Cognitive Impairments And Post Traumatic Stress Symptoms In Children With Traumatic Brain Injury: A Longitudinal Study
Funder
National Health and Medical Research Council
Funding Amount
$482,250.00
Summary
Traumatic brain injury in children is common with more than 2000 new cases a year in Queensland and Victoria alone. Many children who experience a brain injury go on to have long-term difficulties such as significant educational and social problems. Post-traumatic stress occurs in children following traumatic physical injury. However it is not clear to what extent this is so for children who have received a traumatic brain injury. Furthermore, when there is a traumatic brain injury and traumatic ....Traumatic brain injury in children is common with more than 2000 new cases a year in Queensland and Victoria alone. Many children who experience a brain injury go on to have long-term difficulties such as significant educational and social problems. Post-traumatic stress occurs in children following traumatic physical injury. However it is not clear to what extent this is so for children who have received a traumatic brain injury. Furthermore, when there is a traumatic brain injury and traumatic stress, it is not clear how these interact, how they influence long-term outcomes, and what factors such as pre-injury functioning and family support and distress mediate outcomes. These issues are very important since effective rehabilitation of children following traumatic brain injury is essential to maximise long-term functioning and minimise disability. To be effective, rehabilitation must be guided by the knowledge about key factors that determine the recovery process. This study aims to provide answers to these questions by following two cohorts of children (aged 6-14) over 18 months after receiving a traumatic brain injury. In total 240 children will be recruited from Brisbane and Melbourne hospitals. They will be assessed at three, six, twelve and eighteen months post-injury using measures of cognitive, psychological and social functioning. Information on parent distress and behaviours will also be obtained. The information obtained will provide the basis for the development of a specific rehabilitation strategy for children with traumatic brain injury, including information on strategies to help prevent any confounding impact of post-traumatic stress on recovery.Read moreRead less
A Prospective Study Of Traumatic Stress In Children Involved In Motor Vehicle Accidents
Funder
National Health and Medical Research Council
Funding Amount
$185,889.00
Summary
Motor vehicle accidents (MVAs) are relatively frequent major life trauma that represent significant life threatening experiences. Not surprisingly evidence suggests that MVAs represent a frequent trigger for the development of post traumatic stress disorder (PTSD), although studies have typically focussed upon adult survivors. Local statistics indicate a significant proportion of children will experience a MVA of sufficient severity to warrant attendance at hospital. This project is of significa ....Motor vehicle accidents (MVAs) are relatively frequent major life trauma that represent significant life threatening experiences. Not surprisingly evidence suggests that MVAs represent a frequent trigger for the development of post traumatic stress disorder (PTSD), although studies have typically focussed upon adult survivors. Local statistics indicate a significant proportion of children will experience a MVA of sufficient severity to warrant attendance at hospital. This project is of significance because it will provide badly needed information about the prevalence and course of emotional and behavioural problems in children following exposure to a serious MVA. More broadly the study should provide valuable information on post-traumatic stress responses in children. Furthermore, it will enable us to identify the factors that place children at particular risk of developing psychological problems following a MVA. This will provide information to help design of interventions to prevent the development of PTSD and other forms of psychopathology following MVAs. Such data will also permit identification of those children who are at particular risk of psychological morbidity after MVA trauma and for whom preventive interventions are most likely to be beneficial.Read moreRead less
Comparison Of Cognitive-behavioural Treatments For Children With PTSD Following An Accidental Injury: A Multi-site RCT.
Funder
National Health and Medical Research Council
Funding Amount
$359,111.00
Summary
Children who experience a traumatic event are at increased risk of developing Post traumatic stress disorder (PTSD). Despite the significant consequences, and the poor prognosis of this disorder, few evaluations of interventions for PTSD in children exist. This project will compare two active treatments (child vs. family-focused cognitive behaviour therapy) for children experiencing PTSD following an accidental injury (the most common category of traumatic events experienced by children).
