Barry Rosenfeld

• PhD
• Professor (Full) at Fordham University

Objectives Wishes to hasten death (WTHDs) are common in patients with serious illness. The Schedule of Attitudes Toward Hastened Death (SAHD) is a validated 20-item instrument for measuring WTHD. Two short versions have also been developed based on statistical item selection. However, all existing versions show some limitations with potential for i...

Objectives: The objective of this study was to engage national experts in geriatric psychiatry and oncology in qualitative interviews to develop consensus regarding how older adult cancer survivors (OACS) experience depressive symptoms, and how best to assess OACs for depression. Methods: Expert clinicians in geriatric oncology disciplines were...

As migrants, refugees, and asylum seekers continue to arrive at the Mexico–U.S. border and solutions to this situation remain elusive, growing opportunities exist for research to inform policy decisions. One policy implemented (and subsequently rescinded) by the U.S. Department of Homeland Security was to limit asylum claims to only those individua...

Currently, there is a need for research on brief risk assessment measures in Latin American countries. The Violence Risk Appraisal Guide–Revised (VRAG-R; Rice et al., 2013) is a violence risk assessment measure known for its objectivity, ease of administration, and accuracy in prison settings. Because the VRAG-R was developed in Canada, the appropr...

We tested whether patients’ trust in physician moderated the hypothesized indirect association between intolerance of uncertainty (IU; inability to tolerate the unknown) and emotional distress through the mediator, experiential avoidance (EA; efforts to avoid negative emotions, thoughts, or memories), in patients with advanced cancer. The sample in...

Background Despite the importance of accurate prognostic understanding in patients with advanced cancer, there is little consensus around how to conceptualize and measure the multidimensional construct. Most studies focus on single aspects of prognostic understanding (e.g., curability) that clinicians have identified as important; no previous resea...

Objective To identify the phenomenology of depression in older adults with cancer (OACs) in order to improve the accuracy of depression screening for this population. Method Inclusion criteria were: ≥70 years old, history of cancer, no cognitive impairment or severe psychopathology. Participants completed a demographic questionnaire, a diagnostic...

Stalking poses a serious problem to the criminal legal system as solutions for legal consequences, victim protection, and offender treatment and rehabilitation remain underdeveloped. This review of the literature on stalking provides an overview of the characteristics of stalking perpetrators, theories behind stalking behavior, impact on victims, a...

Since the first edition of The Handbook of Psychiatry in Palliative Medicine was released in 2000, it has come to occupy an important and distinctive niche within the literary anthology of palliative medicine. The Handbook is widely regarded as the definitive reference on psychosocial issues affecting patients with life-threatening and life-limitin...

Objective: In patients with cancer across the illness trajectory, treatment decisions are often influenced by one's perception of their prognosis (i.e., curability of disease, life expectancy, quality of life). However, research on how patients understand their prognosis (i.e., prognostic understanding) has been limited by simplistic measurement t...

Objective:Individuals may be motivated to conceal or minimize psychological symptoms and engage in positive impression management (PIM) in order to achieve desired outcomes across high stakes contexts (e.g. fitness for duty evaluations, pre-sentencing assessments, medical procedure evaluations, civil commitment). Despite the importance of this topi...

This prospective study investigated the predictive validity of a culturally adapted version of the Historical-Clinical-Risk Management-20 (HCR-20V3) with a sample of 114 incarcerated males in a medium-security prison in Mexico City. The goal was to integrate a culturally responsive approach to violence risk assessment by incorporating culturally re...

Objective: This systematic review and preliminary meta-analysis examined the effectiveness of translated versions of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the MMPI-2 Restructured Form (MMPI-2-RF) in detecting response distortion (i.e., symptom exaggeration and minimization), a central concern in forensic assessment. Hypot...

The accuracy of performance validity tests (PVTs) with culturally diverse populations has increasingly been questioned. High false positive rates have been found in some PVTs in culturally and linguistically diverse individuals within the U.S. and internationally. No study to date has investigated the accuracy of PVTs with Chinese-speaking immigran...

Several meta-analyses of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) have examined these instruments’ ability to detect symptom exaggeration or feigning. However, limited research has directly compared whether the scales across these two instruments are e...

This presentation drew on data from a sample of the late 2018 Central American migrant caravan to identify migrant subgroups based on their reasons for migration, traumatic event exposure and asylum criteria, expanding on subgroup characteristics and associations between class-membership and severity of PTSD and depression.

