Rhea Dornbush - Academia.edu (original) (raw)

Papers by Rhea Dornbush

Academic Psychiatry

One model is presented for a behavioral science course for medical schools with large classes in ... more One model is presented for a behavioral science course for medical schools with large classes in the preclinical year. A study was undertaken to evaluate the ability to prepare students in behavioral science regardless of college background in this area. Three classes, entering in 1971, 1972, and 1973, were compared as to their college background in the behavioral sciences, performance in a behavioral science course taught in the preclinical years of medical school, performance in the behavioral science examination of the National Board of Medical Examiners, and in part, later performance in clinical clerkships. It was determined that when a comprehensive course is presented behavioral science can be taught successfully to large classes with students of diverse behavioral science backgrounds; that this can compensate for inadequate behavioral science preparation in college; that the early presentation of material on disordered behavior has a positive effect on learning; and that this preclinical learning may enhance clinical performance.

Trauma Surgery & Acute Care Open, 2021

Background Post-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequ... more Background Post-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or screening tools at different time points in patients hospitalized after admission to the hospital after significant physical trauma, but with stable vitals (level II trauma). Methods Patients completed the ‘initial question’ and the National Stressful Events Survey Acute Stress Disorder Scale (NSESSS) at 3 days to 5 days after trauma (NSESSS-1). The same scale was administered 2 weeks to 4 weeks after trauma (NSESSS-2). The Posttraumatic Stress Disorder Symptoms Scale Interview for DSM-5 (PSSI-5) was administered 2 months after trauma. PTSD diagnosis and PTSD severity were extracted from the PSSI-5. Linear multivariate regression analyses were used to establish whether scores for NSESSS-1 ...

Journal of Psychiatric Education, 1978

An evaluation of Cotrans students at New York Medical College (NYMC) indicated that while their N... more An evaluation of Cotrans students at New York Medical College (NYMC) indicated that while their NBME Part I scores in Psychiatry were significantly lower than the performance of NYMC’s own students and lower than the national mean, their performance in their psychiatric clinical clerkships, based on faculty evaluations, were indistinguishable from NYMC students; their performance in the NBME Part II in Psychiatry while lower than NYMC’s own students was above the national mean. Although there has been concern about the capabilities and background of Cotrans students, this evaluation suggests that with a good didactic and clinical training program Cotrans students can attain a level of performance equal to that of medical students educated entirely in this country.

Community Mental Health Journal

This report describes the development, implementation and outcomes of a "COVID-19 Anxiety Hotline... more This report describes the development, implementation and outcomes of a "COVID-19 Anxiety Hotline," designed to address the community's mental health crisis provoked by the coronavirus pandemic. The service was specifically designed using survey data regarding the effects of the COVID-19 pandemic on its staff and community members. Callers had aroundthe-clock direct access to mental healthcare providers at no cost. Quantitative analysis showed that nearly three out of four callers experienced new onset anxiety and insomnia driven by fear of exposure, and had difficulty accessing mental health care. In addition to immediate support, referral to tele-mental health care was provided to 86% of callers. Qualitative analysis indicates the effectiveness of immediate support and appropriate referrals using a tele-health platform. Our report indicates that the service was utilized by the general population, by health care workers, and rapidly provided referrals to individuals with limited access to mental health care during the pandemic.

Journal of Psychiatric Research

The American Journal of Geriatric Psychiatry

Introduction The cerebellum is historically known to modulate and control motor functions and rec... more Introduction The cerebellum is historically known to modulate and control motor functions and recently has gained attention to be studied for potential role in cognitive functions and affect regulation. The cerebellum is a complex structure with high neuronal density located in the hind brain and functions as a co-processor of movements in coordination with cerebral cortex and basal ganglia (1). The deficiencies in motor functions secondary to cerebellar lesions were first introduced as cerebellar syndrome (2). In late 1990’s Schmahmann and colleagues described cases of significant neuropsychological deficits among patients with isolated cerebellar lesions characterized by executive function deficits, linguistic problems and personality changes with decline in intellectual function (3). Years after the description, there is still reluctance among clinicians to accept the role of the cerebellum beyond non-motor functions, especially with respect to cognition and affective modulation. The literature hardly appreciates the deficits related to cerebellar lesions, although there is some acknowledgement in cases as postoperative pediatric cerebellar mutism syndrome (4. 5). There is a growing body of evidence that the cerebellum works in concert with mid-brain and cerebral cortex and hence is involved in regulation of cognitive function and affect modulation along with the motor functions. Methods chart review/literature search through pubmed on topics of cerebellum+cognition+affect Results In this report we present a case of cerebellar lesion in a patient with long-standing bipolar illness presenting with decline in cognitive function and affective modulation. We will review the proposed non-motor functions of cerebellum as an outcome of bidirectional neuronal networks connecting cerebellum to cortical and midbrain regions supporting the functional hypothesis of an integrated system. We will discuss the interventional limitations and ethical challenges associated with interventions for apparently benign intracranial lesions but with significant impact on the cognitive function and health related quality of life. Ms. Z is a 65-years-old woman with previous psychiatric history significant for bipolar disorder, compliant with the medications, who was re-admitted with worsening depression, anxiety and disorganization less than three months following discharge for similar reasons. Patient reported progressive difficulties with daily living tasks becoming dependent on her caretaker along with the speech and memory deficits. Patient had been on fluoxetine and clonazepam. Over the course of stay, her medications were optimized with standing regimen of fluoxetine, lithium and clonazepam. Patient reported improved stable mood but continued to report difficulties in focus, recall and word finding difficulties with associated anxiety. Neurophysiological testing was performed as work up for possible dementia and neurology service was consulted. Magnetic resonance imaging revealed dura based right posterior fossa mass (2.5 × 1.9 × 2.6?cm (AP x TV x CC)), along the posterior table of right petrous temporal bone with mass effect on the right cerebellar hemisphere. Positron emission topography scan of brain returned with normal physiological metabolic activity. Patient and her health care proxy did not consent for cerebrospinal fluid testing for further dementia workup. Physical examination was insignificant for cerebellar motor function impairment. She showed deficits on detailed Neuropsychological testing in spatial cognition, working memory and abstract reasoning. Neurosurgery service was consulted for posterior fossa mass and did not recommend surgical intervention, citing concerns over preserved motor functions. Patient was diagnosed with working diagnosis of cerebellar-cognitive-affective syndrome. Advancement in the imaging modalities has enhanced the understanding of cerebellar organization and function. During the central nervous system development, the cerebellum enlarges parallel to prefrontal and association cortices (6, 7). Observations from functional magnetic resonance imaging (fMRI) studies indicate cerebellar functional organization of cognitive functions with lateral cerebellar distribution while medial localization of sensory-motor functions (8). Our patient had word finding difficulties and it is reported that lesions of right posterior cerebellar hemisphere can impair linguistic function among individuals who are left cerebral hemisphere language dominant (9). It is also reported that lateral posterior cerebellum make reciprocal connections with prefrontal cortex and Broca's area (9, 14). Current literature suggests that cognitive and limbic regions are localized in the posterior lobules (VI and VII) of the cerebellum with lateralization of cognitively relevant areas. (1). As in our case, lesions of posterior lobe are reported to present as constellation of symptoms from impaired executive function and…

