The relationship between employment status and psychological well-being is investigated in a long... more The relationship between employment status and psychological well-being is investigated in a longitudinal study of 16-year-old school leavers. Significant differences between employed, unemployed and government training scheme groups on a number of measures of well-being were found, these differences persisting after adjustment for individual differences and for other factors known to affect mental health. Implications for clinical practice and public health are considered and possible explanations for the poorer psychological health of the unemployed group are discussed.
This paper reports the process of developing an assistive technology transitional living service ... more This paper reports the process of developing an assistive technology transitional living service for brain injury rehabilitation. The aim of the service is to take advantage of smart home technology to assess, rehabilitate and promote independence in individuals with acquired brain injury who wish to live on their own in the community.
Objectives: To describe five new measures of non-cognitive neuro-behavioural change after acquire... more Objectives: To describe five new measures of non-cognitive neuro-behavioural change after acquired brain injury (impulsivity, disinhibition, emotion regulation, social perception and motivation) and to evaluate their criterion validity with reference to a group of healthy individuals. Methods: This study used a cross-sectional mixed design. The BNBS were administered to a non-clinical sample of the general adult population (n = 128) and proxy data was collected for 26% of this sample. The BNBS were also administered to a sample of individuals with acquired brain injury (ABI) (n = 84) with 88% providing proxy data. Results: Mean scores of the non-clinical sample were compared with the ABI group who scored significantly higher. Furthermore, individuals from the non-clinical group scored themselves higher than their relatives on the social perception scale, but no significant differences were found between self- and proxy- reports in the ABI group. Receiver Operating Characteristic (RO...
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, Jan 17, 2015
The aim of this study was to describe the translation and adaptation of the BIRT personality ques... more The aim of this study was to describe the translation and adaptation of the BIRT personality questionnaires for the Italian population. This included the replication of validity testing and the collection of normative data. Following translation and adaptation according to cross-cultural guidelines, the questionnaires were administered as a pre-test to a sample of 20 healthy subjects and then to 10 patients. The questionnaires were then administered to 120 healthy subjects equally distributed by sex, education, and age, to collect normative data from an Italian population. The questionnaires were easily administered to both healthy subjects and patients. Statistical analysis on normative data was conducted to find the mean value for each questionnaire. This study lays the foundations for using a new instrument to assess behavioral changes after acquired brain injury on the Italian population.
The long term support of people with neurobehavioural disorders following a severe traumatic brai... more The long term support of people with neurobehavioural disorders following a severe traumatic brain injury (TBI) can amount to a lifetime cost of several million dollars. Such costs are often obtained from personal injury compensation. However, those not eligible for such awards often depend on their families to provide support and care at no direct financial cost, but with indirect financial and human costs in terms of loss of productivity, and increased stress and health problems. The aim of this paper is to examine the role of support workers in the long-term care of those with neurobehavioural deficits following severe TBI and to discuss the feasibility of meeting some aspects of their role with technological solutions. This critical review uses observational and cost-analysis methodologies to establish the roles and costs associated with staff supporting people with neurobehavioural disorders resulting from severe TBI. The role of support workers is varied and includes prompting...
ABSTRACT Brain injury affects sexual function in wide-ranging ways. It can have either a direct e... more ABSTRACT Brain injury affects sexual function in wide-ranging ways. It can have either a direct effect on sexual function or an indirect effect by means of the effect of brain injury on motor, sensory, cognitive, behavioural and emotional function. Studies of the nature and prevalence of sexual dysfunction following traumatic brain injury are reviewed. Means to determine the nature of such sexual problems are discussed and appropriate means of intervention outlined. A proactive approach to assessment and intervention is advocated.
A review of the literature on psychological recovery from head injury in childhood reveals a lack... more A review of the literature on psychological recovery from head injury in childhood reveals a lack of well designed, long-term follow-up studies. Tentative conclusions concerning cognitive and behavioural changes after childhood head injury are drawn and the implications for rehabilitation discussed. Most children with mild or moderate injuries appear to make excellent recoveries with little evidence of long-term sequelae. However,
This study explored the effects of severe acquired brain injury (ABI) on self-esteem. A within-su... more This study explored the effects of severe acquired brain injury (ABI) on self-esteem. A within-subjects design investigated 22 severe ABI survivors' self-reported responses on measures of self-esteem, mood and awareness of deficit. Data on cognitive ability and awareness of degree of executive impairment were included in the analysis. Self-esteem was measured using Rosenberg's Self-Esteem Scale (Rosenberg) and psychological distress by the Hospital Anxiety and Depression Scale (HADS). Self-esteem was found to be consistent over a two-week interval. Participants reported that their self-esteem had suffered following ABI when contrasting their current self-esteem with their retrospective perceptions. Self-esteem was highly correlated with psychological distress. More intact cognitive functioning and awareness of deficit were associated with lower self-esteem. The paradoxical finding that survivors who were more impaired cognitively and/or less aware of their deficits reported higher self-esteem poses an ethical dilemma for clinicians. It is hoped that this finding, along with the consistency of self-esteem ratings sparks further debate about how best to address issues of self-esteem among severe ABI survivors, particularly in the context of psychological distress, during rehabilitation.