Objective: Hopelessness, or a sense of despair about the future, has been a growing focus of psychological research among patients with serious medical illnesses. This study evaluated the psychometric properties of the Hopelessness Assessment in Illness (HAI) questionnaire, developed specifically for those facing a life-threatening illness. Partic...

Coaching individuals on test-taking strategies presents legal and ethical concerns and threatens the validity of psychological test score interpretations, which could lead to inaccuracies in clinical settings and injustices within the legal system. This meta-analysis examined the impact of coaching on the detection of symptom exaggeration or feigni...

Aim Although the absolute risk of violence is small for individuals with mental illnesses, a specific subgroup of individuals who appear to be at increased risk for violence includes young people experiencing emerging or early psychosis. Prior research has identified risk factors for violence in this population, though no prior studies using a form...

This prospective study investigated the predictive validity of the Historical-Clinical-Risk Management–20, Version 3 (HCR-20 V3 ) in a sample of incarcerated males in a Mexico City prison. Data were collected from 114 male adults incarcerated in a medium-security prison in Mexico City. Participants were an average of 36.86 years old ( SD = 9.93 yea...

Objective: This study examined whether patients who were randomly assigned to their preferred therapy arm had stronger engagement with their treatment than those who were randomly assigned to a non-preferred therapy arm. Method: Data were drawn from a RCT comparing Individual Meaning-Centered Psychotherapy (IMCP), with Individual Supportive Psychot...

This chapter provides an overview of prognostic understanding in patients with advanced cancer. It reviews how the construct has been defined and measured historically, including current research on the multidimensional nature of prognostic understanding. It further highlights the importance of prognostic understanding for patients and their loved...

Few studies have empirically examined children’s symptoms during immigration detention. This study investigated the behavioral problems of detained children through their mothers’ reports by interviewing 42 female immigrants from Honduras, El Salvador, and Guatemala who had been in family detention centers in Texas, using the Strengths and Difficul...

Background: Lung cancer-related inflammation is associated with depression. Both elevated inflammation and depression are associated with worse survival. However, outcomes of patients with concomitant depression and elevated inflammation are not known. Materials & methods: Patients with metastatic lung cancer (n = 123) were evaluated for depression...

Background Inflammation may contribute to the high prevalence of depressive symptoms seen in lung cancer. “Sickness behavior” is a cluster of symptoms induced by inflammation that are similar but distinct from depressive symptoms. The Sickness Behavior Inventory-Revised (SBI-R) was developed to measure sickness behavior. We hypothesized that the SB...

Objective: Posttraumatic growth and benefit finding describe the potential for positive changes resulting from traumatic experiences, including cancer. In oncology, these constructs are increasingly examined concurrently using the Posttraumatic Growth Inventory (PTGI) and the Benefit Finding Scale (BFS). However, distinctions between these constru...

Context Accurate prognostic understanding is associated with increased advance care planning, symptom control, and patient autonomy in oncology. The impact of prognostic understanding on patients’ health and prognostic information preferences (HIPs) is unknown and has important implications for healthcare communication. Objectives The present stud...

Objective: This study synthesized the results of 22 studies (N = 3,912) of feigned posttraumatic stress disorder (PTSD) symptoms that used the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Method: Robust variance estimation was used to analyze variables that affected the accuracy of scales used to detect feigned symptoms. Results: Th...

Background: The literature has focused on explicit communications of suicidal ideation, although such communications are infrequent and less overt symptoms are comparable indicators of suicide risk. Aims: Our aim was to understand how clinicians consider inexplicit suicide risk factors in assessments of risk. Method: A national sample of 75 psychia...

Background: Patients with lung cancer with greater systemic inflammation have higher rates of depression. Tumor mutation burden (TMB) predicts immunotherapy response in patients with lung cancer and is associated with intratumoral inflammation, which may contribute to systemic inflammation and depression. This study evaluated whether higher TMB wa...

The ability to predict the likelihood of violent behavior is an important task that is not constrained by cultures, borders, or geographic regions. This qualitative study analyzed 15 semi-structured interviews with forensic professionals to understand violence risk assessment (VRA) processes and procedures in Argentina, Colombia, and Mexico. Partic...

Dr. Elisabeth Kübler-Ross is credited as one of the first clinicians to formalize recommendations for working with patients with advanced medical illnesses. In her seminal book, On Death and Dying, she identified a glaring gap in our understanding of how people cope with death, both on the part of the terminally ill patients that face death and as...

