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Kerimofski KL, Panton KR, Pestell CF. Australian psychologists' knowledge, confidence, and practices in fetal alcohol spectrum disorder diagnostic assessment. Alcohol Clin Exp Res (Hoboken) 2024; 48:653-666. [PMID: 38316430 DOI: 10.1111/acer.15275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a neurodevelopmental disorder caused by prenatal alcohol exposure (PAE). There are many documented barriers to FASD diagnostic assessment, including a limited number of trained clinicians. This study aimed to establish baseline levels of Australian psychologists' knowledge and practices in FASD assessment to develop training and improve future diagnostic capacity. METHODS An online survey was completed by 106 Australian psychologists. The survey elicited respondents' demographics, knowledge about FASD, confidence in various aspects of assessment and perceived future training needs. RESULTS Respondents reported a broad understanding of the FASD diagnostic term and potential harm of prenatal alcohol exposure (PAE). However, most respondents were not confident in their ability to conduct the psychometric assessments that provide a diagnostic assessment of FASD or ask about PAE. There was a significant positive correlation between the number of correct knowledge items and the psychologists' confidence in conducting FASD assessments. The clinical neuropsychologists demonstrated significantly greater knowledge and confidence in applying FASD diagnostic criteria and assessing PAE than school, clinical, and other psychologists. Most psychologists were more confident in their ability to apply the diagnostic criteria for other neurodevelopmental disorders. CONCLUSIONS Recognition of FASD is growing in Australia, however, further work is required to improve clinicians' understanding of and confidence in completing FASD assessments. Most participants indicated a preference for online training to learn more about FASD assessment.
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Affiliation(s)
- Katherine L Kerimofski
- School of Psychological Science, University of Western Australia (WA), Crawley, Western Australia, Australia
| | - Kirsten R Panton
- School of Psychological Science, University of Western Australia (WA), Crawley, Western Australia, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia (WA), Crawley, Western Australia, Australia
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2
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Kerry J, Tan GKY, Panton KR, Mutch R, Freeman J, Passmore H, Pestell CF. Neuropsychological profiles of adolescents sentenced to detention in Western Australia with and without prenatal alcohol exposure. Crim Behav Ment Health 2024; 34:163-181. [PMID: 38268129 DOI: 10.1002/cbm.2329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 01/04/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND/AIMS Youth with prenatal alcohol exposure (PAE) are under-recognised in the justice system, warranting improved identification. This study aimed to compare neuropsychological profiles of adolescents, with and without PAE and identify neuropsychological tasks predictive of PAE-group membership. It was hypothesised that participants with PAE would score significantly lower on neuropsychological tests. METHODS Participants included 85 young people sentenced to detention (mean 15.7 years, 78 males), 46 with PAE. A one-way-multivariate analysis of variance tested differences in neuropsychological functioning between PAE/No-PAE groups, while logistic regression determined tests predictive of PAE. RESULTS No statistically significant difference in test scores emerged between groups, and regression was not indicative of any models predictive of PAE-group membership. Neuropsychological profiles were characterised by both strengths and weaknesses, with lower verbal and mathematical skills. CONCLUSION(S) While no statistically significant differences were found between the groups, the results provided a unique insight into the neurocognitive profile of Australian youth in detention. Routine screening assessments were recommended for young people sentenced to detention.
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Affiliation(s)
- Jed Kerry
- School of Psychological Science, University of WA, Perth, Western Australia, Australia
| | - Grace Kuen Yee Tan
- School of Psychological Science, University of WA, Perth, Western Australia, Australia
| | - Kirsten R Panton
- School of Psychological Science, University of WA, Perth, Western Australia, Australia
| | - Raewyn Mutch
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Perth, Western Australia, Australia
- Department of General Paediatrics, Child and Adolescent Health Service, Perth Children's Hospital, Perth, Western Australia, Australia
- Department of Health, Perth, Western Australia, Australia
- Department of Paediatrics, Faculty of Health and Medical Sciences, Medical School, University of WA, Perth, Western Australia, Australia
- Faculty of Health Sciences, Curtin Medical School, Curtin University, Bentley, Perth, Western Australia, Australia
- Invited Faculty, Harvard Program for Refugee Trauma, Harvard Medical School and School of Public Health and Massachusetts General Hospital, Cambridge, Massachusetts, USA
| | - Jacinta Freeman
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Perth, Western Australia, Australia
| | - Hayley Passmore
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Perth, Western Australia, Australia
- School of Law, University of WA, Crawley, Perth, Western Australia, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of WA, Perth, Western Australia, Australia
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, Perth, Western Australia, Australia
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Thorne J, Hellewell SC, Cowen G, Ring A, Jefferson A, Chih H, Gozt AK, Buhagiar F, Thomas E, Papini M, Bynevelt M, Celenza A, Xu D, Honeybul S, Pestell CF, Fatovich D, Fitzgerald M. Symptoms Associated With Exercise Intolerance and Resting Heart Rate Following Mild Traumatic Brain Injury. J Head Trauma Rehabil 2024:00001199-990000000-00129. [PMID: 38453632 DOI: 10.1097/htr.0000000000000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
OBJECTIVES People may experience a myriad of symptoms after mild traumatic brain injury (mTBI), but the relationship between symptoms and objective assessments is poorly characterized. This study sought to investigate the association between symptoms, resting heart rate (HR), and exercise tolerance in individuals following mTBI, with a secondary aim to examine the relationship between symptom-based clinical profiles and recovery. METHODS Prospective observational study of adults aged 18 to 65 years who had sustained mTBI within the previous 7 days. Symptoms were assessed using the Post-Concussion Symptom Scale, HR was measured at rest, and exercise tolerance was assessed using the Buffalo Concussion Bike Test. Symptom burden and symptom-based clinical profiles were examined with respect to exercise tolerance and resting HR. RESULTS Data from 32 participants were assessed (mean age 36.5 ± 12.6 years, 41% female, 5.7 ± 1.1 days since injury). Symptom burden (number of symptoms and symptom severity) was significantly associated with exercise intolerance (P = .002 and P = .025, respectively). Physiological and vestibular-ocular clinical profile composite groups were associated with exercise tolerance (P = .001 and P = .014, respectively), with individuals who were exercise intolerant having a higher mean number of symptoms in each profile than those who were exercise tolerant. Mood-related and autonomic clinical profiles were associated with a higher resting HR (>80 bpm) (P = .048 and P = .028, respectively), suggesting altered autonomic response for participants with symptoms relating to this profile. After adjusting for age and mechanism of injury (sports- or non-sports-related), having a higher mood-related clinical profile was associated with persisting symptoms at 3 months postinjury (adjusted odds ratio = 2.08; 95% CI, 1.11-3.90; P = .013). CONCLUSION Symptom-based clinical profiles, in conjunction with objective measures such as resting HR and exercise tolerance, are important components of clinical care for those having sustained mTBI. These results provide preliminary support for the concept that specific symptoms are indicative of autonomic dysfunction following mTBI.
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Affiliation(s)
- Jacinta Thorne
- Author Affiliations: School of Allied Health (Ms Thorne and Mr Ring) and Curtin Medical School (Drs Cowen, Jefferson, and Xu), Faculty of Health Sciences, Curtin Health Innovation Research Institute (Mss Thorne and Papini and Drs Hellewell, Cowen, Gozt, Pestell, and Fitzgerald), and School of Population Health (Drs Chih, Thomas, and Xu), Curtin University, Bentley, Western Australia; Perron Institute for Neurological and Translational Science, Nedlands, Western Australia (Mss Thorne and Papini and Drs Hellewell, Gozt, and Fitzgerald); Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia (Mr Ring); School of Psychological Science (Drs Buhagiar and Pestell) and Divisions of Surgery (Dr Thomas) and Emergency Medicine (Dr Celenza), School of Medicine, The University of Western Australia, Nedlands, Western Australia; Neurological Intervention & Imaging Service of Western Australia (Dr Bynevelt) and Emergency Department (Dr Celenza), Sir Charles Gairdner Hospital, Nedlands, Western Australia; The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China (Dr Xu); Sir Charles Gairdner, Royal Perth and Fiona Stanley Hospitals, Perth, Western Australia (Dr Honeybul); Emergency Medicine, Royal Perth Hospital, University of Western Australia (Dr Fatovich); and Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, Western Australia (Dr Fatovich)
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Green DJ, Silva GO, Smith KJ, Maslen BA, Cox KL, Lautenschlager NT, Pestell CF, Ainslie PN, Haynes A, Naylor LH. Impact of Water- and Land-Based Exercise Training on Risk Factors and Vascular Function in Middle-Aged and Older Men and Women. Med Sci Sports Exerc 2024; 56:230-237. [PMID: 37710393 DOI: 10.1249/mss.0000000000003302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Exercise improves vascular function, but it is unclear whether benefits are mediated by traditional cardiovascular risk factors or whether sex differences in training effects exist in older adults. We hypothesized that exercise would improve cardiovascular risk factors, that males and females would benefit similarly, and that improvements in risk factors would correlate with changes in vascular function. METHODS Seventy-two healthy middle-aged/older adults (age, 62 ± 7 yr; 26%♂) were randomized to a land-walking ( n = 23), water-walking ( n = 25), or a nonexercise control group (C; n = 23). The exercise groups undertook supervised and monitored training three times a week for 50 min per session, across 24 wk. Blood pressure, body composition (dual x-ray absorptiometry), blood lipids and glucose, and flow-mediated brachial artery dilation were assessed in all participants at weeks 0 and 24. To maximize power for sex differences and correlation analyses, we pooled the training groups (land-walking + water-walking). RESULTS Training prevented increases in LDL and total cholesterol/HDL ratio observed in the nonexercise control group. No group by time interactions were observed for other risk factors. Sex differences in training effects existed for visceral fat (-187 ± 189 g♂ vs -15 ± 161 g♀; P = 0.006) and lean mass (-352 ± 1045 g♂ vs 601 ± 1178 g♀; P = 0.008). Improvement in flow-mediated brachial artery dilation was correlated with decreased waist girth ( r = -0.450, P = 0.036), but not with other risk factors. CONCLUSIONS Exercise training prevented deterioration in lipid levels, whereas sex differences existed for body composition changes with training. Improvement in vascular function was not dependent on changes in risk factors in middle-aged/older adults, suggesting that artery health may be dependent on other exercise-related stimuli.
