has not previously been described in a hospital-based outpatient psychiatric clinic. This study assessed the prevalence of 10 ACEs in such a clinic and correlated ACEs with indicators of case severity.

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Background: Machine learning-based facial and vocal measurements have demonstrated relationships with schizophrenia diagnosis and severity. Demonstrating utility and validity of remote and automated assessments conducted outside of controlled experimental or clinical settings can facilitate scaling such measurement tools to aid in risk assessment and tracking of treatment response in populations that are difficult to engage.

Objective: This study aimed to determine the accuracy of machine learning-based facial and vocal measurements acquired through automated assessments conducted remotely through smartphones.

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While genetic factors play a critical role in the risk for schizophrenia and other psychotic disorders, increasing evidence points to the role of childhood adversity as one of several environmental factors that can significantly impact the development, manifestations and outcome of these disorders. This paper reviews the epidemiological evidence linking childhood adversity and psychotic disorders and explores various theoretical models that seek to explain the connection. We discuss neurobiological parallels between the impact of childhood trauma and psychosis on the brain and then explore the impact of childhood adversity on different domains of clinical presentation.

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Introduction: Motor abnormalities have been shown to be a distinct component of schizophrenia symptomatology. However, objective and scalable methods for assessment of motor functioning in schizophrenia are lacking. Advancements in machine learning-based digital tools have allowed for automated and remote "digital phenotyping" of disease symptomatology.

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The World Health Organization (WHO) has included complex post-traumatic stress disorder (C-PTSD) in the final draft of the 11th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-11), which was published in June, 2018 and is scheduled to be submitted to WHO's World Health Assembly for official endorsement in 2019. Mental health providers will want to be informed about this diagnosis in order to provide effective treatment. Complex PTSD, or developmental PTSD as it is also called, refers to the constellation of symptoms that may result from prolonged, chronic exposure to traumatic experiences, especially in childhood, as opposed to PTSD which is more typically associated with a discrete traumatic incident or set of traumatic events.

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Objective: Advanced paternal age is consistently associated with an increased risk for schizophrenia, accounting for up to a quarter of cases in some populations. If paternal age-related schizophrenia (PARS) involves a distinct etiopathology, then PARS cases may show specific characteristics, vis-à-vis other schizophrenia cases. This study examined if PARS exhibits the symptom profile and sex differences that are consistently observed for schizophrenia in general, wherein males have an earlier onset age and more severe negative symptoms than females.

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This study examined the relationship between having a family history of affective disorder and neuropsychological functioning and PANSS symptoms in schizophrenia patients falling into four exclusive family history groups (affective spectrum disorders, schizophrenia spectrum disorders, both, or neither). Schizophrenia patients with a family history of affective illness had the best performance on IQ tests and executive function measures. Symptoms showed fewer family history group differences.

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Poison or cure: meanings of medication in schizophrenia.

J Am Acad Psychoanal Dyn Psychiatry

August 2007

Antipsychotic medications provide tremendous relief to many individuals with schizophrenia, but can have significant costs, including adverse metabolic, neurological, and psychological effects. Prescribers and consumers of these medications often have different perceptions of the safety and utility of medications, ranging from "poison" to "cure." While much of the literature on the meaning of medication in schizophrenia discusses patients' negative perceptions of medication, poor insight, and other risk factors for nonadherence, a variety of additional factors should be considered, including both doctors' and patients' perspectives.

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There are few clinical data describing the relative risks of extrapyramidal symptoms (EPS) at higher doses of ziprasidone (i.e., greater than 160 mg/day) when compared to lower doses.

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Introduction: Medical students face many challenges as they progress through training, some of which refer to learning how to manage the stresses and anxiety of confronting illness and suffering. In trying to relieve anxiety, they may develop maladaptive responses that lead to a decrease in their level of empathy for patients. Education should aim to teach students how to deal with their responses so that they can tolerate patients' distress and treat them effectively.

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Introduction: An expanding database supports the notion that the deficit syndrome (DS) is a discrete condition within schizophrenia and recent data argues that Smell Identification Deficits (SID) may have a primary relationship with its pathophysiology. If so, then the relationship of University of Pennsylvania Smell Identification Test (UPSIT) scores with other neurocognitive measures in DS patients may point to the neural substrate of the deficit syndrome.

Method: We examined the relationship of UPSIT scores and Wechsler Adult Intelligence Scale-Revised (WAIS-R) performance in 46 DSM-IV schizophrenia patients.

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Background: Previous research has established a relationship between smell identification deficits (SID) and particular aspects of cognitive function among patients with schizophrenia.

Objective: To expand the extant literature, we examined the relationship between SID and the Trail Making Test to determine if processing speed is related to SID.

Methods: Our sample included 60 inpatients from the New York State Psychiatric Institute's Schizophrenia Research Unit.

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