80 Background: Early Childhood Adversity (ECA) explains the presence of psychological issues such as depression in many chronic disease settings but has not been measured in lung cancer. ECA may increase the positive predictive value for detecting lung cancer related psychological problems. ECA is associated with inflammation in adulthood independe...

Aparcero, M., Nijdam-Jones, A., Rosenfeld, B. & García-López, E. (2019). Professional Psychology: Research and Practice, Oct 17. Most cross-cultural research on sex offender risk assessment measures have simply examined translated risk assessment tools, developed primarily in United States, Canada, and Europe. This approach relies on the assumptio...

Depression remains poorly managed in oncology, in part because of the difficulty of reliably screening and assessing for depression in the context of medical illness. Whether somatic items really skew the ability to identify "true" depression, or represent meaningful indicators of depression, remains to be determined. This study utilized item respo...

Aim Individuals with serious mental illnesses have a small increased risk of engaging in violence or legal involvement compared to the general population. This seems to be particularly true for young adults experiencing early stages of psychosis. This study analysed the prevalence of and risk factors for reports of violence and legal involvement in...

Objective: The purpose of this cross-sectional study was to identify the neuropsychological underpinnings of decision-making capacity in terminally ill patients with advanced cancer. Method: Participants were 108 English-speaking adults. More than half (n = 58) of participants had a diagnosis of advanced cancer and were receiving inpatient palli...

Introduction: Cognitive efforts tests, such as the Test of Memory Malingering (TOMM), are widely used internationally, yet emerging research suggests that performance on the TOMM can be affected by culture and education. This study examined the specificity of the TOMM and performance differences among Colombian adults, contrasting those with varyin...

Background Urine drug testing techniques have different rates of false-positive and false-negative test results. However, clinicians may have highly varying perceptions of test accuracy and may compensate for perceived inaccuracy by incorporating other factors into their interpretation of observed test results. Thus, there is the potential for adve...

The objective was to evaluate the relative efficacy of dialectical behavior therapy modified for stalking offenders (DBT-S) versus a cognitive-behavioral anger management intervention for the treatment of stalking offenders. We expected DBT to result in significantly lower rates of renewed stalking behavior and significantly greater improvements in...

e23159 Background: Depression and inflammation are both associated with lung cancer. Tumor Mutation Burden (TMB) can be used to predict immunotherapy response which relies on tumor immunogenicity, a form of inflammation. This study evaluated whether higher TMB was associated with increased depression and various forms of inflammation. Methods: Pati...

Thinking styles that predispose offenders to antisocial behavior have been shown to predict violence and aggression among inmates. This study explored this relationship among civil psychiatric inpatients. Medical records of N = 74 discharged patients were reviewed for inpatient incidents using the Overt Aggression Scale (OAS), occurring subsequent...

Objectives Depression is highly prevalent in Non‐Small Cell Lung cancer (NSCLC) and is associated with elevated inflammation. However, certain subtypes of driver mutation associated NSCLC such as Epidermal Growth Factor Receptor (EGFR) mutated NSCLC may be associated with less depression given the differences in their underlying biology and disease...

Despite several decades of growing interest in the concept of neurolaw in English-speaking countries, it is only a recent area of focus in Latin America. The objective of this article was to facilitate evidence-informed public policy by examining the current state of neurolaw in Latin America. To achieve this goal, this systematic review summarizes...

Objective: The generalizability of palliative care intervention research is often limited by high rates of study attrition. This study examined factors associated with attrition from a random-ized controlled trial comparing meaning-centered group psychotherapy (MCGP), an intervention designed to help advanced cancer patients sustain or enhance thei...

Accurate measurement of depressive symptoms in the cancer setting is critical for ensuring optimal quality of life and patient outcomes. The present study compared the one-factor, correlated two-factor, correlated four-factor, and second-order factor models of the Center for Epidemiologic Studies Depression Scale (CES-D), a commonly used measure in...

Background Depression is highly prevalent in lung cancer. Although there is a known association between inflammation and depression, this relationship has not been examined in patients with lung cancer who undergo treatment with immune and other targeted drug therapies. Peripheral blood C‐reactive protein (CRP), a marker of systemic inflammation, m...

Given the increased cultural, linguistic and socioeconomic diversity of individuals undergoing legal proceedings, forensic mental health professionals around the world are often tasked with evaluating defendants who are drastically different from themselves. There appears to be a clear consensus that cultural competency should be a key component of...

