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Author: Jennie L Ponsford (58)


Jan
2018

The aim of this study was to evaluate the impact of computer-assisted "drill-and-strategy" cognitive remediation (CR) for community-dwelling individuals with schizophrenia on cognition, everyday self-efficacy, and independent living skills.
Fifty-six people with schizophrenia or schizoaffective disorder were randomized into CR or computer game (CG) playing (control), and offered twenty 1-hr individual sessions in a group setting over 10 weeks. Measures of cognition, psychopathology, self-efficacy, quality of life, and independent living skills were conducted at baseline, end-group and 3 months following intervention completion.

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Dec
1969

The study aimed to determine the efficacy of melatonin supplementation for sleep disturbances in patients with traumatic brain injury (TBI).
This is a randomised double-blind placebo-controlled two-period two-treatment (melatonin and placebo) crossover study. Outpatients were recruited from Epworth and Austin Hospitals Melbourne, Australia.

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Jan
2018

To characterise on-road driving performance in individuals with traumatic brain injury who fail on-road driving assessment, compared with both those who pass assessment and healthy controls, and the injury and cognitive factors associated with driving performance.
Cross-sectional.
Forty eight participants with traumatic brain injury (Age M = 40.

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Dec
2017

The objective of this systematic review is to synthesize the best available evidence on the effectiveness and harms of pharmacotherapy as compared to all types of comparators for the management of neurobehavioral symptoms in post-traumatic amnesia in adults aged 16 years and over who have sustained a traumatic brain injury. This review forms part of a larger project which aims to gather the evidence for the pharmacological treatment of neurobehavioral symptoms post traumatic brain injury as a prelude to the development of a clinical guideline.

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Dec
1969

A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking.
To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI.

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Nov
2017

Recent research has provided extensive characterization as to the frequency and nature of sleep disturbances following traumatic brain injury (TBI). This review summarizes the current state of knowledge and proposes future directions for research.
Complaints of sleep disturbance are common following TBI, and objective assessments of sleep largely corroborate these complaints.

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Jun
2017

A systematic review of factors that might be associated with, or influence, clinical recovery from sport-related concussion. Clinical recovery was defined functionally as a return to normal activities, including school and sports, following injury.
Systematic review.

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May
2017

The objective of this study was to evaluate the effectiveness of individual cognitive behavioural therapy (CBT) for post-stroke fatigue and sleep disturbance compared to treatment as usual (TAU). In a parallel two-group pilot randomised controlled trial of 15 participants, nine were allocated to eight weekly sessions of adapted CBT and six continued usual care rehabilitation. The primary outcome was the Fatigue Severity Scale (FSS-7) at two and four months from baseline.

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May
2017

To examine the frequency and nature of postconcussive symptoms (PCSs) and behavioral outcomes in young children following mild traumatic brain injury (mTBI) or concussion.
Emergency department.
Children aged 2 to 12 years presenting with either a concussion or minor bodily injury (control).

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Apr
2017

Valued living (VL) is associated with improved enjoyment and engagement with daily activities despite negative emotional state or ongoing pain. However, the role of VL in recovery following traumatic brain injury (TBI) has yet to be investigated. This study aimed to examine changes in VL over the course of recovery and variables associated with VL.

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Dec
1969

To evaluate the efficacy of adapted cognitive behavioral therapy (CBT) for sleep disturbance and fatigue in individuals with traumatic brain injury (TBI).
Parallel 2-group randomized controlled trial.
Outpatient therapy.

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Apr
2017

Behaviours of Concern (BoC) are a debilitating consequence of Traumatic Brain Injury (TBI). Whilst perspectives of clinicians, carers and family members on BoC have been previously explored, few qualitative studies have included individuals with TBI. The aim of this study was to explore the lived experience of BoC in individuals with TBI, their close others and clinicians.

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Dec
1969

The medial forebrain bundle (MFB) contains ascending catecholamine fibers that project to the prefrontal cortex (PFC). Damage to these fibers following traumatic brain injury (TBI) may alter extracellular catecholamine levels in the PFC and impede attention and working memory ability. This study investigated white matter microstructure of the medial MFB, specifically the supero-lateral branch (slMFB), following TBI, and its association with performance on attention and working memory tasks.

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Apr
2018

To describe the goals, processes, resources and outcomes of on-road training lessons provided to drivers with traumatic brain injury (TBI) who failed an initial occupational therapy (OT) driver assessment.
Descriptive cohort study using file audit design of 340 drivers with mild to severe TBI. Measures included; number and goals of on-road training lessons and reassessments, time from injury to independent driving, license restrictions, years licensed, physical/visual impairments and injury severity.

