Massey Documents by Type

Permanent URI for this communityhttps://mro.massey.ac.nz/handle/10179/294

Browse

Subject: search.filters.subject.Mild traumatic brain injury

Search Results

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Patterns of post-traumatic stress symptoms in mild traumatic brain injury and their relationship with outcomes: a latent profile analysis.
    (Taylor and Francis Group, 2023-06-23) Faulkner JW; Snell DL; Theadom A; de Terte I; Low R
    INTRODUCTION: Post-traumatic stress symptoms (PTSS) are known to contribute to postconcussion symptoms and functional status following mild traumatic brain injury (mTBI). Identifying symptom cluster profiles provide an opportunity to better understand PTSS and their influence on these outcomes. In this study, latent profiles of PTSS following mTBI were identified, and their association with mTBI outcomes was examined. The predictive role of demographic and injury related variables on profile membership was also explored. METHOD: Adults (N = 252) completed self report measures of PTSS and mTBI outcomes (post-concussion symptoms and functional status) within three months of mTBI. These measures were re-administered six months later (N = 187). Latent profile analysis (LPA) was used to ascertain the latent class structure of PTSS, and regression analysis to examine predictors of profiles. ANCOVA, with general psychological distress as a covariate, revealed the relationship between profiles and mTBI outcomes. RESULTS: LPA identified a four-profile model to best describe PTSS at baseline. This included a resilient (49.6%), moderate (30.6%), moderate with high intrusion/avoidance (14.3%) and a highly symptomatic profile (5.6%). A secondary school education or less and/or unemployment before mTBI was significantly more likely in the highly symptomatic profile, as well as sustaining an mTBI due to an assault or motor vehicle accident. PTSS latent class membership was significantly associated with mTBI outcomes even when controlling for general psychological distress. The resilient group had significantly better outcomes at baseline and six-month follow-up. However, no significant differences in mTBI outcomes emerged between the moderate, moderate with high intrusion/avoidance and the highly symptomatic profiles. CONCLUSION: The current study provides novel information on the symptom profiles of PTSS in mTBI, predictors of profile membership and their relationship with mTBI outcomes. Although future research using this approach is needed, the current study offers a more in-depth understanding of PTSS in mTBI to inform clinical care.
  • Thumbnail Image
    Item
    Energy crisis : prevalence, severity, treatment and persistence of fatigue after mild traumatic brain injury : a dissertation presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 2012) Norrie, Joan
    The objectives of this research were to investigate the prevalence and severity of post-mild traumatic brain injury (MTBI) fatigue in a non-litigant New Zealand sample and to evaluate the effectiveness of a treatment programme. Subsequently, a third objective evolved – the investigation of the natural history of post-MTBI fatigue and the degree to which reliable clinically significant change occurred over time regardless of intervention type. The research took the form of two studies where analysis was based on group data followed by analysis of the Study Two data at an individual participant level. Study One, a longitudinal prospective study examined fatigue prevalence, severity, predictors and co-variates over six months post mild traumatic brain injury (MTBI). Participants completed the Fatigue Severity Scale (FSS), Rivermead Postconcussion Symptoms Questionnaire (RPSQ), Hospital Anxiety and Depression Scale (HADS) and the Short Form 36 Health Survey-Version 2 (SF-36v2). Complete data were available for 159 participants. Key measures; prevalence - RPSQ Item 6: severity - FSS. The effect of time on fatigue prevalence and severity was examined using ANOVA. Multiple regression analysis identified statistically significant covariates. The study found post-MTBI fatigue prevalence was 68%, 38% and 34% at 1 week, 3 and 6 months respectively. There was a strong effect for time over the first three months and moderate to high correlations between fatigue prevalence and severity. Early fatigue strongly predicted later fatigue. Depression, but not anxiety, was a predictor. Fatigue was seen as laziness by family or friends in 30% of cases. Conclusions for Study 1 were that post-MTBI fatigue is a persistent postconcussion symptom, exacerbated by depression but not anxiety. It diminishes in the first three months and then becomes relatively stable, suggesting the optimum intervention placement is at three months or more post-MTBI. Study Two was a quasi-experimental longitudinal prospective controlled study which had a two by three, treatment by time, repeated measures research design. Participants with a history of MTBI were recruited from three Concussion Clinics. Post-MTBI fatigue was identified through Item 6 of the Rivermead Postconcussion