... Both programmes were influenced by approaches established in the USA (Ben-Yishay & Gold, ... more ... Both programmes were influenced by approaches established in the USA (Ben-Yishay & Gold, 1990; Prigatano et al., 1996). The Ticehurst Unit was established in a psychiatric hospital whereas at Unsted there was a tradition of physical and neurological rehabilitation. ...
The case of Julia, a young woman with a severe memory impairment following an anterior communicat... more The case of Julia, a young woman with a severe memory impairment following an anterior communicating artery aneurism, is presented. Her case demonstrates the effective use to which compensatory strategies can be put and the improved level of independence that can be achieved. The development of her strategies is described and the question of why some people are much more
To determine whether gains in personal independence can be achieved in individuals 10 or more yea... more To determine whether gains in personal independence can be achieved in individuals 10 or more years after very severe acquired brain injury. Four individuals in a continuing (slow stream) rehabilitation centre were assessed by an occupational therapist (OT) and programmes were designed to help the individual enhance personal independence. Support staff were trained to implement these programmes under the guidance of the OT. Methods described by Giles, Ridley, Dill, and Frye (1997) were used. Pre- and post-training measures were taken as well as follow up measures to assess the durability of such changes. The results demonstrate that it is possible to achieve clinically significant improvements in personal independence many years after very severe acquired brain injury. The findings of this study suggest that personally and clinically significant goals can be achieved 10 or more years after brain injury and there should be continuing effort to improve the circumstances of individuals with acquired brain injury. Such gains can be achieved through consistent application of such programmes by support workers working under the supervision of an occupational therapist.
The literature on brain injury and the family is examined to provide an evidence base for family ... more The literature on brain injury and the family is examined to provide an evidence base for family intervention. In the absence of methodologically sound studies which evaluate the efficacy of family intervention, current practice should be based on the findings of studies that have investigated how families adapt and the difficulties they face in this process. The implications of this literature should be considered at all stages in the rehabilitation process and in all forms of contact with the family.
Journal of Clinical and Experimental Neuropsychology, 2011
Disturbances in emotional regulation following acquired brain injury have been found to be both p... more Disturbances in emotional regulation following acquired brain injury have been found to be both prevalent and particularly disabling. Despite this, relatively little attention has been given to identifying characteristics of such deficits in a systematic way. We therefore describe the development of a new questionnaire measure of disturbances in emotional regulation that may occur following acquired brain injury. The measure demonstrates excellent psychometric properties, including high test-retest (.95) and split half (.96) reliability, high internal consistency (.96), and good concurrent validity (r = .64-.82). The questionnaire measures characteristics that are distinguishable from measures of cognitive ability and from other tests of affect. There was moderate overlap between self-report and relative versions of the questionnaire. Results suggest that the relative version has the stronger predictive value. The potential uses of the measure in relation to theory and practice are discussed.
Journal of Clinical and Experimental Neuropsychology, 2008
Motivational deficits following acquired brain injury have been found to be both prevalent and pa... more Motivational deficits following acquired brain injury have been found to be both prevalent and particularly disabling. Despite this, relatively little attention has been given to such deficits. The development of self and informant versions of a new questionnaire measure of the changes in motivation that may occur following acquired brain injury is described. The measure demonstrates excellent psychometric properties including high test-retest (r = .90) and split-half reliability (.94), high internal consistency (Cronbach's alpha = .94), and good concurrent validity. The study also demonstrates that the questionnaire is measuring a different domain to cognitive tests and tests of affect, but one that is predictive of brain injury outcome. There was moderate overlap between self-report and relative versions of the questionnaire (r = .41) but results suggest that the relative version has the stronger predictive value. The potential uses of the measure in relation to theory and practice are discussed.
