Ashley Craig

Kolling Institute, Faculty of Medicine and Health The University of Sydney · John Walsh Centre for Rehabilitation Research

Purpose: To determine the relationships between impact of secondary health conditions (SHCs), treatment of SHCs, and life satisfaction (LS) following spinal cord injury (SCI) across 21 countries. Hypotheses were as follows: (1) Persons with SCI and fewer SHCs report higher LS and (2) Persons who receive treatment for SHCs report higher LS than tho...

This study examined the brain source space functional connectivity from the electroencephalogram (EEG) activity of 48 participants during a driving simulation experiment where they drove until fatigue developed. Source-space functional connectivity (FC) analysis is a state-of-the-art method for understanding connections between brain regions that m...

Adults with spinal cord injury (SCI) are reported to have heightened risk of cognitive impairment, notably mild cognitive impairment (MCI). Reports of increased risk of MCI are almost exclusively based on cross-sectional assessments of cognitive function using norm-referenced scores. Norm-referenced single-point assessments do not reflect cognitive...

Introduction Poor sleep is common among people with spinal cord injury (SCI), yet little is known about its impact on employment and participation outcomes. This study aimed to describe the sleep quality of a large sample of Australians with SCI; examine associations between sleep quality and participant characteristics; and explore the relationshi...

Study design Cross-sectional survey. Objectives To describe design and methods of Australian arm of International Spinal Cord Injury (Aus-InSCI) community survey, reporting on participation rates, potential non-response bias and cohort characteristics. Setting Survey of community-dwelling people with SCI at least 12 months post-injury, recruited...

Background and Objectives Estimates of the prevalence (10-60%) of cognitive impairment in individuals with spinal cord injury (SCI) are too broad and which domains of cognition are most affected is unclear. We performed a meta-analysis to investigate impairments across domains of cognitive functioning to provide a nuanced picture of research conduc...

Background Road traffic injuries (RTIs), primarily musculoskeletal in nature, are the leading cause of unintentional injury worldwide, incurring significant individual and societal burden. Investigation of a large representative cohort is needed to validate early identifiable predictors of long-term work incapacity post-RTI. Therefore, up until two...

Spinal cord injury (SCI) is a severe neurological injury that results in damage to multiple bodily systems. SCI rehabilitation requires a significant focus on improving adjustment to the injury. This paper presents a detailed description of the Spinal Cord Injury Adjustment Model (SCIAM), which clarifies how individuals adjust to SCI and contends t...

Danielle Sandalic,1,2 Mohit Arora,1,2 Ilaria Pozzato,1,2 Grahame Simpson,1,2 James Middleton,1,2 Ashley Craig1,2 1Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; 2John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, Sydney, New South Wales, AustraliaCorrespondence: Ashley Craig, Fa...

Study design Cross-sectional population-based survey for the Australian cohort of the International Spinal Cord Injury (InSCI) Community Survey. Objectives To differentiate subgroups of people with spinal cord injury (SCI) who self-report good and poor overall quality of life (QoL) using domains of the International Classification of Functioning (...

Background: Health literacy (HL) is rarely addressed in rehabilitation research and practice but can play a substantial role in the recovery process after an injury. We aimed to identify factors associated with low HL and its relationship with 6-month health outcomes in individuals recovering from a non-catastrophic road traffic injury. Methods:...

Objective: A prospective cohort study to investigate how injury and early post-injury psychosocial factors influence health outcomes 12 months after road traffic injury. Methods: Residents of New South Wales, Australia, with road traffic injury in the period 2013-16 were recruited. Explanatory factors were evaluated for outcomes over 12 months u...

The assessment of mild cognitive impairment (MCI) following spinal cord injury (SCI) is vital. However, there are no neurocognitive screens which have been developed specifically to meet the unique requirements for SCI, nor are there consistent MCI criteria applied to determine the rates of MCI. The aim of this study was to determine the suitabilit...

