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Soo CA, Tate RL, Catroppa C, Benson S, McDonald S, Rapee RM, Anderson V. A randomized controlled trial of cognitive behavioural therapy for managing anxiety in adolescents with acquired brain injury. Neuropsychol Rehabil 2024; 34:74-102. [PMID: 36534593 DOI: 10.1080/09602011.2022.2154811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
The aim of this randomized controlled trial was to evaluate an adapted cognitive behavioural therapy (CBT) programme for treating anxiety in adolescents with acquired brain injury (ABI). Participants with ABI (12-19 years, N = 36) recruited from two sites were randomly allocated into either the intervention receiving 11 sessions of CBT (n = 19) or a wait-list control group (n = 17). The primary outcome was participants' anxiety and secondary outcomes were participants' depression, self-perception, and participation in daily activities, and parental stress, measured at (i) pre-intervention, (ii) immediately post-intervention, (iii) 2 months post-intervention and (iv) 6 months post-intervention. Repeated measures ANOVAs revealed significant treatment effects with the intervention group demonstrating greater improvements in self-reported anxiety, as well as self- and parent-reported depression from pre- to immediately post-treatment, compared to wait-list controls. Little evidence of treatment effects was found for the remaining outcomes (parent-reported anxiety, self-perception, daily participation, and parental stress). Significant improvement in self-reported anxiety found immediately post-treatment was maintained at two- and six-month follow-up. Findings provide support for adapted CBT as an effective means of reducing anxious and depressive symptomatology in adolescents with ABI compared to waitlist controls, and offer support for the use of these techniques to manage anxiety in this population.
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Affiliation(s)
- Cheryl A Soo
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Robyn L Tate
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, St Leonards, Australia
| | - Cathy Catroppa
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Suzanne Benson
- Rehabilitation Department, Children's Hospital at Westmead, Sydney, Australia
| | - Skye McDonald
- School of Psychology, University of NSW, Sydney, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Macquarie University, Sydney, Australia
| | - Vicki Anderson
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
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Soo C, Kiernan M, Anderson V. Trait Mindfulness as a Mediator of Anxiety and Psychosocial Functioning in Young People with Acquired Brain Injury. Dev Neurorehabil 2020; 23:231-239. [PMID: 31362568 DOI: 10.1080/17518423.2019.1645225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Following acquired brain injury (ABI), young people may experience increased anxiety as well as difficulties with their psychosocial functioning. This study examined trait mindfulness as a mediator of the relationship between anxiety and psychosocial domains of School and Leisure Activities (SLA), Interpersonal Relationships (IR) and Daily Living Skills (DLS).Method: Participants were adolescents with ABI (aged 12-19 years, N = 38). Standardised measures were used to assess anxiety, trait mindfulness, and psychosocial functioning.Results: Higher levels of anxiety were found to be associated with reduced IR (p < .05) and DLS (p < .05). Increased trait mindfulness was found to be associated with lowered anxiety (p < .01), as well as with better IR (p < .05) and DLS (p <.01). Mediation analyses found a significant indirect effect for the relationship between anxiety and DLS through trait mindfulness.Conclusion: Findings highlight the contribution of trait mindfulness as a mediator between anxiety and psychosocial functioning, such that increased mindfulness and lower levels of anxiety are related to better DLS.
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Affiliation(s)
- Cheryl Soo
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia
| | | | - Vicki Anderson
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia
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Wearne T, Anderson V, Catroppa C, Morgan A, Ponsford J, Tate R, Ownsworth T, Togher L, Fleming J, Douglas J, Docking K, Sigmundsdottir L, Francis H, Honan C, McDonald S. Psychosocial functioning following moderate-to-severe pediatric traumatic brain injury: recommended outcome instruments for research and remediation studies. Neuropsychol Rehabil 2018; 30:973-987. [DOI: 10.1080/09602011.2018.1531768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Travis Wearne
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
| | - Vicki Anderson
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Clinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Psychological Service, The Royal Children’s Hospital, Parkville, Australia
| | - Cathy Catroppa
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Clinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Psychological Sciences & Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Angela Morgan
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Clinical Sciences, Murdoch Children’s Research Institute, Parkville, VIC, Australia
- Department of Psychological Sciences & Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Jennie Ponsford
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Psychological Sciences, Monash University Monash-Epworth Rehabilitation Centre, Melbourne, VIC, Australia
- Monash-Epworth rehabilitation Research Centre, Melbourne, Australia
| | - Robyn Tate
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, the University of Sydney, Sydney, NSW, Australia
| | - Tamara Ownsworth
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Leanne Togher
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jennifer Fleming
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Science, University of Queensland, St Lucia, QLD, Australia
| | - Jacinta Douglas
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- School of Allied Health, Department of Community and Clinical Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Kimberley Docking
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Linda Sigmundsdottir
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, the University of Sydney, Sydney, NSW, Australia
| | - Heather Francis
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Cynthia Honan
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
- Department of Psychology, School of Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Skye McDonald
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
- Moving Ahead Centre for Research Excellence in Brain Recovery, Sydney, Australia
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Ryan NP, Catroppa C, Godfrey C, Noble-Haeusslein LJ, Shultz SR, O'Brien TJ, Anderson V, Semple BD. Social dysfunction after pediatric traumatic brain injury: A translational perspective. Neurosci Biobehav Rev 2016; 64:196-214. [PMID: 26949224 PMCID: PMC5627971 DOI: 10.1016/j.neubiorev.2016.02.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 02/24/2016] [Accepted: 02/24/2016] [Indexed: 12/21/2022]
Abstract
Social dysfunction is common after traumatic brain injury (TBI), contributing to reduced quality of life for survivors. Factors which influence the development or persistence of social deficits after injury remain poorly understood, particularly in the context of ongoing brain maturation during childhood and adolescence. Aberrant social interactions have recently been modeled in adult and juvenile rodents after experimental TBI, providing an opportunity to gain new insights into the underlying neurobiology of these behaviors. Here, we review our current understanding of social dysfunction in both humans and rodent models of TBI, with a focus on brain injuries acquired during early development. Modulators of social outcomes are discussed, including injury-related and environmental risk and resilience factors. Disruption of social brain network connectivity and aberrant neuroendocrine function are identified as potential mechanisms of social impairments after pediatric TBI. Throughout, we highlight the overlap and disparities between outcome measures and findings from clinical and experimental approaches, and explore the translational potential of future research to prevent or ameliorate social dysfunction after childhood TBI.
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Affiliation(s)
- Nicholas P Ryan
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia.
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia; Department of Psychology, Royal Children's Hospital, Parkville, VIC, Australia.
| | - Celia Godfrey
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia.
| | - Linda J Noble-Haeusslein
- Departments of Neurological Surgery and Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA.
| | - Sandy R Shultz
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
| | - Terence J O'Brien
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
| | - Vicki Anderson
- Australian Centre for Child Neuropsychological Studies, Murdoch Childrens Research Institute, Parkville, VIC, Australia; Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia; Department of Psychology, Royal Children's Hospital, Parkville, VIC, Australia.
| | - Bridgette D Semple
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, VIC, Australia.
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