The relationship between employment status and psychological well-being is investigated in a long... more The relationship between employment status and psychological well-being is investigated in a longitudinal study of 16-year-old school leavers. Significant differences between employed, unemployed and government training scheme groups on a number of measures of well-being were found, these differences persisting after adjustment for individual differences and for other factors known to affect mental health. Implications for clinical practice and public health are considered and possible explanations for the poorer psychological health of the unemployed group are discussed.
This paper reports the process of developing an assistive technology transitional living service ... more This paper reports the process of developing an assistive technology transitional living service for brain injury rehabilitation. The aim of the service is to take advantage of smart home technology to assess, rehabilitate and promote independence in individuals with acquired brain injury who wish to live on their own in the community.
Objectives: To describe five new measures of non-cognitive neuro-behavioural change after acquire... more Objectives: To describe five new measures of non-cognitive neuro-behavioural change after acquired brain injury (impulsivity, disinhibition, emotion regulation, social perception and motivation) and to evaluate their criterion validity with reference to a group of healthy individuals. Methods: This study used a cross-sectional mixed design. The BNBS were administered to a non-clinical sample of the general adult population (n = 128) and proxy data was collected for 26% of this sample. The BNBS were also administered to a sample of individuals with acquired brain injury (ABI) (n = 84) with 88% providing proxy data. Results: Mean scores of the non-clinical sample were compared with the ABI group who scored significantly higher. Furthermore, individuals from the non-clinical group scored themselves higher than their relatives on the social perception scale, but no significant differences were found between self- and proxy- reports in the ABI group. Receiver Operating Characteristic (RO...
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, Jan 17, 2015
The aim of this study was to describe the translation and adaptation of the BIRT personality ques... more The aim of this study was to describe the translation and adaptation of the BIRT personality questionnaires for the Italian population. This included the replication of validity testing and the collection of normative data. Following translation and adaptation according to cross-cultural guidelines, the questionnaires were administered as a pre-test to a sample of 20 healthy subjects and then to 10 patients. The questionnaires were then administered to 120 healthy subjects equally distributed by sex, education, and age, to collect normative data from an Italian population. The questionnaires were easily administered to both healthy subjects and patients. Statistical analysis on normative data was conducted to find the mean value for each questionnaire. This study lays the foundations for using a new instrument to assess behavioral changes after acquired brain injury on the Italian population.
The long term support of people with neurobehavioural disorders following a severe traumatic brai... more The long term support of people with neurobehavioural disorders following a severe traumatic brain injury (TBI) can amount to a lifetime cost of several million dollars. Such costs are often obtained from personal injury compensation. However, those not eligible for such awards often depend on their families to provide support and care at no direct financial cost, but with indirect financial and human costs in terms of loss of productivity, and increased stress and health problems. The aim of this paper is to examine the role of support workers in the long-term care of those with neurobehavioural deficits following severe TBI and to discuss the feasibility of meeting some aspects of their role with technological solutions. This critical review uses observational and cost-analysis methodologies to establish the roles and costs associated with staff supporting people with neurobehavioural disorders resulting from severe TBI. The role of support workers is varied and includes prompting...
ABSTRACT Brain injury affects sexual function in wide-ranging ways. It can have either a direct e... more ABSTRACT Brain injury affects sexual function in wide-ranging ways. It can have either a direct effect on sexual function or an indirect effect by means of the effect of brain injury on motor, sensory, cognitive, behavioural and emotional function. Studies of the nature and prevalence of sexual dysfunction following traumatic brain injury are reviewed. Means to determine the nature of such sexual problems are discussed and appropriate means of intervention outlined. A proactive approach to assessment and intervention is advocated.
A review of the literature on psychological recovery from head injury in childhood reveals a lack... more A review of the literature on psychological recovery from head injury in childhood reveals a lack of well designed, long-term follow-up studies. Tentative conclusions concerning cognitive and behavioural changes after childhood head injury are drawn and the implications for rehabilitation discussed. Most children with mild or moderate injuries appear to make excellent recoveries with little evidence of long-term sequelae. However,
This study explored the effects of severe acquired brain injury (ABI) on self-esteem. A within-su... more This study explored the effects of severe acquired brain injury (ABI) on self-esteem. A within-subjects design investigated 22 severe ABI survivors' self-reported responses on measures of self-esteem, mood and awareness of deficit. Data on cognitive ability and awareness of degree of executive impairment were included in the analysis. Self-esteem was measured using Rosenberg's Self-Esteem Scale (Rosenberg) and psychological distress by the Hospital Anxiety and Depression Scale (HADS). Self-esteem was found to be consistent over a two-week interval. Participants reported that their self-esteem had suffered following ABI when contrasting their current self-esteem with their retrospective perceptions. Self-esteem was highly correlated with psychological distress. More intact cognitive functioning and awareness of deficit were associated with lower self-esteem. The paradoxical finding that survivors who were more impaired cognitively and/or less aware of their deficits reported higher self-esteem poses an ethical dilemma for clinicians. It is hoped that this finding, along with the consistency of self-esteem ratings sparks further debate about how best to address issues of self-esteem among severe ABI survivors, particularly in the context of psychological distress, during rehabilitation.