Neuropathic pain in people with spinal cord injury is thought to be due to altered central neuronal activity. A novel therapeutic intervention using virtual reality (VR) head-mounted devices was investigated in this study for pain relief. Given the potential links to neuronal activity, the aim of the current study was to determine whether use of VR...

BACKGROUND: Peer-facilitated interventions have been successfully used in chronic disease management. Less is known about their application in vocational rehabilitation. OBJECTIVE: To pilot-test an online peer discussion forum to improve exploration of employment options in job-seekers with long-term multiple sclerosis (MS). METHODS: Twenty-nine pe...

Spinal cord injury (SCI) is a neurological condition arising from traumatic injury or disease that not only impairs voluntary motor control and sensory function, but causes disturbances in the autonomic nervous system, affecting cardiovascular, cognitive, bladder and bowel functions among others. People with a SCI experience psychosocial challenges...

Objective: To analyze and compare life satisfaction (LS) in persons with spinal cord injury (SCI) living in 22 countries participating in the International SCI (InSCI) community survey. The study tested the hypothesis that there are differences in LS across InSCI countries according to the countries’ economic status specified as gross domestic prod...

Abstract Background Serious injuries and fatalities among vulnerable road users on two wheeled motorised vehicles have increased across Australia and internationally in the past decade yet fallen for motor vehicle occupants. Almost half of all reported motorcycle injury crashes cause serious injury or death, nearly double that of motor vehicle poli...

Purpose Adults who stutter (AWS) have increased risk of comorbid social anxiety about speaking in social contexts. AWS also report experiencing embarrassment in different social situations; however, research has rarely been conducted on embarrassment and its relationship to social anxiety in AWS. Method AWS ( N = 200) reported their level of embar...

Objectives We aimed to analyse the degree of carer burden and depressive symptoms in family carers of persons with age-related macular degeneration (AMD) and explore the factors independently associated with carer burden and depressive symptoms. Methods Cross-sectional study using self-administered and interviewer-administered surveys, involving 9...

Background Spinal cord injury (SCI) is associated with autonomic imbalance and significant secondary conditions, including cardiac and brain dysfunction that adversely impact health and wellbeing. This study will investigate the effectiveness (intention-to-treat) of a neuro-cardiac self-regulation therapy to improve autonomic and neural/brain activ...

Context/Objective: Prolonged unemployment is common for people living with a spinal cord injury or disorder (SCI/D) and can impact negatively on quality of life. The present study examines stakeholder perspectives and experiences with the job search process in order to identify service gaps and return-to-work solutions. Design: In-depth semi-struct...

People who sustain injury in a road traffic crash (RTC) have significant risk of psychiatric morbidity, but effective screening for identifying at-risk individuals soon after the RTC is lacking. We investigated whether pre-injury vulnerability can assist as an early screen to manage this risk. We recruited 120 adults who sustained physical injury i...

Background There is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia. Metho...

Background: Serious injuries and fatalities among vulnerable road users on two wheeled motorised vehicles have increased across Australia and internationally in the past decade, yet fallen for motor vehicle occupants. Almost half of all reported motorcycle injury crashes cause serious injury or death, nearly double that of motor vehicle police-repo...

Background Traumatic injuries can have long-term negative impacts on health, especially psychological health. A biopsychosocial approach is recommended to identify those likely to experience psychosocial stress, however large individual differences exist in stress reactivity and post-injury health that remain unexplored. Therefore, we investigated...

Purpose People with age‐related macular degeneration (AMD) experience high rates of depression, but rarely engage in or have access to tailored mental wellbeing programmes. This qualitative study investigated the perspectives of those primarily with late AMD on mental health and mental wellbeing programmes. Methods Twenty‐eight people with late AM...

Introduction Risk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or T...

Study design Within-subject, randomised cross-over trial. Objectives To determine whether a commercially available 3D head-mounted (HMD) virtual reality (VR) device results in significant reductions in neuropathic pain compared to using a 2D screen device in people with spinal cord injury (SCI). Setting Greenwich Hospital, Sydney, Australia. Met...