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Nov
2016

The aim of this study was to explore self-reported driving habits and the factors associated with these within the first three months of return to driving following traumatic brain injury (TBI). Participants included 24 individuals with moderate to severe TBI (post-traumatic amnesia duration M = 33.26, SD = 29.

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Nov
2016

The present study aimed to investigate whether self-awareness of falls risk is associated with rehabilitation engagement, motivation for rehabilitation, and number of falls after hospital discharge. The sample comprised 91 older adults (M=77.97, SD=8.

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Feb
2017

Traumatic brain injury (TBI) is associated with an elevated frequency of mood disorders that may, in part, be explained by changes in white-matter microstructure. This study is the first to examine the relationship between mood disorders and white-matter pathology in a sample of patients with mild to severe TBI using a standardized psychiatric interview. This study reports on a sub-sample of 29 individuals recruited from a large prospective study that examined the evolution of psychiatric disorders following complicated, mild to severe TBI.

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Feb
2017

The aim of this study was to develop and provide initial validation data for a self-awareness of on-road driving ability measure for individuals with brain injury.
Thirty-nine individuals with Traumatic Brain Injury completed an on-road driving assessment, the Self-Regulation Skills Interview (SRSI) and the newly developed Brain Injury Driving Self-Awareness Measure (BIDSAM).
BIDSAM self, clinician and discrepancy scales demonstrated high levels of internal consistency (α = 0.

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Jun
2017

To investigate the feasibility, safety and efficacy of extended-release methylphenidate in enhancing processing speed, complex attentional functioning and everyday attentional behaviour after traumatic brain injury.
Seven week randomised, placebo-controlled, double-blind, parallel pilot study.
Inpatient and outpatient Acquired Brain Injury Rehabilitation Program.

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Dec
1969

Sleep-wake disturbances are highly prevalent following traumatic brain injury (TBI), impeding rehabilitaion and quality of life. However, the mechanisms underlying these sleep disturnbances are unclear, and efficacious treatments are lacking. To investigate possible mechanisms underlying sleep disturbance in TBI, we examined characteristics of the circadian rhythm of melatonin, a hormone involved in sleep-wake regulation.

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Dec
1969

To examine self-rated, clinician-rated, and self-awareness of on-road driving performance in individuals with traumatic brain injury (TBI) deemed fit and unfit to resume driving and healthy controls, and to explore their associations with demographic, injury, cognitive, and mood variables.
Participants included 37 individuals with moderate to severe TBI, and 49 healthy age, sex, and education-matched controls from Australia and Canada. Participants completed an on-road assessment, the Brain Injury Driving Self-Awareness Measure (BIDSAM), and a comprehensive neuropsychological assessment.

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Dec
2015

The degree to which individuals with traumatic brain injury (TBI) and their close others share a common understanding and experience of post-injury neuropsychological changes is currently unclear. The aim of this preliminary study was to longitudinally examine levels of agreement between self and close other reports of neuropsychological dysfunction following TBI and explore factors associated with these agreement levels.
Sixty-three people with TBI and their nominated close others independently completed the Structured Outcome Questionnaire at 1- and 5-years post-injury, reporting whether the person with TBI was experiencing any negative cognitive, behavioural or emotional changes compared to pre-injury.

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Dec
1969

To examine pre- and post-injury self-reported driver behaviour and safety in individuals with traumatic brain injury (TBI) who returned to driving after occupational therapy driver assessment and on-road rehabilitation.
A self-report questionnaire, administered at an average of 4.5 years after completing an on-road driver assessment, documenting pre- and post-injury crash rates, near-crashes, frequency of driving, distances driven, driving conditions avoided and navigation skills, was completed by 106 participants, who had either passed the initial driver assessment (pass group n = 74), or required driver rehabilitation, prior to subsequent assessments (rehabilitation group n = 32).

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Dec
2015

To characterize self-awareness in older adults undergoing inpatient rehabilitation and explore factors associated with reduced awareness of falls risk.
Prospective, cross-sectional design.
Older adult inpatient rehabilitation setting.

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Jun
2016

Duration of post-traumatic amnesia (PTA) has emerged as a strong measure of injury severity after traumatic brain injury (TBI). Despite the growing international adoption of this measure, there remains a lack of consistency in the way in which PTA duration is used to classify severity of injury. This study aimed to establish the classification of PTA that would best predict functional or productivity outcomes.