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Affiliation(s)
- Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | | | | | - Barbara A Maslen
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | | | | | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, WA, AUSTRALIA
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, CANADA
| | - Andrew Haynes
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
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Fynn DM, Preece DA, Gignac GE, Pestell CF, Weinborn M, Becerra R. Alexithymia as a risk factor for poor emotional outcomes in adults with acquired brain injury. Neuropsychol Rehabil 2023; 33:1650-1671. [PMID: 37988367 DOI: 10.1080/09602011.2022.2140680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Emotional disorders are pervasive in the acquired brain injury (ABI) population, adversely affecting quality of life and rehabilitation. This study aimed to explore the unique associative effects of alexithymia as measured by the Perth Alexithymia Questionnaire (PAQ; i.e., difficulty identifying positive/negative feelings, difficulty describing positive/negative feelings, and externally orientated thinking), on emotional outcomes as measured by the Depression Anxiety Stress Scale-21 (DASS-21) and Mayo-Portland Adaptability Inventory (MPAI-4) Adjustment index, in 83 adults with ABI. The addition of alexithymia to hierarchical multiple regression models (controlling for demographic, injury-related, and functional outcome variables) yielded statistically significant changes in R2 for all emotional outcome measures (i.e., Depression, Anxiety, Stress, and Adjustment). Difficulty identifying negative feelings was found to be a significant unique predictor of Depression (β = .43 p = <.001), Anxiety (β = .40, p <.001), Stress (β = .49, p <.001), and Adjustment (β = .26, p = .001). Externally oriented thinking was found to be a significant unique predictor of Adjustment (β = -.15, p = .033). These findings strengthen the argument that alexithymia, especially difficulties identifying negative feelings, may be an important risk factor for psychological distress in ABI and should be considered during early rehabilitation.
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Affiliation(s)
- Danielle M Fynn
- School of Psychological Science, The university of Western Australia, Perth, Australia
| | - David A Preece
- School of Psychological Science, The university of Western Australia, Perth, Australia
- School of Population Health and Curtin enAble Institute, Curtin University, Perth, Australia
| | - Gilles E Gignac
- School of Psychological Science, The university of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, The university of Western Australia, Perth, Australia
| | - Michael Weinborn
- School of Psychological Science, The university of Western Australia, Perth, Australia
| | - Rodrigo Becerra
- School of Psychological Science, The university of Western Australia, Perth, Australia
- Telethon Kids Institute, Perth, Australia
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Malkani MK, Sheridan AMC, Crichton AJ, Bucks RS, Pestell CF. In-person versus online delivery of a behavioral sleep intervention (Sleeping Sound ©) for children with ADHD: protocol for a parallel-group, non-inferiority, randomized controlled trial. BMC Pediatr 2023; 23:502. [PMID: 37803298 PMCID: PMC10557213 DOI: 10.1186/s12887-023-04329-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience sleep difficulties such as difficulty initiating and maintaining sleep. Problem sleep may impact children's daily functioning and behaviors and exacerbate ADHD symptoms. Most effective behavioral interventions to improve sleep are conducted in person, limiting accessibility to treatment for individuals in remote or rural communities or those who are unable to attend a clinic. This trial aims to assess the efficacy of delivering an established behavioral intervention online, Sleeping Sound with ADHD©, compared to a face-to-face delivery mode. METHODS This parallel group, non-inferiority, randomized controlled trial (RCT) will include at least 68 children, aged 5-12 years old with ADHD. Families of children will be recruited from private developmental and psychological clinics and social media, within the state of Western Australia (WA). Once written informed consent and baseline questionnaires are completed, families are randomized to receive the behavioral intervention either in-person or online via Telehealth services. The intervention targets the assessment and management of reported sleep problems, through two individual consultations and a follow-up phone call with a trained clinician. The sleep outcomes assessed consist of a parent-reported sleep questionnaire and actigraphy. DISCUSSION To the best of our knowledge, this is the first RCT to investigate sleep treatment modality for children with ADHD. If effective, clinicians can provide an evidence-based sleep intervention in an accessible manner. TRIAL REGISTRATION ANZCTR, ACTRN12621001681842 . Registered 9 December 2021-Retrospectively registered.
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Affiliation(s)
- Maya K Malkani
- School of Psychological Science, University Western Australia, Perth, Australia.
| | - Andrew M C Sheridan
- School of Psychological Science, University Western Australia, Perth, Australia
| | | | - Romola S Bucks
- School of Psychological Science, University Western Australia, Perth, Australia
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, University Western Australia, Perth, Australia
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Mateo‐Arriero I, Lalovic A, Dowden G, Markey L, Cox KL, Flicker L, Bessarab D, Thompson S, Kickett C, Woods D, Pestell CF, Edgill P, Etherton‐Beer C, Smith K. Co-design of dementia prevention program for Aboriginal Australians (DAMPAA). Alzheimers Dement 2023; 19:4564-4571. [PMID: 36933191 PMCID: PMC10955769 DOI: 10.1002/alz.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/19/2023]
Abstract
INTRODUCTION Dementia is highly prevalent in older Aboriginal Australians, with several modifiable risk factors. Currently, there is limited evidence on how to prevent cognitive decline in Aboriginal Australians. METHODS Based on our Theory of Change (ToC) framework, we co-developed the Dementia risk management and prevention program for Aboriginal Australians (DAMPAA) aged over 45 years in partnership with Aboriginal community-controlled organizations (ACCOs) and Elders. Qualitative data were collected through ACCO staff workshops, Elders yarning, and governance groups to inform the protocol. Additionally, we conducted a small pilot study. RESULTS Expected DAMPAA ToC outcomes are: (1) improved daily function, (2) better cardiovascular risk management, (3) falls reduction, (4) improved quality of life, and (5) reduced cognitive decline. Attendance enablers are social interaction, environment, exercise type/level, and logistics. DISCUSSION Findings suggest that ToC is an effective collaborative approach for co-designing Aboriginal health programs.
