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Dive into the research topics where Mitchell S. Rosenthal is active.

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Featured researches published by Mitchell S. Rosenthal.


Neuropsychopharmacology | 1998

Persistent QEEG Abnormality in Crack Cocaine Users at 6 Months of Drug Abstinence

Kenneth Alper; Leslie S. Prichep; Sharon C. Kowalik; Mitchell S. Rosenthal; E. Roy John

The major objective of this study was to examine the persistence of abnormal quantitative EEG (qEEG) measures over a six month time interval in subjects in strictly supervised drug free residential treatment for crack cocaine dependence. Seventeen subjects were assessed with qEEG at five to 10 days, one month and six months following their last use of cocaine. No significant changes were noted over time in abnormal qEEG measures, which included deficits of absolute and relative power in the delta band and increased relative alpha power. The persistence of qEEG abnormality in crack cocaine withdrawal suggests a persistent neurobiologic alteration resulting from chronic cocaine exposure. The specificity of the qEEG findings is discussed, and an interpretation is suggested with reference to the hypothesis of neural sensitization in cocaine dependence.


Biological Psychiatry | 1996

Quantitative electroencephalographic characteristics of crack cocaine dependence

Leslie S. Prichep; Kenneth Alper; Sharon C. Kowalik; Henry Merkin; MeeLee Tom; E. Roy John; Mitchell S. Rosenthal

This study replicates preliminary findings reporting a quantitative electroencephalographic (QEEG) profile of crack cocaine dependence in abstinence. All subjects (n = 52) met criteria for DMS-III-R cocaine dependence (in the form of crack), and were residing in a drug-free therapeutic community. Baseline QEEG evaluations were conducted at intake (5-10 days after last use of crack, and at follow-up (1 month after last reported use). Previous findings of significant excess of relative alpha power and deficit of absolute and relative delta and theta power were replicated in this expanded group. Abnormalities were greater in anterior than posterior regions, and disturbances in interhemispheric relationships were also observed. Further, QEEG showed little change in the interval between the first and second evaluations. This QEEG profile may reflect persistent alterations in neurotransmission as a possible consequence of chronic cocaine exposure.


American Journal of Drug and Alcohol Abuse | 1979

Therapeutic community dropouts: criminal behavior five years after treatment.

George De Leon; Margaret Andrews; Harry K. Wexler; Jerome Jaffe; Mitchell S. Rosenthal

Two hundred and two male dropouts, mainly heroin abusers averaging 3 to 6 years out of treatment, were sampled from the 1970-1971 Phoenix House admissions by race and time in program (less than 1 month to more than 2 years). Criminal justice arrest records were compared between three pre- and all posttreatment years. Percent and rate of arrest declined significantly in followup. Magnitude of reductions was uniform across race and legal status, varied by age, but increased systematically by time in program. Results replicated and extended earlier findings, confirming long-term positive change in criminal behavior associated with length of stay in the therapeutic community.


Clinical Eeg and Neuroscience | 2002

Outcome Related Electrophysiological Subtypes of Cocaine Dependence

Leslie S. Prichep; Kenneth Alper; Lev Sverdlov; Sharon C. Kowalik; Erwin Roy John; Henry Merkin; MeeLee Tom; Bryant Howard; Mitchell S. Rosenthal

We previously described the existence of two quantitative EEG (QEEG) subtypes of cocaine dependent males, identified at baseline, displaying differential pronenessto relapse. The current study expands the population to include females and enhances the measure set to include both QEEG and somatosensory EP (SEP) features. Fifty-seven cocaine dependent adults (16 F, 41 M) were evaluated 5–14 days after last cocaine use, while in residence at a drug-free therapeutic community. The median length of stay in treatment (continued abstinence) was 25 weeks. Using a small subset of QEEG and SEP baseline features, three subtypes (CLUS) were identified. CLUS 2 (n=25) and CLUS 3 (n=23) replicated the published subtypes, while CLUS 1 (n=9) was previously undescribed. Cluster membership was significantly associated with length of stay in treatment (χ2=13.789, P<0.001), but not with length of exposure to crack cocaine or to any demographic or clinical features. Seventy-eight percent of CLUS 1 and 65% of CLUS 3 left treatment ≤ 25 weeks, whereas 80% of CLUS 2 remained in treatment > 25 weeks. The existence of outcome related subtypes may reflect: [1] differential neurophysiological vulnerability, “traits,” predisposing individuals to cocaine addiction; or [2] differential neurosensitivity, “states,” due to the effects of chronic cocaine exposure, and associated differences in treatment outcome. Using Variable Resolution Electrical Tomographic Analysis (VARETA), the mathematically most probable neuroanatomical source of the scalp recorded EEG data was localized. Computation of VARETA on the baseline Cluster profiles suggest significant differences in the underlying pathophysiology of these subtypes.


Drug and Alcohol Dependence | 1999

Prediction of treatment outcome in cocaine dependent males using quantitative EEG

Leslie S. Prichep; Kenneth Alper; Sharon C. Kowalik; Larisa S. Vaysblat; Henry Merkin; MeeLee Tom; E. Roy John; Mitchell S. Rosenthal