Inhibition Of Fear Memories By Extinction: Neural Substrates.
Funder
National Health and Medical Research Council
Funding Amount
$234,250.00
Summary
Anxiety disorders [e.g., Post Traumatic Stress Disorder (PTSD)] are the most prevalent type of psychopathology in the industrialised world. They are associated with characteristic behavioural (e.g., heightened startle) and autonomic (e.g., cardiovascular) reactions. These disorders are often characterised as an inability to regulate the emotion of fear. Significant progress has been made in understanding the neural and cellular processes involved in the establishment of fear memories, but relati ....Anxiety disorders [e.g., Post Traumatic Stress Disorder (PTSD)] are the most prevalent type of psychopathology in the industrialised world. They are associated with characteristic behavioural (e.g., heightened startle) and autonomic (e.g., cardiovascular) reactions. These disorders are often characterised as an inability to regulate the emotion of fear. Significant progress has been made in understanding the neural and cellular processes involved in the establishment of fear memories, but relatively little is known about the mechanisms by which fear memories can be inhibited or suppressed. Understanding this latter process is a key to the development of effective treatments for anxiety disorders such as PTSD where the patient suffers from persistent, intrusive, unwanted trauma memories. A common experimental procedure for reducing learned fear is to repeatedly expose the subject to a fear-eliciting stimulus but without any aversive outcome. This procedure leads to a progressive loss, or extinction, of the fear reactions elicited by the stimulus. Historically, the extinction of fear was thought to be due to an erasure of the fear memory. However, recent evidence shows that extinction inhibits, rather than erases, the fear memory. Because the fear memories remain intact, some structure(s) in the brain must inhibit activity in the fear pathway. This project uses extinction of conditioned fear reactions in rat subjects to determine the structure(s) in the brain that inhibit fear memories and their behavioural and cardiovascular expression. It brings together the expertise of four well-established researchers and uses a combination of behavioural, physiological, immunohistochemical, tract tracing, and lesion approaches to achieve this aim. The proposed experiments will reveal the structure(s) in the brain that control the inhibition of fear, as well as the site(s) of this inhibition in the fear pathwayRead moreRead less
Effective Management Of Acute Whiplash Injuries Requires A Pragmatic Approach: An RCT With Stratified Treatments
Funder
National Health and Medical Research Council
Funding Amount
$382,550.00
Summary
Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. ....Whiplash injuries from a motor vehicle crash continue to incur substantial personal and financial costs to the community and the insurance industry. The current approaches to an acute whiplash injury in Australia and internationally have failed to lessen the rate of how many people develop chronic neck pain. Between 40 and 60% still have pain 6 months after injury. Motor Accident Insurance Commission (Qld) figures indicate that 20% of patients with chronic whiplash account for 60% of the costs. Transition from an acute to a chronic condition must be prevented. A new direction in management in the acute stage is urgently required as once the pain has become chronic, it is difficult to help. This research will conduct a novel randomised controlled trial for acute whiplash. It will test individually prescribed multi-professional management against usual care with the aim to lessen the numbers who go on to develop chronic pain. It will be the first clinical trial that acknowledges from the outset that the whiplash injuries and affects people in different ways. Our previous research with acute whiplash patients has documented the variations in presentation from physical, physiological and psychological perspectives. In this trial, management will be prescribed as directed by measurable pain, muscle and psychological impairments in the individual, rather than regard all patients as the same as in other trials. This trial will offer individualised treatments; medical, physiotherapy and-or psychological using an empirically derived treatment algorithm. Cost-effectiveness of the program will be evaluated against that incurred during usual care. It is predicted that early multi-professional management will be less expensive in the long term than existing approaches. This RCT stands to extend knowledge in the management of whiplash associated disorders (WAD).Read moreRead less
The Construction And Validation Of The Assessment Of Mental Health Related Quality Of Life (PsyQoL) Instrument
Funder
National Health and Medical Research Council
Funding Amount
$539,450.00
Summary