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Affiliation(s)
- Irene Mateo‐Arriero
- Centre for Aboriginal Medical and Dental HealthUniversity of Western AustraliaPerthWAAustralia
| | - Alexander Lalovic
- Centre for Aboriginal Medical and Dental HealthUniversity of Western AustraliaPerthWAAustralia
| | - Glennette Dowden
- Centre for Aboriginal Medical and Dental HealthUniversity of Western AustraliaPerthWAAustralia
| | - Lesley Markey
- Centre for Aboriginal Medical and Dental HealthUniversity of Western AustraliaPerthWAAustralia
| | - Kay L. Cox
- Centre for Aboriginal Medical and Dental HealthUniversity of Western AustraliaPerthWAAustralia
- West Australian Centre for Health and AgeingUniversity of Western AustraliaPerthWAAustralia
| | - Leon Flicker
- West Australian Centre for Health and AgeingUniversity of Western AustraliaPerthWAAustralia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental HealthUniversity of Western AustraliaPerthWAAustralia
| | - Sandra Thompson
- Western Australian Centre for Rural HealthUniversity of Western AustraliaGeraldtonWAAustralia
| | | | - Deborah Woods
- Geraldton Regional Aboriginal Medical ServiceGeraldtonWAAustralia
| | - Carmela F. Pestell
- School of Psychological ScienceUniversity of Western AustraliaPerthWAAustralia
| | - Paula Edgill
- Derbarl Yerrigan Health ServiceEast PerthWAAustralia
| | | | - Kate Smith
- Centre for Aboriginal Medical and Dental HealthUniversity of Western AustraliaPerthWAAustralia
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Long D, Anderson VA, Crossley L, Sood NT, Charles KR, MacDonald AD, Bora S, Pestell CF, Murrell K, Pride NA, Anderson PJ, Badawi N, Rose B, Baillie H, Masterson K, Chumbes Flores J, Sherring C, Raman S, Beca J, Erickson S, Festa M, Anderson BW, Venugopal P, Yim D, Andrews D, Cheung M, Brizard C, Gentles TL, Iyengar A, Nicholson I, Ayer J, Butt W, Schlapbach LJ, Gibbons KS. Longitudinal cohort study investigating neurodevelopmental and socioemotional outcomes in school-entry aged children after open heart surgery in Australia and New Zealand: the NITRIC follow-up study protocol. BMJ Open 2023; 13:e075429. [PMID: 37648380 PMCID: PMC10471882 DOI: 10.1136/bmjopen-2023-075429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Despite growing awareness of neurodevelopmental impairments in children with congenital heart disease (CHD), there is a lack of large, longitudinal, population-based cohorts. Little is known about the contemporary neurodevelopmental profile and the emergence of specific impairments in children with CHD entering school. The performance of standardised screening tools to predict neurodevelopmental outcomes at school age in this high-risk population remains poorly understood. The NITric oxide during cardiopulmonary bypass to improve Recovery in Infants with Congenital heart defects (NITRIC) trial randomised 1371 children <2 years of age, investigating the effect of gaseous nitric oxide applied into the cardiopulmonary bypass oxygenator during heart surgery. The NITRIC follow-up study will follow this cohort annually until 5 years of age to assess outcomes related to cognition and socioemotional behaviour at school entry, identify risk factors for adverse outcomes and evaluate the performance of screening tools. METHODS AND ANALYSIS Approximately 1150 children from the NITRIC trial across five sites in Australia and New Zealand will be eligible. Follow-up assessments will occur in two stages: (1) annual online screening of global neurodevelopment, socioemotional and executive functioning, health-related quality of life and parenting stress at ages 2-5 years; and (2) face-to-face assessment at age 5 years assessing intellectual ability, attention, memory and processing speed; fine motor skills; language and communication; and socioemotional outcomes. Cognitive and socioemotional outcomes and trajectories of neurodevelopment will be described and demographic, clinical, genetic and environmental predictors of these outcomes will be explored. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Children's Health Queensland (HREC/20/QCHQ/70626) and New Zealand Health and Disability (21/NTA/83) Research Ethics Committees. The findings will inform the development of clinical decision tools and improve preventative and intervention strategies in children with CHD. Dissemination of the outcomes of the study is expected via publications in peer-reviewed journals, presentation at conferences, via social media, podcast presentations and medical education resources, and through CHD family partners. TRIAL REGISTRATION NUMBER The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry as 'Gene Expression to Predict Long-Term Neurodevelopmental Outcome in Infants from the NITric oxide during cardiopulmonary bypass to improve Recovery in Infants with Congenital heart defects (NITRIC) Study - A Multicentre Prospective Trial'. TRIAL REGISTRATION ACTRN12621000904875.
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Affiliation(s)
- Debbie Long
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Paediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Vicki A Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Psychology Service, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Louise Crossley
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Nikita Tuli Sood
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Karina R Charles
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
- Paediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Anna D MacDonald
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - Samudragupta Bora
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Kathryn Murrell
- Consult Liaison Team, Starship Children's Hospital, Auckland, New Zealand
| | - Natalie A Pride
- Kids Neuroscience Centre, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Nadia Badawi
- Grace Centre for Newborn Care, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Brian Rose
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Australian and New Zealand Fontan Advocacy Committee, HeartKids Australia Inc, Sydney, New South Wales, Australia
| | - Heidi Baillie
- Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Kate Masterson
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Paediatric Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jenipher Chumbes Flores
- Paediatric Intensive Care Unit, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Claire Sherring
- Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand
| | - Sainath Raman
- Paediatric Intensive Care Unit, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
| | - John Beca
- Paediatric Intensive Care Unit, Starship Children's Hospital, Auckland, New Zealand
| | - Simon Erickson
- Paediatric Intensive Care Unit, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Marino Festa
- Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Benjamin W Anderson
- Queensland Paediatric Cardiac Service, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- School of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
| | - Prem Venugopal
- School of Medicine, The University of Queensland, South Brisbane, Queensland, Australia
- Department of Cardiac Surgery, Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Deane Yim
- Department of Paediatric Cardiology, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - David Andrews
- Department of Cardiothoracic Surgery, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Michael Cheung
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Cardiology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Christian Brizard
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Cardiac Surgery, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Thomas L Gentles
- Paediatrics, Child and Youth Health, The University of Auckland, Auckland, New Zealand
- Paediatric and Congenital Cardiac Service, Starship Children's Hospital, Auckland, New Zealand
| | - Ajay Iyengar
- Paediatric and Congenital Cardiac Service, Starship Children's Hospital, Auckland, New Zealand
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Ian Nicholson
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Julian Ayer
- Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Warwick Butt
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Paediatric Intensive Care Unit, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Luregn J Schlapbach
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
- Department of Intensive Care and Neonatology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Kristen S Gibbons
- Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
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Wolff B, Franco VR, Magiati I, Pestell CF, Glasson EJ. Neurocognitive and self-reported psychosocial and behavioral functioning in siblings of individuals with neurodevelopmental conditions: a study using remote self-administered testing. J Clin Exp Neuropsychol 2023; 45:513-536. [PMID: 37779193 DOI: 10.1080/13803395.2023.2259042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/10/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE This study compared and explored the neurocognitive profiles of siblings of persons with and without neurodevelopmental conditions (NDCs) and associations between objective test performance and self-reported psychosocial functioning. METHODS Siblings of persons with and without NDCs (64 NDC and 64 control siblings; mean age 19.88 years, range 11-27 years, 73.44% female, 75.78% White Caucasian) completed self-report questionnaires and self-administered computerized neurocognitive tests of executive functioning (EF). Using Bayesian analyses, we examined cross-sectional associations between self-reported psychosocial functioning and cognitive test performance, and predictors of EF over 15 months. RESULTS NDC siblings had poorer working memory, inhibition, attention, and shifting compared to controls, as measured by experimental paradigms on the backward Corsi span, N-Back 2-back task, Stop Signal Task, Sustained Attention to Response Task, and the Wisconsin Card Sorting Test (effect size δ ranging 0.49 to 0.64). Bayesian cross-sectional networks revealed negative emotion reactivity and working memory difficulties were central to the NDC sibling network. Over 15 months, poorer EF (k low test scores) was predicted by negative emotion reactivity, sleep problems, and anxiety, over and above effects of age and subclinical autistic and ADHD traits. Siblings of autistic individuals and persons with fetal alcohol spectrum disorder had higher rates of neurocognitive and psychiatric difficulties than other NDCs and controls (Bayes factors >20). CONCLUSIONS Neurocognitive difficulties were associated with transdiagnostic vulnerability to poorer wellbeing in NDC siblings. These findings demonstrate the feasibility of remote online cognitive testing and highlight the importance of individualized prevention and intervention for NDC siblings.
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Affiliation(s)
- Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | | | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia
- Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
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10
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Panton KR, Fitzpatrick JP, Pestell CF. An evaluation of a multi-site fetal alcohol spectrum disorder models of care project. Front Public Health 2023; 11:1195484. [PMID: 37554728 PMCID: PMC10406497 DOI: 10.3389/fpubh.2023.1195484] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
Fetal alcohol spectrum disorder (FASD) continues to be underdiagnosed in Australia, partly due to the lack of trained clinicians and diagnostic services. This project aimed to help increase FASD knowledge and diagnostic capacity across Australia. Six sites across Australia formed part of a national consortium, delivering training clinics, diagnostic clinics and community education sessions. The number of FASD diagnoses significantly increased across the project. Additionally, the number of community education sessions steadily increased across the project, with largely positive feedback. Participants attending the training clinics demonstrated increased knowledge of and confidence in FASD diagnosis. This evaluation showcases the benefits of a coordinated approach to prevention, assessment, diagnosis and training in FASD.
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Affiliation(s)
- Kirsten R. Panton
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
| | - James P. Fitzpatrick
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
- Patches Assessment Services, Subiaco, WA, Australia
| | - Carmela F. Pestell
- School of Psychological Science, The University of Western Australia, Perth, WA, Australia
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11
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Wolff B, Franco VR, Magiati I, Pestell CF, Glasson EJ. Psychosocial and neurocognitive correlates of suicidal thoughts and behaviours amongst siblings of persons with and without neurodevelopmental conditions. Res Dev Disabil 2023; 139:104566. [PMID: 37441861 DOI: 10.1016/j.ridd.2023.104566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/24/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE Siblings of individuals with neurodevelopmental conditions (NDCs) have greater incidence of neuropsychiatric diagnoses and neurocognitive difficulties compared to siblings of persons without NDCs. Despite suicidality being labelled a global health crisis (WHO, 2014) and NDC siblings experiencing risk factors implicated in suicidality, no previous studies examined suicidality amongst adolescent and young adult siblings of persons with NDCs. Our study aimed to bridge this gap. METHOD The present study used Bayesian analyses and risk classification models to examine individual and environmental risk factors associated with suicidal thoughts and behaviours amongst siblings of persons with and without NDCs (n = 267; 132 NDC, 135 control group, mean age 20.61, range 14-27, 76.40% female, 76.78% White Caucasian), as measured using self-report survey data and remote self-administered cognitive tests. RESULTS NDC siblings had higher rates of current nonsuicidal self-injury (NSSI; 18.94% versus 14.07%, δ = -0.32), suicidal ideation (25.76% versus 8.89%, δ = -0.40) and history of suicide attempts (18.18% versus 4.44%, δ = -0.43) compared to controls. Classification models using boosting and random forest demonstrated adequate performance: positive predictive value 0.86-0.91, negative predictive value 0.81-0.90, false negative rates 0.11-0.24. Cognitive inflexibility, alexithymia, inattention, bullying, depression, NSSI, and eating or psychotic disorder history had the highest relative importance in predicting lifetime suicidality. Poorer executive functioning (measured by the Wisconsin Card Sorting Task, Sustained Attention to Response Task, Stop Signal Task, and N-Back 2-back task) was strongly correlated with suicidality. CONCLUSIONS Screening for proximal and modifiable risk factors is critical to inform suicidal behaviour intervention and prevention programs for at-risk siblings.