The American Journal of Medicine

BACKGROUND The Beck Depression Inventory (BDI-II) may be used to evaluate individuals for symptom... more BACKGROUND The Beck Depression Inventory (BDI-II) may be used to evaluate individuals for symptoms of depression. METHODS In a 1-year prospective study, 52 adult Lyme disease patients with erythema migrans and 104 matched control subjects were clinically assessed and completed the BDI-II at study entry and approximately 6 and 12 months later following antibiotic treatment. RESULTS The mean BDI-II score was significantly higher at the baseline visit among Lyme disease patients compared with controls (P = .002), but no significant differences between the groups were observed at either the 6- or 12-month study visits. Over the course of the study, the mean BDI-II scores decreased an average of approximately 0.22 points per month (P < .0005) for Lyme disease patients, whereas the mean scores changed very little for controls (mean change = -0.02 per month, P = .50). The total number of somatic symptoms, of the 12 symptoms evaluated, strongly and directly correlated with the BDI-II scores at the baseline visit for the Lyme disease patients. CONCLUSIONS The mean BDI-II scores of patients with early Lyme disease significantly exceeded that of matched controls at study entry, but by 6 months the values did not differ significantly. There was a good-to-excellent direct correlation between the BDI-II score and the total number of symptoms, suggesting that the BDI-II scores were reflecting somatic rather than affective depressive symptoms. When using the BDI-II as an assessment tool of patients with Lyme disease, infection-related somatic symptoms per se need to be considered in the interpretation of the results.

Pharmacol Biochem Behav, 1976

Psychonomic Science, 1966

The results of two discrimination experiments are presented. In the first, five-year olds learned... more The results of two discrimination experiments are presented. In the first, five-year olds learned size discriminations more rapidly with stereometric stimuli than with pattern stimuli; for seven-year olds there was little difference in learning the two discriminations. In Experiment II five-year olds learned size discriminations between perspective stimuli more rapidly than between control patterns without perspective. As in Experiment I both discriminations were equally easy for the seven-year olds. It was concluded that stimuli with depth provide added cues on which to base size discriminations.

Journal of Experimental Psychology, 1968

A transfer experiment with 56 Ss examined the role that knowledge of item position plays in seria... more A transfer experiment with 56 Ss examined the role that knowledge of item position plays in serial learning (SL). Paired-associate (PA) learning of numbers (as stimulus items) paired with nonsense syllables provided knowledge of the absolute positions of the syllables in subsequent SL to 1 group and knowledge of relative position to a 2nd, while for a 3rd group there was no correspondence at all between the numerals of PA and item position in SL. A 4th group for whom syllables (as response items) were paired with words served as a control. Prior knowledge of absolute positions was found to be of significant aid in SL, showing the greatest effect for the middlemost items. Those Ss given knowledge of relative positions learned more rapidly than did the control.

Marijuana and Health Hazards, 1975

Diseases of the nervous system

Annals of the New York Academy of Sciences

Journal of the National Medical Association

The use of phencyclidine (PCP) was investigated in the psychiatric population of an East Harlem, ... more The use of phencyclidine (PCP) was investigated in the psychiatric population of an East Harlem, New York, hospital. Sixty-eight consecutive PCP-user admissions were interviewed through a 77-item questionnaire. The patient population served by the facility was 48 percent Hispanic and 32 percent black. The sample of PCP users was 86 percent black. This suggests that, in this area, either more blacks use PCP, or nonblack PCP users seek psychiatric help less frequently than black users. This study emphasizes the many problems affecting the sample population and shows evidence that a large portion of the sample is at risk to develop psychiatric symptoms. Phencyclidine (PCP) was synthesized in 1956 and was used for several years as an anesthetic for surgical procedures. Its use as an anesthetic was discontinued in 1966 because of undesirable side