The aging of America will include a significant increase in the number of older patients with cancer, many of whom will experience significant depressive symptoms. Although geriatric depression is a well-studied construct, its symptom presentation in the context of cancer is less clear. Latent profile analysis was conducted on depressive symptoms i...

The study of prognostic understanding is imperative as the trend toward individualized medicine continues. However, without guidelines for discussing prognosis, palliative care clinicians face challenges presenting prognostic information in a way that optimizes patient understanding, psychological adjustment, and decision-making. The present study...

Nijdam-Jones, A., García-López, E., Rosenfeld, R., & Aparcero, M. (2018, June). Violence risk assessment of Spanish-speaking Latino adults: An exploratory study. Paper presented at the Annual Conference of the International Association of Forensic Mental Health Services, Antwerp, Belgium.

Research indicates that most stalking victims are harassed by a prior intimate partner and that this group of victims is at a higher risk for violence than other stalking victims. Furthermore, many researchers found a relationship between prior intimate partner stalking (IPS) and intimate partner violence (IPV). The present study focused on identif...

BACKGROUND Patients with advanced cancer have high rates of psychological distress, including depression, anxiety, and spiritual despair. This study examined the effectiveness of individual meaning‐centered psychotherapy (IMCP) in comparison with supportive psychotherapy (SP) and enhanced usual care (EUC) in improving spiritual well‐being and quali...

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Objectives: Understanding the group process informs group interventions. However, there is little systematic research on group process variables in psychotherapy groups for patients with cancer. Methods: We analyzed the psychometric properties of the Group Therapy Experience Scale and evaluated its potential importance in advanced cancer therapy...

Comprehensive violence risk assessment can require substantial time and resources, which may be challenging for an already strapped public mental health system. Herein, we describe a naturalistic study of the Fordham Risk Screening Tool (“FRST”), a violence risk screening instrument designed to quickly identify individuals for whom thorough violenc...

This study examined the correlates of stalking behavior and psychopathology among stalking offenders assessed using a rigorous diagnostic tool. A total of 137 stalking offenders were interviewed and diagnosed using the Structured Clinical Interview for DSM-IV Axis I and Axis II Disorders. Analyses examined the extent to which stalking behaviors and...

This presentation examines the utility of inquiring about violent threats or violent thoughts when conducting a violence risk screening, in order to determine those patients who will require a full violence risk assessment.

Objective: The potentially confounding influence of somatic symptoms in identifying depression in medically ill patients has long been of concern, resulting in several proposed alternative diagnostic approaches. These approaches have been compared in the cancer setting, but the strengths and weaknesses of the alternative approaches have rarely bee...

Assessment of sexual and nonsexual recidivism risk is important for juveniles who have offended sexually (JSOs). It is unclear whether clinicians who assess risk for both types of recidivism should use a JSO-specific measure alone or in combination with an assessment of other potential risk factors, such as psychopathy. Using a sample of 72 JSOs, t...

Objective: Despite the clinical, ethical, and legal magnitude of end-of-life decision-making, the capacity of terminally ill patients to make the medical decisions they often face is largely unknown. In practice, clinicians are responsible for determining when their patients are no longer competent to make treatment decisions, yet the accuracy of...

Objectives: Meaning-Centered Group Psychotherapy (MCGP) has been demonstrated to be an effective method for improving advanced cancer patients' quality of life and reducing their depression, hopelessness, and desire for hastened death. To further understand MCGP, this study examined the mechanisms of change in MCGP on these outcomes via advanced c...

Diversion programs offer opportunities to offenders with substance abuse or mental illness to attend treatment as an alternative to incarceration. The present study identified variables associated with drug relapse and recidivism and the moderating role of substance use on recidivism in a diversion sample. Data were collected from 80 clients with p...

This chapter provides an overview of the literature on the treatment of psychopathy in adults. First, early treatment approaches are reviewed, with a particular focus on therapeutic communities. Next, studies examining the effectiveness of cognitive–behavioral therapy (CBT) for the treatment of psychopathy are summarized, including investigations o...

Objective The diagnosis and treatment of depression are complicated by the presence of a serious medical illness, such as cancer. The role of inflammation in the pathophysiology of depression remains unknown; however, the symptom cluster of sickness behavior is more clearly related to inflammation. Symptom clusters may provide the specificity neede...

Cognitive efforts tests, such as the Test of Memory Malingering (TOMM; Tombaugh, 1997), are widely used internationally, yet there is a dearth of research that has assessed the utility of these measures in different cultures, countries, and languages. This study evaluated the specificity of the TOMM Trial 2 among a sample of 3,590 Spanish-speaking...