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Affiliation(s)
- Brittany Wolff
- School of Psychological Science, The University of Western Australia, Perth, Australia; Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia.
| | | | - Iliana Magiati
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Emma J Glasson
- Telethon Kids Institute, Centre for Child Health Research, The University of Western Australia, Perth, Australia; Discipline of Psychiatry, Medical School, The University of Western Australia, Perth, WA, Australia
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12
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Hayes N, Bagley K, Hewlett N, Elliott EJ, Pestell CF, Gullo MJ, Munn Z, Middleton P, Walker P, Till H, Shanley DC, Young SL, Boaden N, Hutchinson D, Kippin NR, Finlay‐Jones A, Friend R, Shelton D, Crichton A, Reid N. Lived experiences of the diagnostic assessment process for fetal alcohol spectrum disorder: A systematic review of qualitative evidence. Alcohol Clin Exp Res (Hoboken) 2023; 47:1209-1223. [PMID: 37132046 PMCID: PMC10947124 DOI: 10.1111/acer.15097] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 04/21/2023] [Indexed: 05/04/2023]
Abstract
Early assessment and diagnosis of FASD are crucial in providing therapeutic interventions that aim to enhance meaningful participation and quality of life for individuals and their families, while reducing psychosocial difficulties that may arise during adolescence and adulthood. Individuals with lived experience of FASD have expertise based on their own lives and family needs. Their insights into the assessment and diagnostic process are valuable for improving service delivery and informing the provision of meaningful, person- and family-centered care. To date, reviews have focused broadly on the experiences of living with FASD. The aim of this systematic review is to synthesize qualitative evidence on the lived experiences of the diagnostic assessment process for FASD. Six electronic databases, including PubMed, the Cochrane Library, CINAH, EMBASE, PsycINFO, and Web of Science Core Collection were searched from inception until February 2021, and updated in December 2022. A manual search of reference lists of included studies identified additional studies for inclusion. The quality of included studies was assessed using the Critical Appraisal Skills Program Checklist for Qualitative Studies. Data from included studies were synthesized using a thematic analysis approach. GRADE-CERQual was used to assess confidence in the review findings. Ten studies met the selection criteria for inclusion in the review. Thematic analysis identified 10 first-level themes relating to four over-arching topics: (1) pre-assessment concerns and challenges, (2) the diagnostic assessment process, (3) receipt of the diagnosis, and (4) post-assessment adaptations and needs. GRADE-CERQual confidence ratings for each of the review themes were moderate to high. The findings from this review have implications for referral pathways, client-centered assessment processes, and post-diagnostic recommendations and support.
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Affiliation(s)
- Nicole Hayes
- Child Health Research CentreThe University of QueenslandSouth BrisbaneQueenslandAustralia
- Australian Research Council Centre of Excellence for the Digital ChildQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Kerryn Bagley
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
- Living with Disability Research CentreLa Trobe UniversityMelbourneVictoriaAustralia
| | - Nicole Hewlett
- Child Health Research CentreThe University of QueenslandSouth BrisbaneQueenslandAustralia
- First Nations Cancer and Wellbeing Research TeamThe University of QueenslandHerstonQueenslandAustralia
| | - Elizabeth J. Elliott
- Faculty of Medicine and Health, Specialty of Child and Adolescent HealthThe University of SydneySydneyNew South WalesAustralia
- The Sydney Children's Hospitals NetworkSydneyNew South WalesAustralia
| | - Carmela F. Pestell
- School of Psychological ScienceUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Matthew J. Gullo
- School of Applied PsychologyGriffith UniversityMount GravattQueenslandAustralia
| | - Zachary Munn
- Health Evidence Synthesis, Recommendations and Impact, School of Public Health, Faculty of Health and Medical SciencesThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Philippa Middleton
- South Australian Health and Medical Research InstituteAdelaideSouth AustraliaAustralia
- The University of AdelaideAdelaideSouth AustraliaAustralia
| | - Prue Walker
- Victorian Fetal Alcohol ServiceMonash Children's HospitalClaytonVictoriaAustralia
- Australian Childhood FoundationAbbotsfordVictoriaAustralia
| | - Haydn Till
- Child Development ServiceGold Coast Hospital and Health ServiceSouthportQueenslandAustralia
- School of Applied PsychologyGriffith UniversityGold CoastQueenslandAustralia
| | - Dianne C. Shanley
- School of Applied PsychologyGriffith UniversityGold CoastQueenslandAustralia
- Menzies Health Institute of QueenslandGriffith UniversityGold CoastQueenslandAustralia
| | - Sophia L. Young
- Child Health Research CentreThe University of QueenslandSouth BrisbaneQueenslandAustralia
| | - Nirosha Boaden
- School of Social Sciences, Faculty of Social WorkThe University of New South WalesSydneyNew South WalesAustralia
| | - Delyse Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Faculty of HealthDeakin UniversityGeelongVictoriaAustralia
- National Drug and Alcohol Research CentreThe University New South WalesSydneyNew South WalesAustralia
- Centre for Adolescent HealthMurdoch Children's Research Institute, Royal Children's HospitalMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of Melbourne, Royal Children's HospitalMelbourneVictoriaAustralia
| | - Natalie R. Kippin
- Curtin School of Allied HealthCurtin UniversityWestern AustraliaBentleyAustralia
| | - Amy Finlay‐Jones
- Telethon Kids InstituteNedlandsWestern AustraliaAustralia
- School of Population HealthCurtin UniversityBentleyWestern AustraliaAustralia
- Medical SchoolUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Rowena Friend
- Patches Assessment ServiceDarwinNorthern TerritoryAustralia
- Faculty of HealthCharles Darwin UniversityDarwinNorthern TerritoryAustralia
| | - Doug Shelton
- School of Medicine and DentistryGriffith UniversityGold CoastQueenslandAustralia
- Community Child HealthGold Coast Hospital and Health ServiceSouthportQueenslandAustralia
| | - Alison Crichton
- Victorian Fetal Alcohol ServiceMonash Children's HospitalClaytonVictoriaAustralia
- Department of PaediatricsMonash UniversityMelbourneVictoriaAustralia
| | - Natasha Reid
- Child Health Research CentreThe University of QueenslandSouth BrisbaneQueenslandAustralia
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Wu JS, Nankoo MMA, Bucks RS, Pestell CF. Short form Conners' Adult ADHD Rating Scales: Factor structure and measurement invariance by sex in emerging adults. J Clin Exp Neuropsychol 2023; 45:345-364. [PMID: 37610373 DOI: 10.1080/13803395.2023.2246213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
INTRODUCTION The short version of the Conners' Adult ADHD Rating Scales (CAARS-S:S) is a self-report measure used to identify symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) during adulthood. However, its psychometric properties specifically in emerging adults, or the transitional age group between adolescence and adulthood, remain understudied. This study aimed to validate the factor structure of the CAARS-S:S in a sample of emerging adults. METHOD The CAARS-S:S measure was completed by adults (n = 591) aged 18 to 29 located in English-speaking countries, including Australia, Canada and the United States. Confirmatory factor analysis was used to test a four-factor model of Inattention/Memory Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability and Problems with Self-Concept, as well as the model's invariance by sex. Sex was also included as a covariate in the model to examine differences in males' and females' scores on each factor. RESULTS Overall, the four-factor structure fit the data and was invariant across males and females. All factors demonstrated high internal reliability (average ωt and α = .86). It was observed that males tended to score higher on Inattention/Memory Problems while females scored higher on Problems with Self-Concept. CONCLUSION This research establishes the psychometric properties of the CAARS-S:S, placing greater confidence in using it to screen for ADHD symptoms in emerging adults living in a Westernized cultural context. The detailed findings of this research, implications for the use of the CAARS-S:S in this age group and potential future directions for examining the properties of the measure are discussed.