This study investigates the existence of outcome related neurophysiological subtypes within a population of abstinent cocaine dependent adults. We have previously reported and replicated the existence of a distinctive quantitative EEG (QEEG) profile in such a population, and demonstrated the persistence of this pattern at one and six month follow-up evaluations. This profile is characterized by significant deficits of absolute and relative delta and theta power, and excess of relative alpha power, as compared with age expected normal values. Abnormalities were greater in anterior than posterior regions, and disturbances in interhemispheric relationships were also observed. In the current study, 35 adult males with DSM-III-R cocaine dependence, were evaluated while residents of a drug-free residential therapeutic community, 5-15 days after last use of crack cocaine. Using multivariate cluster analysis, two neurophysiological subtypes were identified from the baseline QEEGs; Cluster 1 characterized by significant deficits of delta and theta activity, significant excess of alpha activity and more normal amounts of beta activity (alpha CLUS) and Cluster 2 characterized by deficits of delta, more normal amounts of theta and anterior excess of alpha and beta activity beta CLUS). No significant relationships were found between QEEG subtype membership and length of exposure to cocaine, time since last use of cocaine or any demographic characteristics. Further, no significant relationships were found between the commonly reported comorbid clinical features of depression and anxiety and subtype membership. However, a significant relationship was found between QEEG subtype membership and length of stay in treatment, with members of the alpha CLUS retained in treatment significantly longer than members of the beta CLUS.


Journal of Substance Abuse Treatment | 1984

Therapeutic communities: a treatment alternative for many but not all

Mitchell S. Rosenthal

Therapeutic communities (TCs) provide the most comprehensive form of drug abuse treatment and offer an established route of recovery from all forms of drug abuse. They employ 24-hour-a-day residential treatment that optimally lasts for 15 or more months. The goal of treatment is return of the client to society as a drug-free and productive member. Rehabilitation is viewed as global and involves efforts to remedy chronic social, economic, and educational deficits. Drug abuse is perceived as a disorder of the whole person, and treatment based on social learning and self-help. Clients suitable for treatment are most often chronic drug abusers with some degree of psychological dependency. Criminal involvement (unless it includes a history of violence, sexual abuse, or arson) is considered behavior that can be addressed within the TC. Suitable candidates often show signs of social dysfunction, anti-social behavior, dysfunctional family relationships, an inability to maintain interpersonal relationships, and acute or chronic dysfunction in the workplace or in mainstream academic settings. The TC is capable of treating clients with a considerable range of emotional disturbance-including even profound character disorder, but frank psychiatric illness has typically been recognized as a cause for exclusion. Outcome studies show a long-term success rate of more than 75% for those who complete treatment, and a maximum to moderate success rate among half of the clients who drop out. However, attempts to determine characteristics of those clients most likely to succeed have not proven very revealing.


Journal of Substance Abuse Treatment | 1994

HIV antibody testing and client retention in the therapeutic community

Isidoro Gonzalez; Mitchell S. Rosenthal; Mark O. Bigler; Kenneth Alper; Wendy M. Geringer

This report describes the current approach to testing for the human immunodeficiency virus (HIV) antibody at Phoenix House, a large therapeutic community (TC) in the northeastern United States, and presents findings on retention of clients who have been tested for HIV antibodies and notified of their HIV serostatus. A total of 240 clients were tested while in treatment at Phoenix House between April 1988 and July 1992. Of these, 51 tested HIV positive. An additional 76 clients had tested positive for HIV antibodies prior to entering treatment. The difference in length of treatment stay between those who tested negative while in treatment and those who tested positive while at Phoenix House was not significant (t = 0.41, df = 238, p > .683). Although clients who tested seronegative during treatment were found to remain in treatment a significantly longer amount of time than the total population of seropositive clients (t = 4.54, df = 314, p < .001), those who learned of their seropositive status while in treatment remained in the program longer than clients who entered treatment aware of their seropositivity (t = 4.08, df = 125, p < .001). These findings suggest that acute reactions to the knowledge of seropositivity did not determine most premature terminations. The use of a small group, a core technical element of the TC, may have provided a favorable context for the task of HIV counseling and testing.


Archive | 2002

Electrophysiologic Evidence of Neural Injury or Adaptation in Cocaine Dependence

Kenneth Alper; Leslie S. Prichep; E. Roy John; Sharon C. Kowalik; Mitchell S. Rosenthal

The electroencephalogram (EEG) is an emergent phenomenon of neural activity, which suggests that the EEG might reflect the apparently abnormal neurobiology observed in cocaine dependence. The EEG is noninvasive, inexpensive, and quantitative analysis of the EEG (QEEG) is based on information processing technology that is constantly growing with respect to analytic power and accessibility. Clinically, QEEG has been shown to be sensitive to psychiatric conditions, such as depression or attention deficit hyperactivity disorder (ADHD) that are often comorbid with cocaine dependence (1–3). Pretreatment QEEG has been shown to be predictive of subsequent psychotropic drug response in patients with a variety of psychiatric disorders evaluated prospectively (4,5). Neural injury or adaptation in cocaine dependence resulting in changes in the underlying sources of the EEG and reflected quantitatively in the QEEG, could be relevant to “staging” the disorder with respect to the identification of reversible vs irreversible components, and could potentially provide an approach to the development or selection of treatment. This chapter focuses on data obtained from a large population of cocaine-dependent subjects in our ongoing National Institute on Drug Abuse (NIDA) funded work on cocaine dependence. The chapter first provides a brief overview of structural and metabolic imaging studies in cocaine dependence, then reviews studies of EEG power spectral findings in chronic cocaine exposure in animals and humans, and our work on persistence of QEEG abnormality and evidence of electrophysiologic heterogeneity and its clinical correlates in cocaine dependence. Lastly, we attempt an interpretation of our QEEG findings will be considered in the context of hypothetical mechanisms of neural injury or adaptation.


Archives of General Psychiatry | 1973

Phoenix House: Changes in Psychopathological Signs of Resident Drug Addicts

George De Leon; Andrew E. Skodol; Mitchell S. Rosenthal


JAMA | 1972

Phoenix House. Criminal activity of dropouts.

George De Leon; Sherry Holland; Mitchell S. Rosenthal

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