... Both programmes were influenced by approaches established in the USA (Ben-Yishay & Gold, ... more ... Both programmes were influenced by approaches established in the USA (Ben-Yishay & Gold, 1990; Prigatano et al., 1996). The Ticehurst Unit was established in a psychiatric hospital whereas at Unsted there was a tradition of physical and neurological rehabilitation. ...
The case of Julia, a young woman with a severe memory impairment following an anterior communicat... more The case of Julia, a young woman with a severe memory impairment following an anterior communicating artery aneurism, is presented. Her case demonstrates the effective use to which compensatory strategies can be put and the improved level of independence that can be achieved. The development of her strategies is described and the question of why some people are much more
To determine whether gains in personal independence can be achieved in individuals 10 or more yea... more To determine whether gains in personal independence can be achieved in individuals 10 or more years after very severe acquired brain injury. Four individuals in a continuing (slow stream) rehabilitation centre were assessed by an occupational therapist (OT) and programmes were designed to help the individual enhance personal independence. Support staff were trained to implement these programmes under the guidance of the OT. Methods described by Giles, Ridley, Dill, and Frye (1997) were used. Pre- and post-training measures were taken as well as follow up measures to assess the durability of such changes. The results demonstrate that it is possible to achieve clinically significant improvements in personal independence many years after very severe acquired brain injury. The findings of this study suggest that personally and clinically significant goals can be achieved 10 or more years after brain injury and there should be continuing effort to improve the circumstances of individuals with acquired brain injury. Such gains can be achieved through consistent application of such programmes by support workers working under the supervision of an occupational therapist.
The literature on brain injury and the family is examined to provide an evidence base for family ... more The literature on brain injury and the family is examined to provide an evidence base for family intervention. In the absence of methodologically sound studies which evaluate the efficacy of family intervention, current practice should be based on the findings of studies that have investigated how families adapt and the difficulties they face in this process. The implications of this literature should be considered at all stages in the rehabilitation process and in all forms of contact with the family.
Journal of Clinical and Experimental Neuropsychology, 2011
Disturbances in emotional regulation following acquired brain injury have been found to be both p... more Disturbances in emotional regulation following acquired brain injury have been found to be both prevalent and particularly disabling. Despite this, relatively little attention has been given to identifying characteristics of such deficits in a systematic way. We therefore describe the development of a new questionnaire measure of disturbances in emotional regulation that may occur following acquired brain injury. The measure demonstrates excellent psychometric properties, including high test-retest (.95) and split half (.96) reliability, high internal consistency (.96), and good concurrent validity (r = .64-.82). The questionnaire measures characteristics that are distinguishable from measures of cognitive ability and from other tests of affect. There was moderate overlap between self-report and relative versions of the questionnaire. Results suggest that the relative version has the stronger predictive value. The potential uses of the measure in relation to theory and practice are discussed.
Journal of Clinical and Experimental Neuropsychology, 2008
Motivational deficits following acquired brain injury have been found to be both prevalent and pa... more Motivational deficits following acquired brain injury have been found to be both prevalent and particularly disabling. Despite this, relatively little attention has been given to such deficits. The development of self and informant versions of a new questionnaire measure of the changes in motivation that may occur following acquired brain injury is described. The measure demonstrates excellent psychometric properties including high test-retest (r = .90) and split-half reliability (.94), high internal consistency (Cronbach's alpha = .94), and good concurrent validity. The study also demonstrates that the questionnaire is measuring a different domain to cognitive tests and tests of affect, but one that is predictive of brain injury outcome. There was moderate overlap between self-report and relative versions of the questionnaire (r = .41) but results suggest that the relative version has the stronger predictive value. The potential uses of the measure in relation to theory and practice are discussed.
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Papers by Michael Oddy