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Affiliation(s)
- Jasmine S Wu
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Marie M A Nankoo
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
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14
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Buhagiar F, Fitzgerald M, Bell J, Hellewell S, Moore S, Pestell CF. Post-Concussion Symptoms, Cognition and Brain Connectivity in an Australian Undergraduate Population: A Quantitative Electroencephalography Study. J Integr Neurosci 2023; 22:50. [PMID: 36992597 DOI: 10.31083/j.jin2202050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/02/2022] [Accepted: 12/07/2022] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND An estimated 99 in 100,000 people experience a traumatic brain injury (TBI), with 85% being mild (mTBI) in nature. The Post-Concussion Symptom Scale (PCSS), is a reliable and valid measure of post-mTBI symptoms; however, diagnostic specificity is challenging due to high symptom rates in the general population. Understanding the neurobiological characteristics that distinguish high and low PCSS raters may provide further clarification on this phenomenon. AIM To explore the neurobiological characteristics of post-concussion symptoms through the association between PCSS scores, brain network connectivity (using quantitative electroencephalography; qEEG) and cognition in undergraduates. HYPOTHESES high PCSS scorers will have (1) more network dysregulation and (2) more cognitive dysfunction compared to the low PCSS scorers. METHODS A sample of 40 undergraduates were divided into high and low PCSS scorers. Brain connectivity was measured using qEEG, and cognition was measured via neuropsychological measures of sustained attention, inhibition, immediate attention, working memory, processing speed and inhibition/switching. RESULTS Contrary to expectations, greater frontoparietal network dysregulation was seen in the low PCSS score group (p = 0.003). No significant difference in cognitive dysfunction was detected between high and low PCSS scorers. Post-hoc analysis in participants who had experienced mTBI revealed greater network dysregulation in those reporting a more recent mTBI. CONCLUSIONS Measuring post-concussion symptoms alone is not necessarily informative about changes in underlying neural mechanisms. In an exploratory subset analysis, brain network dysregulation appears to be greater in the early post-injury phase compared to later. Further analysis of underlying PCSS constructs and how to measure these in a non-athlete population and clinical samples is warranted.
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Affiliation(s)
- Francesca Buhagiar
- School of Psychological Science, University of Western Australia, 6009 Perth, WA, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, 6102 Bentley, WA, Australia
- Perron Institute for Neurological and Translational Science, 6009 Nedlands, WA, Australia
| | - Jason Bell
- School of Psychological Science, University of Western Australia, 6009 Perth, WA, Australia
| | - Sarah Hellewell
- Curtin Health Innovation Research Institute, Curtin University, 6102 Bentley, WA, Australia
- Perron Institute for Neurological and Translational Science, 6009 Nedlands, WA, Australia
| | - Samantha Moore
- School of Psychological Science, University of Western Australia, 6009 Perth, WA, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, 6009 Perth, WA, Australia
- Curtin Health Innovation Research Institute, Curtin University, 6102 Bentley, WA, Australia
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15
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Nankoo MMA, Panton KR, Fitzpatrick JP, Pestell CF. Scoping review of employment resources for individuals with fetal alcohol spectrum disorder and justice involvement. BMJ Open 2023; 13:e063860. [PMID: 36806062 PMCID: PMC9943906 DOI: 10.1136/bmjopen-2022-063860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVES Individuals with fetal alcohol spectrum disorder (FASD) are over-represented within the justice system and have significant employment challenges. The primary aim of this scoping review was to ascertain available employment resources for FASD individuals particularly those involved in the justice system. Secondary aims were to determine available evidence-based interventions for the justice workforce and employment providers. METHODS Eligibility criteria: That the resource was (a) published between 1990 and 2021, (b) in English, (c) available electronically in full text, (d) focused on strategies for improving employment outcomes of individuals with FASD and (f) developed for those aged over 15. Sources of evidence: Electronic searches of the following databases were conducted: EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science and Google Scholar. Grey literature was collected via the databases ProQuest Dissertations & Theses Global, OpenGrey, GreyNet International and Grey Matters. Charting methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews reporting guidelines, a five-stage methodological framework was employed. A quality appraisal of identified resources was conducted. Data were summarised qualitatively using a content analysis method that allowed for analysis of specific terms/themes/concepts/resource elements that resources covered, as well as a quantitative analysis of their frequency. RESULTS An initial search identified 850 articles, 512 of which were obtained through online database searches, 321 through Google Scholar searches and 17 through google searches. Sixteen resources were identified as meeting inclusion criteria, including four peer-reviewed papers and 12 grey literature resources. Six of the resources extracted were deemed 'good' or 'strong' quality, with the remainder-all grey literature resources-being 'adequate' or 'limited'. None of the resources identified were empirically evaluated or could be implemented synergistically. Content analysis revealed common themes addressing FASD-related employment challenges and required supports. CONCLUSIONS This review highlights the need for developing evidence-based employment-related resources for justice-involved people with FASD. Most of the 16 identified resources had a psychoeducational and advocacy component and described typical employment challenges with specific supports and accommodations to maximise workforce participation. However, none had been empirically evaluated, underscoring the importance of future research in this area to better inform more responsive and evidence-based employment-related programmes. TRIAL REGISTRATION NUMBER doi:10.17605/OSF.IO/J5VMB.
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Affiliation(s)
- Marie M A Nankoo
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
- Patches Australia, Perth, Western Australia, Australia
| | - Kirsten R Panton
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - James P Fitzpatrick
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
- Patches Australia, Perth, Western Australia, Australia
| | - Carmela F Pestell
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
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16
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Malkani MK, Pestell CF, Sheridan AMC, Crichton AJ, Horsburgh GC, Bucks RS. Behavioral Sleep Interventions for Children With ADHD: A Systematic Review and Meta-Analysis. J Atten Disord 2022; 26:1805-1821. [PMID: 35758199 DOI: 10.1177/10870547221106239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate intervention characteristics and components within behavioral sleep interventions in school-aged children with ADHD and examine evidence related to effectiveness. METHOD A systematic review was conducted using PsycINFO, Embase, MEDLINE, PubMed, and OpenGray. The subsequent meta-analysis used sleep outcomes to produce comparable effect sizes (Hedges' g) and compare intervention effects between randomized controlled trials and pre-post studies. RESULTS Eleven articles satisfied the inclusion criteria (562 children, across all groups, aged 5-14 years, M = 8.71). Studies reported improvements in sleep although there was marked heterogeneity between studies and limited use of objective sleep measures within them. On average, intervention groups improved more than control groups in the five randomized controlled trials (-0.46, 95% CI = [-0.58, -0.35], k = 4). CONCLUSION The findings support the use of behavioral sleep interventions for school-aged children with ADHD. Findings suggest that brief, individualized intervention may be more effective than standardized.
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Tan GKY, Symons M, Fitzpatrick J, Connor SG, Cross D, Pestell CF. Adverse childhood experiences, associated stressors and comorbidities in children and youth with fetal alcohol spectrum disorder across the justice and child protection settings in Western Australia. BMC Pediatr 2022; 22:587. [PMID: 36217109 PMCID: PMC9549627 DOI: 10.1186/s12887-022-03654-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background Individuals with Fetal Alcohol Spectrum Disorder (FASD) are at risk of having adverse childhood experiences (ACEs), especially those with child protection and/or justice system involvement. The complex relationship between FASD and psychosocial vulnerabilities in the affected individual is an important clinical risk factor for comorbidity. This study (1) explored the ACEs and associated stressors in individuals with FASD; (2) investigated the association between ACEs and negative outcomes, i.e., justice/child protection system involvement; and (3) examined the relationship between ACEs and comorbid conditions such as mood and neurodevelopmental disorders. Methods Data were collected retrospectively via file review from diagnostic clinics in Western Australia. Life adversity was coded using a standardised ACEs questionnaire. A total of 211 participants (72% males) with FASD with a mean age of 11 years (range = 2–21) were included in the final sample. 70% of the total sample had been involved with the child protection system and 40% had trouble with the law. Results Exposure to drinking/substance misuse at home (70%) and domestic violence (52%) were the two most common ACEs across the total sample. In the entire cohort, 39% had four or more ACEs, indicating higher risks of poor health outcomes. Additional stressors recorded were disengagement from school (43%), transiency (19%), victims of bullying (12%), traumatic brain injury (9%) and homelessness (5%). ACEs such as drinking/substance misuse at home, emotional neglect and physical neglect were positively associated with child protection system involvement. Additionally, exposure to domestic violence was positively correlated with justice system involvement. Higher rates of life adversity in this clinical population were associated with an increased number of comorbidities. Specifically, those with FASD who had comorbidities such as attachment disorder, substance use disorder, and PTSD also reported higher ACEs scores. Conclusion ACEs were common in this clinical population. Increased ACEs in this sample were associated with increased comorbidities and involvement with the child protection and/or justice system. This highlights that prevention, intervention and early diagnosis of FASD are important for at risk children to reduce the negative effects of ACEs. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03654-y.