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Jun
2016

Limited research has been conducted comparing different methods for determining the duration of posttraumatic amnesia (PTA). This study compared prospectively recorded PTA duration (P-PTA) with retrospective reports of the return of continuous memory (R-PTA).
Fifty-nine individuals admitted to a head injury rehabilitation unit with a traumatic brain injury who had their PTA duration recorded using the Westmead Post-Traumatic Amnesia Scale.

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May
2015

Despite the availability of evidence-based guidelines for the management of mild traumatic brain injury in the emergency department (ED), variations in practice exist. Interventions designed to implement recommended behaviours can reduce this variation. Using theory to inform intervention development is advocated; however, there is no consensus on how to select or apply theory.

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Dec
1969

This prospective longitudinal study aimed to identify rates and predictors of productivity outcomes (educational or vocational) at 1 year post-injury in young people studying prior to sustaining a traumatic brain injury (TBI).
A total of n = 145 with complicated mild-severe injuries, studying at secondary (45.2%) or tertiary (54.

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Aug
2015

The aim of this study was to examine the rate and causes of mortality following mild to severe traumatic brain injury (TBI) rehabilitation and to develop a multivariate prognostic model of mortality. We conducted a cohort study of 3341 individuals with mild to severe TBI followed-up from a post-acute inpatient rehabilitation center. Rate of death and survival between one and 26 years following injury were examined using standardized mortality ratios (SMRs) and prognostic models developed using Cox regression.

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Feb
2016

The ability to predict costs following a traumatic brain injury (TBI) would assist in planning treatment and support services by healthcare providers, insurers and other agencies. The objective of the current study was to develop predictive models of hospital, medical, paramedical, and long-term care (LTC) costs for the first 10 years following a TBI.
The sample comprised 798 participants with TBI, the majority of whom were male and aged between 15 and 34 at time of injury.

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Jul
2015

Prospective monitoring of posttraumatic amnesia (PTA) is recommended following moderate to severe traumatic brain injury (TBI). However, few studies have examined the typical order in which items recover on PTA scales. Different methods have been used to define recovery, and the order reported is not consistent across the literature.

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Dec
1969

Most studies of quality-of-life (QoL) after traumatic brain injury (TBI) reveal a largely negative picture, yet some survivors show positive changes (PC). Understanding PC in QoL may assist clinicians in facilitating post-injury adjustment. This study aimed to prospectively explore changes in QoL from pre- to post-injury, identify those with PC and examine predictive and associated factors.

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Mar
2015

To examine assessment outcomes and factors associated with passing an occupational therapy (OT) on-road driver assessment after traumatic brain injury (TBI).
Retrospective analysis of outcomes of on-road driver assessment completed by persons with TBI over an 8-year period.
Inpatient and outpatient rehabilitation hospital.

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Dec
1969

To examine self-awareness over the first year following traumatic brain injury (TBI) and the association of demographic, biological, cognitive, psychological and social-environmental factors with change in awareness.
Using a longitudinal design the progression of awareness and association of demographic and biopsychosocial factors with its trajectory were analysed using random effects regression.
Sixty individuals with mainly moderate-to-severe TBI completed assessments at 3, 6 and/or 12 months post-injury.

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Dec
1969

This study examined the relationship between the nature of feedback provided by close-others and self-awareness in individuals with traumatic brain injury (TBI). Using a cross-sectional design, 69 individuals with mild-to-severe TBI and their close-others completed the Awareness Questionnaire, Hospital Anxiety and Depression Scale, Trail Making Test-Part B and Feedback about Cognitive Difficulties Questionnaire, between 3 months and 20 years post-injury. Results showed cognitive and/or behavioural issues post-injury were identified in 97% of individuals with TBI and over 80% of these were provided with feedback by close-others at least sometimes after making errors.

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Jul
2014

Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes.

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Jul
2014

Research suggests that some older individuals may lack awareness of personal falls risk; however, there is no validated scale to measure self-awareness (SA) of falls risk in this population. Therefore, the objective of this study is to describe the development and psychometric evaluation of a new three part (intellectual, emergent, and anticipatory) SAFRM to be used in the older population undergoing inpatient rehabilitation. The SAFRM underwent a comprehensive scale development process.