Techniques to assess violence risk are increasingly common, but no systematic approach exists to help clinicians decide which psychiatric patients are most in need of a violence risk assessment. The Fordham Risk Screening Tool (FRST) was designed to fill this void, providing a structured, systematic approach to screening psychiatric patients and de...

The cross-cultural validity of feigning instruments and cut-scores is a critical concern for forensic mental health clinicians. This systematic review evaluated feigning classification accuracy and effect sizes across instruments and languages by summarizing 45 published peer-reviewed articles and unpublished doctoral dissertations conducted in Eur...

In recent years, increasing numbers of families and individuals have arrived at the U.S. border from Central America, in particular, from Honduras, El Salvador, and Guatemala. This study sought to examine pre-migration trauma exposure and current mental health functioning of migrant families arriving at the U.S. border from the Northern Triangle re...

Final Survey for Central America. (DOCX)

Researchers have developed missing data handling techniques for estimating interaction effects in multiple regression. Extending to latent variable interactions, we investigated full information maximum likelihood (FIML) estimation to handle incompletely observed indicators for product indicator (PI) and latent moderated structural equations (LMS)...

In June of 1987, Dr. William Behringer tested positive for the Human Immunodeficiency Virus (HIV) and was diagnosed with Acquired Immunodeficiency Syndrome (AIDS) (Behringer v. The Medical Center at Princeton 1991). Behringer was a practicing surgeon at the Medical Center at Princeton, which is also where he was diagnosed. Within hours of receiving...

Purpose The schedule of attitudes toward hastened death (SAHD) is widely used to assess the wish to hasten death (WTHD) among patients with life-threatening conditions. A short form of the SAHD would increase its clinical applicability in this population. Method Rasch analysis of data from 101 Spanish palliative inpatients. Item reduction involved...

As the populations of Western countries become more diverse, the risk of inaccurately generalizing knowledge from majority ethnic groups to minority groups is increasing. However, few of the measures used in forensic assessment are based on normative samples that represent the considerable diversity present in forensic settings. This study examined...

Aims To establish preliminary evidence for the feasibility, acceptability, and utility of an abbreviated version of Meaning-Centered Psychotherapy tailored to the needs of palliative care patients in the final weeks or months of life. Background Surprisingly, few mental health interventions have specifically targeted the psychological needs of pal...

Desire for hastened death (DHD) represents a wish to die sooner than might occur by natural disease progression. Efficient and accurate assessment of DHD is vital for clinicians providing care to terminally ill patients. The Schedule of Attitudes Toward Hastened Death (SAHD) is a commonly used self-report measure of DHD. The goal of this study was...

The Juvenile Sex Offender Assessment Protocol–Revised (J-SOAP-II) is the most commonly used measure in the assessment of recidivism risk among juveniles who have committed sexual offenses (JSOs), but mixed support exists for its predictive validity. This study compared the predictive validity of the J-SOAP-II across two offender characteristics, ag...

Background: The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to de...

The United States accepts more refugees than any other industrialized nation. As refugee populations grow, mental health professionals must implement culturally and ethnically appropriate strategies to assess and treat individuals from diverse backgrounds. Culture can exert a powerful and often misunderstood influence on psychological assessment, a...

This study examined the internal validity and predictive accuracy of the Guidelines for Stalking Assessment and Management (SAM), a structured professional judgment risk assessment tool for stalking. Interviewers rated 89 stalking offenders on the Psychopathy Checklist: Screening Version (PCL:SV) and SAM Nature (N) and Perpetrator (P) subscales. Re...

The objectives of this study were to (1) examine psychopathic traits within a sample of individuals charged with stalking behaviours, (2) examine the relationship between these traits and offence severity, and (3) determine whether the presence of psychopathic traits predicted drop-out from treatment. The sample consisted of 93 male offenders manda...

This study provides both a structural analysis of the Historical-Clinical-Risk Management–20 (HCR-20) Version 3 and an examination of the correspondence between the HCR-20 Versions 2 and 3. HCR-20 Versions 2 and 3 risk ratings were completed for 64 psychiatric inpatients. Moderate to good interrater reliability was observed for the Version 3 subsca...

Identifying depression in older adults with cancer presents a set of unique challenges, as it combines the confounding influences of cancer and its treatment with the developmental changes associated with aging. This paper reviews the phenomenology of depression in older adults, and individuals diagnosed with cancer. PsychInfo, PubMed, Web of Scien...