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Affiliation(s)
- Grace Kuen Yee Tan
- School of Psychological Science (M304), The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia. .,Patches Australia, Subiaco, Australia. .,Telethon Kids Institute (TKI), Nedlands, Australia.
| | - Martyn Symons
- School of Psychological Science (M304), The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.,Telethon Kids Institute (TKI), Nedlands, Australia
| | - James Fitzpatrick
- School of Psychological Science (M304), The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.,Patches Australia, Subiaco, Australia
| | | | - Donna Cross
- School of Psychological Science (M304), The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.,Telethon Kids Institute (TKI), Nedlands, Australia
| | - Carmela F Pestell
- School of Psychological Science (M304), The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.,Telethon Kids Institute (TKI), Nedlands, Australia
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18
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Tan GKY, Pestell CF, Fitzpatrick J, Cross D, Adams I, Symons M. Exploring offending characteristics of young people with foetal alcohol spectrum disorder in Western Australia. Psychiatr Psychol Law 2022; 30:514-535. [PMID: 37484511 PMCID: PMC10360980 DOI: 10.1080/13218719.2022.2059028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Neurodevelopmental impairments resulting from Foetal Alcohol Spectrum Disorder (FASD) can increase the likelihood of justice system involvement. This study compared offence characteristics in young people with FASD to demographically matched controls (n = 500) in Western Australia. A novel approach (i.e. association rule mining) was adopted to uncover relationships between personal attributes and offence characteristics. For FASD participants (n = 100), file records were reviewed retrospectively. Mean age of the total sample was 15.60 years (range = 10-24), with 82% males and 88% Australian Aboriginal. After controlling for demographic factors, regression analyses showed FASD participants were more likely than controls to be charged with reckless driving (odds ratio, OR = 4.20), breach of bail/community orders (OR = 3.19), property damage (OR = 1.84), and disorderly behaviour (OR = 1.54). Overall, our findings suggest justice-involved individuals with FASD have unique offending profiles. These results have implications for sentencing, diversionary/crime prevention programs and interventions.
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Affiliation(s)
- Grace Kuen Yee Tan
- School of Psychological Science, University of Western Australia (UWA), Perth, WA, Australia
- Patches Australia, Nedlands, WA, Australia
- Telethon Kids Institute (TKI), Nedlands, WA, Australia
| | - Carmela F. Pestell
- School of Psychological Science, University of Western Australia (UWA), Perth, WA, Australia
| | - James Fitzpatrick
- School of Psychological Science, University of Western Australia (UWA), Perth, WA, Australia
- Patches Australia, Nedlands, WA, Australia
| | - Donna Cross
- School of Psychological Science, University of Western Australia (UWA), Perth, WA, Australia
- Telethon Kids Institute (TKI), Nedlands, WA, Australia
| | - Isabelle Adams
- School of Psychological Science, University of Western Australia (UWA), Perth, WA, Australia
- Patches Australia, Nedlands, WA, Australia
| | - Martyn Symons
- School of Psychological Science, University of Western Australia (UWA), Perth, WA, Australia
- Telethon Kids Institute (TKI), Nedlands, WA, Australia
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Fynn DM, Preece DA, Gignac GE, Pestell CF, Allan A, Kraats CV, Green SL, Weinborn M, Becerra R. Assessing alexithymia in adults with acquired brain injury: Psychometric properties of the Perth Alexithymia Questionnaire. J Affect Disord 2022; 302:224-233. [PMID: 35092756 DOI: 10.1016/j.jad.2022.01.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/13/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Alexithymia is a multidimensional personality trait comprised of difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking. The assessment of alexithymia in people with acquired brain injury (ABI) is of clinical interest because alexithymia is linked to poor psychosocial functioning and community reintegration after ABI. To date, alexithymia measures have not been psychometrically investigated/validated in an ABI sample, restricting confident empirical work in this area. We aimed to fill this gap by assessing the psychometric properties of the Perth Alexithymia Questionnaire (PAQ) in adults with ABI and determining whether the alexithymia construct manifests similarly in ABI samples compared to the general community. METHODS The PAQ and Depression Anxiety Stress Scales-21 were administered to an ABI sample (N = 350) and a community sample (N = 1012). Factor structure, measurement invariance, internal consistency reliability, and concurrent/discriminant validity were explored. RESULTS Our confirmatory factor analysis of the PAQ supported the intended five-factor correlated model as the best solution, where items loaded well onto the five intended subscales. This factor structure was invariant across ABI and community samples. Good reliability and concurrent and discriminant validity were also established. LIMITATIONS The PAQ is a self-report measure and may be impacted by insight deficits known to occur after ABI. CONCLUSION Our data suggests that the PAQ has good validity and reliability as a measure of alexithymia. The latent structure of alexithymia manifests similarly in ABI and community samples. This study provides the first psychometric foundation for confident assessment of alexithymia in ABI.
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Affiliation(s)
- Danielle M Fynn
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | | | - Gilles E Gignac
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Carmela F Pestell
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | | | | | - Sarah L Green
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Michael Weinborn
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Rodrigo Becerra
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
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20
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Mason EC, Gaston JE, Pestell CF, Page AC. A comprehensive group-based cognitive behavioural treatment for blood-injection-injury phobia. Br J Clin Psychol 2021; 61:494-509. [PMID: 34750831 DOI: 10.1111/bjc.12345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A key feature of blood-injection-injury (BII) phobia is activation of disgust responses, in addition to fear. Yet, standard treatments have largely neglected addressing disgust responses. The disorder is further complicated by fainting in 75% of sufferers. Moreover, treatments have been traditionally delivered in an individual format, which may not be as efficient as group treatment. The aim of this study was to develop a group-based programme for BII phobia, with components targeting fear, disgust, and fainting, to determine feasibility and effectiveness of such an intervention. METHODS Participants took part in an 8-session, group-based Cognitive Behavioural Therapy (CBT) programme for BII phobia (N = 40). The key outcome measure was the Multidimensional Blood/Injury Phobia Inventory, which assesses a range of phobic stimuli and responses (including fear, disgust, and fainting). RESULTS There were significant improvements, with large effect sizes, across symptoms over the course of treatment. Participants with higher disgust sensitivity reported higher pre-treatment symptom severity and greater life interference than those with lower disgust scores. Despite this, neither pre-treatment disgust sensitivity nor fainting history impacted on treatment response. For the first time, however, we showed that greater reductions in disgust to BII stimuli were associated with greater overall symptom reductions, highlighting the importance of disgust in the treatment of this disorder, and potentially others. CONCLUSION Despite the heterogeneous nature of BII phobia, this group-based, modified CBT intervention was effective in reducing a variety of phobic responses, including fear, disgust, and fainting. PRACTITIONER POINTS Disgust is a key maintaining factor in blood-injection-injury phobia, which clinicians should consider in their assessment and treatment of this disorder. There is little in the existing literature to guide clinicians in this regard. This study examined a novel group treatment for blood-injection-injury phobia which included strategies to target disgust, in addition to traditional CBT strategies to address fear and fainting. The treatment was feasible and acceptable. Symptoms of fear, disgust, and fainting reduced significantly over treatment. Changes in disgust symptoms were associated with overall symptom changes, however a control group is needed to determine the effects of individual treatment components and to make more robust conclusions about the benefits of this enhanced approach.
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Affiliation(s)
- Elizabeth C Mason
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Jonathan E Gaston
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Andrew C Page
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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21
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Gozt AK, Hellewell SC, Thorne J, Thomas E, Buhagiar F, Markovic S, Van Houselt A, Ring A, Arendts G, Smedley B, Van Schalkwyk S, Brooks P, Iliff J, Celenza A, Mukherjee A, Xu D, Robinson S, Honeybul S, Cowen G, Licari M, Bynevelt M, Pestell CF, Fatovich D, Fitzgerald M. Predicting outcome following mild traumatic brain injury: protocol for the longitudinal, prospective, observational Concussion Recovery ( CREST) cohort study. BMJ Open 2021; 11:e046460. [PMID: 33986061 PMCID: PMC8126315 DOI: 10.1136/bmjopen-2020-046460] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Mild traumatic brain injury (mTBI) is a complex injury with heterogeneous physical, cognitive, emotional and functional outcomes. Many who sustain mTBI recover within 2 weeks of injury; however, approximately 10%-20% of individuals experience mTBI symptoms beyond this 'typical' recovery timeframe, known as persistent post-concussion symptoms (PPCS). Despite increasing interest in PPCS, uncertainty remains regarding its prevalence in community-based populations and the extent to which poor recovery may be identified using early predictive markers. OBJECTIVE (1) Establish a research dataset of people who have experienced mTBI and document their recovery trajectories; (2) Evaluate a broad range of novel and established prognostic factors for inclusion in a predictive model for PPCS. METHODS AND ANALYSIS The Concussion Recovery Study (CREST) is a prospective, longitudinal observational cohort study conducted in Perth, Western Australia. CREST is recruiting adults aged 18-65 from medical and community-based settings with acute diagnosis of mTBI. CREST will create a state-wide research dataset of mTBI cases, with data being collected in two phases. Phase I collates data on demographics, medical background, lifestyle habits, nature of injury and acute mTBI symptomatology. In Phase II, participants undergo neuropsychological evaluation, exercise tolerance and vestibular/ocular motor screening, MRI, quantitative electroencephalography and blood-based biomarker assessment. Follow-up is conducted via telephone interview at 1, 3, 6 and 12 months after injury. Primary outcome measures are presence of PPCS and quality of life, as measured by the Post-Concussion Symptom Scale and the Quality of Life after Brain Injury questionnaires, respectively. Multivariate modelling will examine the prognostic value of promising factors. ETHICS AND DISSEMINATION Human Research Ethics Committees of Royal Perth Hospital (#RGS0000003024), Curtin University (HRE2019-0209), Ramsay Health Care (#2009) and St John of God Health Care (#1628) have approved this study protocol. Findings will be published in peer-reviewed journals and presented at scientific conferences. TRIAL REGISTRATION NUMBER ACTRN12619001226190.