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Jul
2014

To examine the stability of employment between 1 and 3 years following traumatic brain injury (TBI) and to identify the variables associated with continued employment throughout this time span.
This study included 236 individuals with predominantly moderate to very severe TBI, who had received rehabilitation in the context of a no-fault accident compensation system. Participants were eligible for the current study if they were employed before injury and reported their employment status at 1, 2, and 3 years following their injury as part of a longitudinal head injury outcome study.

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Jul
2014

To examine self-awareness and injury-related, emotional and demographic factors across acute/subacute (3-12 months), medium-term (24-60 months), and long-term (120-240 months) time periods after traumatic brain injury (TBI), because unawareness of injury-related changes can affect engagement in rehabilitation and functional outcomes.
A total of 168 individuals with mild to severe TBI and 105 of their close others.
Awareness Questionnaire (AQ) and Hospital Anxiety and Depression Scale.

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Mar
2014

Sleep and fatigue following traumatic brain injury.

Psychiatr Clin North Am 2014 Mar 10;37(1):77-89. Epub 2014 Jan 10.
Jennie L Ponsford, Kelly L Sinclair
This article reviews literature relating to sleep disturbance and fatigue after traumatic brain injury. It discusses the nature and prevalence of sleep disturbances associated with traumatic brain injury and the measures used to assess them. Potential causes are discussed, including damage to sleep-wake regulating centers, disruption of circadian timing of sleep, and secondary causes, such as pain, depression, and anxiety.

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May
2014

Fatigue is a common, persistent complaint following traumatic brain injury (TBI). Effective treatment is not well established.
.

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Dec
2013

The development and utilization of newer neuroimaging modalities provides the capability to more accurately detect the extent of pathology after TBI. The current study examined the ability of susceptibility-weighted imaging (SWI) to detect lesions after TBI as well as the relationship to subsequent clinical outcome. The performance of SWI was compared to that of fluid-attenuated inversion recovery (FLAIR).

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Jan
2014

The deleterious consequences of traumatic brain injury (TBI) impair capacity to return to many avenues of pre-morbid life. However, there has been limited longitudinal research examining outcome beyond five years post-injury. The aim of this study was to examine aspects of function, previously shown to be affected following TBI, over a span of 10 years.

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Oct
2013

There has been limited examination of the effect of brain pathology on subsequent function. The current study examined the relationships between regional variation in grey matter volume, age and cognitive impairment using a semi-automated image analysis tool. This study included 69 individuals with mild-to-severe TBI, 41 of whom also completed neuropsychological tests of attention, working memory, processing speed, memory and executive functions.

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Oct
2013

To examine the influence of self-reported preinjury coping on postinjury coping, psychosocial functioning, emotional functioning, and quality of life at 1 year following traumatic brain injury (TBI).
Inpatient hospital and community.
One hundred seventy-four participants with TBI.

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Oct
2013

Previous research has demonstrated that sexuality is compromised following traumatic brain injury (TBI).
The aim of this study was to determine the association between sexuality following TBI and demographic, injury-related, and postinjury variables (age, gender, time since injury, posttraumatic amnesia duration, independence in activities of daily activities (ADL), antidepressant use, depression, and self-esteem).
Participants included 986 individuals with predominantly moderate to severe TBI, who completed the Brain Injury Questionnaire of Sexuality (BIQS), the Hospital Anxiety and Depression Scale, and the Rosenberg Self-Esteem Scale and an ADL assessment on 1 or more occasions, providing a total of 1673 assessments across 1, 2, 3, 5, 10, and 20 years postinjury.

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Oct
2013

Previous research has suggested that sexuality is compromised following traumatic brain injury (TBI), but there has been limited comparison with healthy samples.
The aim of the current study was to compare sexuality in individuals with TBI with that in healthy controls matched for age and gender. In doing this, the current study aimed to characterize those individuals who reported a decrease in sexuality relative to those reporting an increase according to certain demographic and injury variables.

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Sep
2013

Traumatic brain injuries (TBI) impose a significant burden on the health care system. The aim of the current study was to explore variation in costs in a group of rehabilitation patients in Victoria, Australia, following complicated mild-to-severe TBI treated under the accident compensation system administered by the Transport Accident Commission. Study participants included 1237 individuals with mild-to-severe TBI recruited consecutively from a TBI rehabilitation program.

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Sep
2013

Sleep changes are frequently reported following traumatic brain injury (TBI) and have an impact on rehabilitation and quality of life following injury. Potential causes include injury to brain regions associated with sleep regulation, as well as secondary factors, including depression, anxiety, and pain. Understanding the nature and causes of sleep changes following TBI represents a vital step in developing effective treatments.

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