Symptoms Questionnaire (RPSQ) and the outcome measures were the FSS, Fatigue Assessment Scale, RPSQ, Hospital Anxiety and Depression Scale and Sydney Psychosocial Re-integration Scale. All treatment group participants (N = 18) came from the same Concussion Clinic as the principal researcher, and control participants (N = 23) came from other Concussion Clinics. The question of whether the participants thought their significant others perceived them as lazy was also explored in Study Two. A 12 week manualised programme (PERT) was developed specifically for Study Two and was delivered by either a clinical psychologist or occupational therapist through a combination of personal and phone sessions. No significant time by group effect was found for any of the outcome measures. A time effect was found for all of the outcome measures. During the search for explanations for these findings it was discovered that the two conditions were more similar than expected. The majority (85.7%) of the control group had, in accordance with current rehabilitation practice, engaged in exercise and/or received interventions similar to the treatment group which presented a confound to the study. The data from the two groups was combined and analysed for information regarding reliable clinically significant change RCSC in individual participants. No significant correlations with demographic variables such as time since injury, age, gender, level of education, work type and injury type were found. Female gender was related to positive RCSC at three months post-baseline but not at six months post-baseline. Fatigue severity was significantly positively related to participants’ belief that relatives perceived them as lazy. Study Two provided no evidence to support this treatment for post-MTBI fatigue. Prevalence and severity of post-MTBI fatigue reduced over the six months of Study Two, however on examination of individual data the majority of the participants showed no reliable clinically significant change, supporting the need for further research into finding an effective post-MTBI fatigue treatment. The small sample size and the similarity of the treatment and control group conditions were major factors in confounding the findings of the study. There is a comparatively large percentage of individuals reporting prevalence and severity of post-MTBI fatigue in New Zealand samples and, although the combined psychoeducation and aerobic exercise approach could not be evaluated, the postconcussion and general literature suggests there is merit in continuing research into its effectiveness in treating post-MTBI fatigue.
  • Thumbnail Image
    Item
    Outcome evaluation of the Massey University Concussion Clinic: a pilot study : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 2009) Rifshana, Fathimath
    The primary aim of the present study was to evaluate the effectiveness of the intervention provided by Massey University Concussion Clinic for individuals following Mild Traumatic Brain Injury (MTBI). Concussion Clinics were set up across New Zealand to provide early intervention and assessment for individuals with MTBI to prevent long term complaints. Treatment outcomes at these clinics have not been empirically examined before. The current study compared the levels of post concussion symptoms, anxiety, depression, and psychosocial functioning between an intervention and a control group using a quasi-experimental design. In addition, reasons for nonattendance to the clinic, and participants’ perceptions of their recovery were also explored. The main outcome measures used were the Rivermead Postconcussion Symptoms Questionnaire, the Hospital Anxiety and Depression Scale, and the Sydney Psychosocial Reintegration Scale-2. Outcomes were initially assessed soon after injury or referral to the clinic and then three months later. Participants were recruited from the Palmerston North Hospital Emergency Department and the Massey University Concussion Clinic. With 20 participants in the intervention group and 15 in the control group, the main results showed that the Concussion Clinic intervention significantly decreased the level of anxiety and depression reported by participants in the intervention group over the control group. Greater improvements in post concussion symptoms and psychosocial functioning were also indicated in the intervention group. Additional findings suggest difficulty with transportation as a reason for nonattendance, which could be a potential barrier to recovery. Furthermore, participants highlighted the benefits of attending the service and its role in their recovery. Important issues relating to the referral processes were also identified. Findings of the current study suggest that the Concussion Clinic intervention is effective in improving recovery for those accessing the service. Nevertheless, these results must be interpreted with caution due to the small sample size. Further research is warranted to examine the effectiveness of the Concussion Clinics with larger samples, and the current study may serve as a valuable pilot for these future investigations.