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Affiliation(s)
- Aleksandra Karolina Gozt
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
- Perron Institute of Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Sarah Claire Hellewell
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
| | - Jacinta Thorne
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
| | - Elizabeth Thomas
- Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, Western Australia, Australia
- Division of Surgery, Faculty of Health & Medical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Francesca Buhagiar
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Shaun Markovic
- Australian Alzheimer's Research Foundation, Nedlands, Western Australia, Australia
- The Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Anoek Van Houselt
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Alexander Ring
- Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Western Australia, Australia
- School of Physiotherapy and Exercise Science, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
| | - Glenn Arendts
- Emergency Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia
| | - Ben Smedley
- Emergency Department, Rockingham General Hospital, Cooloongup, Western Australia, Australia
| | - Sjinene Van Schalkwyk
- Emergency Department, Joondalup Health Campus, Joondalup, Western Australia, Australia
| | - Philip Brooks
- Emergency Department, Saint John of God Midland Public Hospital, Midland, Western Australia, Australia
- School of Medicine, The University of Notre Dame and Curtin Medical School, Curtin University, Perth, Western Australia, Australia
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - John Iliff
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
- Emergency Department, Saint John of God Hospital Murdoch, Murdoch, Western Australia, Australia
- Emergency Department, Royal Perth Hospital, Perth, Western Australia, Australia
- Royal Flying Doctor Service- Western Operations, Jandakot, Western Australia, Australia
| | - Antonio Celenza
- Emergency Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Division of Emergency Medicine, School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ashes Mukherjee
- Emergency Department, Armadale Health Service, Mount Nasura, Western Australia, Australia
| | - Dan Xu
- Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, Western Australia, Australia
- The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Suzanne Robinson
- Centre for Clinical Research Excellence, School of Population Health, Curtin University, Bentley, Western Australia, Australia
| | - Stephen Honeybul
- Statewide Director of Neurosurgery, Department of Health Government of Western Australia, Perth, Western Australia, Australia
- Head of Department, Sir Charles Gairdner Hospital, Royal Perth Hospital and Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Gill Cowen
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - Melissa Licari
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
- Telethon Kids Institute, West Perth, Western Australia, Australia
| | - Michael Bynevelt
- Division of Surgery, School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
- The Neurological Intervention & Imaging Service of Western Australia at Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Carmela F Pestell
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Daniel Fatovich
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia
- Emergency Medicine, Royal Perth Hospital, The University of Western Australia, Perth, Western Australia, Australia
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University Faculty of Health Sciences, Bentley, Western Australia, Australia
- Perron Institute of Neurological and Translational Science, Nedlands, Western Australia, Australia
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22
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Green DJ, Smith K, Maslen BA, Cox KL, Lautenschlager NT, Pestell CF, Naylor LH, Ainslie PN, Carter HH. The Impact of 6-Month Land versus Water Walking on Cerebrovascular Function in the Aging Brain. Med Sci Sports Exerc 2021; 53:2093-2100. [PMID: 33867500 DOI: 10.1249/mss.0000000000002685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION To examine the hypothesis that exercise training induces adaptation in cerebrovascular function, we recruited 63 older adults (62 ± 7 yr, 46 females) to undertake 24 wk of either land walking or water walking, or participate in a nonexercise control group. This is the first multi-interventional study to perform a comprehensive assessment of cerebrovascular function in response to longer term (6-month) training interventions, including water-based exercise, in older healthy individuals. METHODS Intracranial blood flow velocities (middle cerebral artery (MCAv) and posterior cerebral artery) were assessed at rest and in response to neurovascular coupling, hypercapnic reactivity, and cerebral autoregulation. RESULTS We observed no change in resting MCAv in response to either training intervention (pre vs post, mean (95% confidence interval), land walking: 65 (59-70) to 63 (57-68) cm·s-1, P = 0.33; water walking: 63 (58-69) to 61 (55-67) cm·s-1, P = 0.92) compared with controls and no change in neurovascular coupling (land walking: P = 0.18, water walking: P = 0.17). There was a significant but modest improvement in autoregulatory normalized gain after the intervention in the water-walking compared with the land-walking group (P = 0.03). Hypercapnic MCAv reactivity was not different based on exercise group (land: P = 087, water: P = 0.83); however, when data were pooled from the exercise groups, increases in fitness were correlated with decreases in hypercapnic reactivity (r2 = 0.25, P = 0.003). CONCLUSIONS Although exercise was not associated with systematic changes across multiple domains of cerebrovascular function, our data indicate that exercise may induce modest changes in autoregulation and CO2 reactivity. These findings should encourage further studies of the longer-term implications of exercise training on cerebrovascular health.
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Affiliation(s)
- Daniel J Green
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | - Kurt Smith
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | - Barbara A Maslen
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | | | | | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, WA, AUSTRALIA
| | - Louise H Naylor
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, CANADA
| | - Howard H Carter
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Perth, WA, AUSTRALIA
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Abstract
In 1995, Kirsch and colleagues published an influential meta-analysis (k = 20, N = 577) which found that CBT enhanced with hypnosis (CBTH) was superior to CBT alone by at least d = .53. However, a lack of full replication and the emergence of new empirical studies prompted this updated analysis. A total of 48 post- (N = 1,928) and 25 follow-up treatments (N = 1,165) were meta-analyzed. CBTH achieved small to medium but statistically significant advantages over CBT at posttreatment (dIGPP/d = .25 to .41), and specifically in the management of depressed mood and pain. At follow-up, there was a medium sized advantage for CBTH (dIGPP/d = .54 to .59), and specifically for the treatment of obesity. These results further support the adjunctive use of hypnosis as an enhancer of CBT's efficaciousness and endurance as a treatment.
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Affiliation(s)
- Nicolino Ramondo
- School of Psychological Science, University of Western Australia, Perth
| | - Gilles E Gignac
- School of Psychological Science, University of Western Australia, Perth
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth
| | - Susan M Byrne
- School of Psychological Science, University of Western Australia, Perth
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Fynn DM, Gignac GE, Becerra R, Pestell CF, Weinborn M. The Prevalence and Characteristics of Alexithymia in Adults Following Brain Injury: A Meta-Analysis. Neuropsychol Rev 2021; 31:722-738. [PMID: 33624197 DOI: 10.1007/s11065-021-09484-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 02/07/2021] [Indexed: 01/06/2023]
Abstract
Alexithymia is the inability to identify and describe one's own emotions. Some research suggests that organic alexithymia may occur after acquired brain injury (ABI). However, the results in the literature are inconsistent, when comparisons are made against healthy controls. Furthermore, a precise estimate of alexithymia prevalence in the ABI population has not yet been reported. Consequently, this meta-analysis aimed to estimate the prevalence and characteristics of alexithymia in ABI, as measured by the Toronto Alexithymia Scale-20 (TAS-20). Based on 22 unique ABI samples, a series of random-effects meta-analyses estimated moderate to large positive effect sizes (i.e., greater alexithymia in ABI samples) for the TAS-20 total scale (Hedges' g = 1.00, 95% CI [0.75, 1.35]), as well as the subscales: difficulty identifying feelings (Hedges' g = 0.92, 95% CI [0.66, 1.17]), difficulty describing feelings (Hedges' g = 0.69, 95% CI [0.50, 0.87]) and externally oriented thinking (Hedges' g = 0.75, 95% CI [0.64, 0.85]). Furthermore, a meta-regression identified a larger effect size (TAS-20 total scale score) for traumatic brain injury (TBI) samples, in comparison to non-TBI samples. Finally, the prevalence of clinically significant levels of alexithymia (TAS-20 total scale ≥ 68.4; i.e., two SDs above the general population mean) in ABI patients was estimated at 15.2%. We interpreted the results to suggest that ABI may have a substantial negative impact on affective processing abilities and, thus, comprehensive assessment of emotional functioning deficits following ABI should be considered by practitioners.
