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Understanding Neurocognitive Impairment After Trauma Exposure

Completed
Conditions
Trauma, Psychological
Earthquake
Interventions
Other: Trauma exposure
Registration Number
NCT05090046
Lead Sponsor
University of Otago
Brief Summary

Individuals living in Canterbury (New Zealand) have experienced significant stress related to the Canterbury earthquake sequence. Previous research conducted at the Department of Psychological Medicine (Christchurch, New Zealand) has shown significant cognitive difficulties in a group of Cantabrians exposed to high levels of earthquake trauma. A high proportion (30%) perceive themselves to have significant cognitive difficulties, even seven years post-earthquake. People who perceive that they have cognitive difficulties find this distressing and tend to function less well in work and parenting. Understanding pathways underlying cognitive difficulties in the population is vital for developing appropriate treatments and strategies to help with this.

This will be the first study to investigate rates of, and factors contributing to, perceived cognitive difficulties in a large population exposed to multiple stressors and is important for the population of Canterbury, and populations affected by natural and man-made disasters worldwide.

Four hundred and sixty people who were exposed to the Canterbury earthquake sequence will be recruited from the Christchurch Health and Development Study (CHDS). Psychological, cognitive, functional and biological factors will be compared between those with the greatest levels of perceived cognitive difficulty and those with the lowest levels of difficulty. This will determine what factors relate most strongly to perceived cognitive difficulties, which will in turn be used to develop treatments for this population.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
128
Inclusion Criteria
  • Cohort member of the Christchurch Health and Development Study (born in 1977)
  • Exposed to the Canterbury earthquake sequence
  • In the highest or lowest quartile with regards to score on the Cognitive Failures Questionnaire
Exclusion Criteria
  • lifetime diagnosed psychotic disorder
  • previous moderate to severe head injury (> 30 minutes loss of consciousness)
  • current pregnancy
  • intellectual disability (IQ < 80)
  • residing outside of Canterbury

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Christchurch Health and Development Study (CHDS)Trauma exposureThe Christchurch Health and Development Study (CHDS) is a birth cohort study comprising 1265 people born in Christchurch in 1977. Participants have been followed to age 40, with 75-80% retention at data collection points.
Primary Outcome Measures
NameTimeMethod
Subjective cognitive functionPast 6 months

Assessed with the Cognitive Failures Questionnaire Minimum score = 0, maximum score = 100, higher scores reflect worse subjective cognitive function

Secondary Outcome Measures
NameTimeMethod
Visuospatial learning and memoryBaseline

Z-scores from variables of the Groton Maze Learning Test (CogState) will be averaged to create a singe Z-score for the domain of 'Visuospatial Learning and Memory', with higher scores reflecting better performance.

Metabolic markersBaseline

Blood levels of HbA1C, total cholesterol, HDL cholesterol, LDL cholesterol (calc), triglycerides

Global cognitive compositeBaseline

Global cognitive composite will average Z-scores across the cognitive domains of (i) verbal learning and memory, (ii) visuospatial learning and memory, (iii) psychomotor speed, (iv) executive function, (v) working memory, (vi) sustained attention, and (vii) emotion processing. The Global cognitive composite score will be a single, averaged Z-value score, with a higher score reflecting better objective cognitive performance.

Verbal learning and memoryBaseline

Z-scores from variables of the Rey Auditory Verbal Learning Test will be averaged to create a singe Z-score for the domain of 'Verbal Learning and Memory', with higher scores reflecting better performance.

Stressful life eventsPast 5 years

Number of stressful life events is assessed with the Life Events Scale (adapted from the Crisis in Family Systems - Revised Questionnaire) Minimum score = 0, higher score reflects more stressful life events

Psychomotor speedBaseline

Z-scores from variables of the Timed Chase Test (CogState), Trail Making Test - Part A, and Digit Symbol Coding Test will be averaged to create a singe Z-score for the domain of 'Psychomotor speed', with higher scores reflecting better performance.

Working memoryBaseline

Z-scores from variables of the Digit Span Test will be averaged to create a singe Z-score for the domain of 'Working memory', with higher scores reflecting better performance.

Sustained attentionBaseline

Z-scores from variables of the Continuous Performance Test will be averaged to create a singe Z-score for the domain of 'Sustained attention', with higher scores reflecting better performance.

Facial emotion processingBaseline

Z-scores from variables of the Facial Expression Recognition Test and the Reading the Mind in the Eyes Test will be averaged to create a singe Z-score for the domain of 'Facial emotion processing', with higher scores reflecting better performance.

Post-traumatic growthPast 12 years

Assessed with the Post-traumatic Growth Inventory (PTGI)

InflammationBaseline

Blood levels of CRP

Executive functionBaseline

Z-scores from variables of the Trail Making Test - Part B and Category Fluency will be averaged to create a singe Z-score for the domain of 'Executive function', with higher scores reflecting better performance.

RuminationBaseline

Assessed with the Ruminative Responses Scale Minimum score = 25, maximum score = 100, higher scores reflect more severe rumination

Mental health diagnosesBaseline

Assessed with the Mini International Neuropsychiatric Interview (MINI)

Sex hormonesBaseline

Blood levels of progesterone, LH, FSH, testosterone, SHBG (females only)

Metacognitive beliefsBaseline

Assessed with the Metacognitions Questionnaire - 30-item version Minimum score = 30, maximum score = 120, higher scores reflect more problematic metacognitive beliefs Minimum score = 25, maximum score = 100, higher scores reflect more severe rumination

Psychosocial functioningPast 2 weeks

Assessed with the Social Adjustment Scale Minimum score = 1, maximum score = 5, higher scores reflect worse psychosocial functioning

COVID-19 impactPast 3 years

Assessed with the COVID Psychosocial Impacts Scale (CPIS) Minimum score = 0, maximum score = 135, higher scores reflect more severe impact of COVID

Trial Locations

Locations (1)

Department of Psychological Medicine, University of Otago, Christchurch

🇳🇿

Christchurch, Canterbury, New Zealand

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