Mental Health is one of the national health priority areas as well as one of the largest contributors to burden of disease. WHO projections suggest that by 2020 the burden of depression alone will be second only to cardiovascular disease. New treatments for mental disorders are being developed which must be evaluated. Current research methods do not allow an accurate comparison of the cost effectiveness of these therapies with the cost effectiveness of other medical services as this requires the ....Mental Health is one of the national health priority areas as well as one of the largest contributors to burden of disease. WHO projections suggest that by 2020 the burden of depression alone will be second only to cardiovascular disease. New treatments for mental disorders are being developed which must be evaluated. Current research methods do not allow an accurate comparison of the cost effectiveness of these therapies with the cost effectiveness of other medical services as this requires the measurement of 'utility' or 'quality of life'. The small number of 'generic' 'quality of life instruments' developed to date vary significantly in their 'sensitivity' to different illnesses-their ability to detect change-and none is very sensitive to changes in mental health states. The present project is to overcome this deficit. This will be achieved by refining and expanding an instrument developed in Australia, the Assessment of Quality of Life (AQoL) instrument. This is the only instrument to date which was both constructed using correct psychometric principles of instrument construction and which describes health states in terms of the effect upon a patient's ability to function in a social environment. The new instrument called the PsyQoL will increase instrument sensitivity by including a mental health 'module' to the existing instrument and revising existing items. The methods used will include several methodological innovations in the description of health states and the derivation of utility scores. The project will include a large scale 'validation' study which will include the construction of population 'norms' and also the creation of 'exchange rates' between the PsyQoL and other instrument scores. The significance of the project is that the PsyQoL will allow valid and reliable measurement of health states in a way that creates a 'level playing field' between mental and other health related interventions.Read moreRead less
Healing The Past By Nurturing The Future: Learning How To Identify And Support Indigenous Parents Who Have Experienced Complex Childhood Trauma
Funder
National Health and Medical Research Council
Funding Amount
$1,193,719.00
Summary
Complex childhood trauma causes profound and long-lasting effects on physical, social and emotional wellbeing, which can be triggered during the transition to parenthood and impede the capacity of parents to nurture their children. The transition offers a unique opportunity for healing and preventing intergenerational transmission of trauma. This project co-designs and evaluates acceptability and feasibility of screening and support for Indigenous parents experiencing complex trauma.
Aboriginal And Non-Aboriginal Women Perpetrators Of Violence: A Trial Of A Prison-based Intervention (Beyond Violence)
Funder
National Health and Medical Research Council
Funding Amount
$1,411,825.00
Summary
The proposed study will be the first of its kind in Australia to test a violence prevention program (Beyond Violence) targeting mental health, substance use and violence among incarcerated female offenders with a history of violence. This research responds to the rapidly escalating imprisonment rates among Aboriginal and non-Aboriginal women (particularly for violent offences), and focuses intervention efforts on improving well-being and decreasing reoffending among this vulnerable group.
Indigenous Mental Health Model Of Care: RCT Based On A Trans-diagnostic CBT Program Co-designed With Community
Funder
National Health and Medical Research Council
Funding Amount
$996,217.00
Summary
We propose to develop an Indigenous Model of Mental Health Care (IMMHC) that encompasses psychological therapy and cultural healing practices developed in consultation with local, participating Indigenous communities, that will for the first time treat highly prevalent mood and anxiety disorders in Indigenous Australians.
Trauma-focused CBT & Exercise For Chronic Whiplash: Addressing All Aspects Of A Chronic Condition
Funder
National Health and Medical Research Council
Funding Amount
$673,562.00
Summary
Chronic pain following whiplash injury is common and incurs substantial personal and economic costs. There are few effective treatments available. Recent research has shown that many people with chronic whiplash also have symptoms of posttraumatic stress. This study will investigate whether combining an intervention aimed at decreasing posttraumatic stress with exercise will decrease pain and disability in people with chronic whiplash