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Affiliation(s)
- Danielle M Fynn
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Gilles E Gignac
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Rodrigo Becerra
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Carmela F Pestell
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Michael Weinborn
- School of Psychology, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
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Agrawal S, Pestell CF, Granich J, Rao S, Nathan E, Wray JA, Whitehouse AJO, Patole S. Difficulties in developmental follow-up of preterm neonates in a randomised-controlled trial of Bifidobacterium breve M16-V - Experience from Western Australia. Early Hum Dev 2020; 151:105165. [PMID: 32871454 DOI: 10.1016/j.earlhumdev.2020.105165] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/20/2020] [Accepted: 08/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Probiotics may be neuroprotective for preterm neonates due to their anti-inflammatory effects and ability to facilitate nutrition. AIM To assess long-term effects of early probiotic supplementation on neuropsychological development in preterm infants. STUDY DESIGN Follow up study. SUBJECTS Children at age 3 to 5 years who had participated as preterm infants (<33 week) in the randomised controlled trial. OUTCOMES Primary: Continuous early learning composite measure derived from the Mullen's Scale of Early Learning (MSEL). Other outcomes were assessed by the Developmental, Dimensional and Diagnostic Interview, Developmental NEuroPSYchological assessment-2nd Edition, Parental questionnaires using children's communication checklist-2nd edition, social responsiveness scale, and Vineland Adaptive Behavioural Scales-2nd edition. MEASURES Continuous scores derived from all the measures. RESULTS 67 children of the 159 participants (42%) (Probiotic: 36/79, Placebo: 31/80) were followed-up for at least one neuropsychological assessment. All six assessments were completed in 18/31 (58.1%) of the control vs. 11/36 (30.6%) probiotic group children. Multivariable analysis of MSEL composite score showed no evidence of probiotic effect univariately, or after adjustment for gestation, intrauterine growth restriction, Apgar <7 at 5 min and age at assessment (adjusted mean effect in probiotic group: -2.7, 95% CI -8.5-3.0, p = 0.349). CONCLUSION There was no significant effect on neurodevelopment of children assessed at the age of 3 to 5 years who participated as preterm neonates in the RCT of B. breve M-16V. The validity of these results is limited by the reduced sample size due to high rate of loss to follow up.
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Affiliation(s)
- S Agrawal
- Neonatal Directorate, KEM Hospital for Women, 374 Bagot Road, Subiaco, WA, Australia.
| | - C F Pestell
- School of Psychological Science, University of WA, 35 Stirling Highway, Crawley, WA, 6009 Perth, Australia; Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA, 6009 Perth, Australia
| | - J Granich
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA, 6009 Perth, Australia
| | - S Rao
- School of Medicine, University of WA, 35 Stirling Highway, Crawley, WA, 6009 Perth, Australia; Neonatal Pediatrics, Perth Children Hospital, 15 Hospital Avenue, Nedlands, WA, 6009 Perth, Australia
| | - E Nathan
- School of Medicine, University of WA, 35 Stirling Highway, Crawley, WA, 6009 Perth, Australia; Women and Infants Research Foundation, King Edward Memorial Hospital for Women, 374, Bagot Road, Subiaco, Perth, WA, Australia
| | - J A Wray
- School of Medicine, University of WA, 35 Stirling Highway, Crawley, WA, 6009 Perth, Australia; Child Development Centre, 4/16 Rheola St, West Perth, WA 6005, Australia
| | - A J O Whitehouse
- Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA, 6009 Perth, Australia
| | - S Patole
- Neonatal Directorate, KEM Hospital for Women, 374 Bagot Road, Subiaco, WA, Australia; School of Medicine, University of WA, 35 Stirling Highway, Crawley, WA, 6009 Perth, Australia
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26
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Connor S, Tan KY, Pestell CF, Fitzpatrick JP. The Demographic and Neurocognitive Profile of Clients Diagnosed With Fetal Alcohol Spectrum Disorder in PATCHES Paediatrics Clinics Across Western Australia and the Northern Territory. Alcohol Clin Exp Res 2020; 44:1284-1291. [PMID: 32333805 DOI: 10.1111/acer.14345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/17/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a diagnosis relating to neurocognitive impairments associated with prenatal alcohol exposure. A key aspect of improving FASD diagnostic processes and management is understanding the demographic and neurocognitive profile of those living with FASD. The aim of this study was to describe the demographic and neurocognitive profile of the first 199 individuals diagnosed with FASD in PATCHES Paediatrics clinics. METHODS A retrospective cross-sectional descriptive study design was conducted with individuals diagnosed with FASD between 2013 and 2018 through a multidisciplinary team according to the Australian FASD Diagnostic Guidelines. RESULTS Participants were primarily male 133 (66.8%) and Aboriginal Australian 147 (73.9%), aged 2 to 31 (mean 10.5), with 94 (47.3%) from remote or very remote parts of Western Australia. Participants came from low 119 (59.8%), medium 48 (24.1%), and high 32 (16.1%) socioeconomic (SE) backgrounds. Low SE background was found to be a predictor of number of sentinel facial features (Wald χ2 (1) = 4.03, p < 0.05). Most received a diagnosis of FASD with <3 sentinel features 165 (82.9%). Participants either had 6 or more 46 (23.1%), 5 44 (22.1%), 4 55 (27.6%), or 3 (27.1%) neurodevelopmental domains impaired. Executive functioning was the most commonly impaired neurodevelopmental domain 158 (79.4%), and 31 (61%) reported sleep disturbance. ADHD was the most observed comorbid condition (41.7%). CONCLUSIONS This study improves our current understanding of neurocognitive and demographic profiles in individuals with FASD that have been clinically referred for diagnosis within Western Australia and the Northern Territory, and highlights the importance of prevention and early assessment/diagnosis as well as guidance regarding more targeted interventions. FASD affects individuals from all cultural and SE backgrounds. Individuals from middle to higher SE groups are at risk of FASD with prevention efforts needing to target these sectors of society. Suggestions for future research directions are also provided.
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Affiliation(s)
- Sophia Connor
- The University of Western Australia, (SC, KYT, CFP, JPF), Crawley, Western Australia, Australia.,PATCHES Paediatrics, (SC, KYT, CFP, JPF), Nedlands, Western Australia, Australia
| | - Kuen Yee Tan
- The University of Western Australia, (SC, KYT, CFP, JPF), Crawley, Western Australia, Australia.,PATCHES Paediatrics, (SC, KYT, CFP, JPF), Nedlands, Western Australia, Australia.,Telethon Kids Institute (TKI), (KYT, CFP, JPF), Nedlands, Western Australia, Australia
| | - Carmela F Pestell
- The University of Western Australia, (SC, KYT, CFP, JPF), Crawley, Western Australia, Australia.,PATCHES Paediatrics, (SC, KYT, CFP, JPF), Nedlands, Western Australia, Australia.,Telethon Kids Institute (TKI), (KYT, CFP, JPF), Nedlands, Western Australia, Australia
| | - James P Fitzpatrick
- The University of Western Australia, (SC, KYT, CFP, JPF), Crawley, Western Australia, Australia.,PATCHES Paediatrics, (SC, KYT, CFP, JPF), Nedlands, Western Australia, Australia.,Telethon Kids Institute (TKI), (KYT, CFP, JPF), Nedlands, Western Australia, Australia
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27
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Yeo YX, Pestell CF, Bucks RS, Allanson F, Weinborn M. Metacognitive knowledge and functional outcomes in adults with acquired brain injury: A meta-analysis. Neuropsychol Rehabil 2019; 31:453-478. [PMID: 31876262 DOI: 10.1080/09602011.2019.1704421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pronounced difficulties in functional outcomes often follow acquired brain injury (ABI), and may be due, in part, to deficits in metacognitive knowledge (being unaware of one's cognitive strengths and limitations). A meta-analytic review of the literature investigating the relationship between metacognitive knowledge and functional outcomes in ABI is timely, particularly given the presence of apparently inconsistent findings. Twenty-two articles revealed two distinct methods of measuring metacognitive knowledge: (1) absolute (the degree of inaccurate self-appraisal regardless of whether the error tends towards under- or over-confident estimations) and (2) relative (the degree and the direction of the inaccuracy) discrepancy. Separate meta-analyses were conducted for absolute and relative discrepancy studies to assess the relationship between metacognitive knowledge and functional outcomes (affect-related quality of life, family and community integration, and work outcomes). The pattern of results found suggested that better metacognitive knowledge is related to better overall functional outcomes, but the relationship may differ depending on the outcome domain. These findings generally support the importance of focusing on metacognitive knowledge to improve outcomes following ABI. Nonetheless, the relatively small effect sizes observed suggest that other predictors of functional outcome should be investigated, including other subdomains of metacognition.
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Affiliation(s)
- Yong Xiang Yeo
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Romola S Bucks
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Fiona Allanson
- School of Psychological Science, University of Western Australia, Perth, Australia
| | - Michael Weinborn
- School of Psychological Science, University of Western Australia, Perth, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Mancini VO, Rudaizky D, Pearcy BT, Marriner A, Pestell CF, Gomez R, Bucks RS, Chen W. Factor structure of the Sleep Disturbance Scale for Children (SDSC) in those with Attention Deficit and Hyperactivity Disorder (ADHD). Sleep Med X 2019; 1:100006. [PMID: 33870165 PMCID: PMC8041133 DOI: 10.1016/j.sleepx.2019.100006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/21/2019] [Accepted: 06/21/2019] [Indexed: 11/25/2022] Open
Abstract
Objective Method Results Conclusion The original SDSC factor structure could not be replicated in an ADHD sample. The fit of competing factor structures was evaluated. An optimal structure including six-specific and a general factor was identified. The alternative structure reported adequate psychometric properties. The SDSC may be used to yield a total sleep difficulties score in ADHD samples.
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Fitzpatrick JP, Pestell CF. Neuropsychological Aspects of Prevention and Intervention for Fetal Alcohol Spectrum Disorders in Australia. J Pediatr Neuropsychol 2016. [DOI: 10.1007/s40817-016-0018-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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