Background: Self-efficacy is an important determinant of adjustment following spinal cord injury. Self-efficacy is defined as the belief that one can successfully execute behavior required to produce the desired outcomes. In its original conceptualization, self-efficacy refers to the confidence that people have in their ability to accomplish speci...

Background: Neuropathic pain is a debilitating secondary condition for many individuals with spinal cord injury (SCI). SCI neuropathic pain often remains poorly responsive to existing pharmacological and non-pharmacological treatments. A growing body of evidence supports the potential for brain-computer interface (BCI) systems to reduce SCI neuropa...

Background: Studies report rates of mild cognitive impairment (MCI) in spinal cord injury (SCI) range between 10 and 60%. This broad estimate of MCI in SCI is most likely a result of: (i) inconsistent operationalization of MCI; (ii) heterogeneity among individuals with SCI; (iii) failure to account for MCI subtypes, thereby adding to the heterogen...

This paper investigates the cause and detection of power-law scaling of brain wave activity due to the heterogeneity of the brain cortex, considered as a complex system, and the initial condition such as the alert or fatigue state of the brain. Our starting point is the construction of a mathematical model of global brain wave activity based on EEG...

How peer support can assist job-seekers with a disability move into work – CORRIGENDUM - Volume 26 Issue 1 - Diana Dorstyn, Gregory Murphy, Elizabeth Potter, Ashley Craig

Background Seeking compensation has been shown to have an adverse effect on the psychological health and recovery of injured patients, however, this effect requires clarification. Methods A total of 2019 adults sustaining a traffic injury were recruited. Of these, 709 (35.1%) lodged a compensation claim. Interviews occurred at 1-, 6- and 12-month...

BACKGROUND Neuropathic pain is a debilitating secondary condition for many individuals with spinal cord injury. Spinal cord injury neuropathic pain often is poorly responsive to existing pharmacological and nonpharmacological treatments. A growing body of evidence supports the potential for brain-computer interface systems to reduce spinal cord inj...

Background: Neuropathic pain is a debilitating secondary condition for many individuals with spinal cord injury (SCI). SCI neuropathic pain often remains poorly responsive to existing pharmacological and non-pharmacological treatments. A growing body of evidence supports the potential for brain-computer interface (BCI) systems to reduce SCI neuropa...

Background Risk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI...

The occurrence of mental fatigue during tasks like driving a vehicle increases risk of injury or death. Changes in electroencephalographic (EEG) activity associated with mental fatigue has been frequently studied and considered a promising biomarker of mental fatigue. This is despite differences in methodologies and outcomes in prior research. A sy...

Older adults with vision impairment experience high rates of mental health problems, but very few access psychological support. We investigated community and stakeholder perspectives of the barriers and facilitators to participation in mental well-being programs for older adults with vision impairment. Adults aged ≥ 50 years with vision impairment...

Background: Mental health symptoms, like depressive mood (DM) and post-traumatic stress (PTS), and pain interference (PI) with daily functioning often co-occur following traffic injury and their comorbidity can complicate recovery. This study aimed to map the course and overlapping trajectories of mental health symptoms, and associations with PI i...

Objective. In this inception cohort study, we investigated differences in health outcomes for bicyclists (cyclists) and car occupants (car driver and passengers) at 12 months after a non-catastrophic traffic injury. We also aimed to determine the independent predictors of key health outcomes among cyclists. Methods. Of the 2019 participants at base...

Objectives To establish the proportion of mild traumatic brain injury (mTBI) diagnosis among people presenting to an emergency department (ED), to determine the accuracy of recorded ED diagnoses. We also aimed to describe challenges in mTBI case identification and its acute hospital management. Design and setting A retrospective chart review of al...

Pre-post cohort mixed factorial design. Excessive daytime sleepiness (EDS) and chronic pain are major problems for people with spinal cord injury (SCI). However, the relationship between chronic pain and EDS requires clarification. The goal of the study was to determine associations between pain catastrophizing (PC) and pain intensity (PI) with EDS...

Anecdotally, there are frequent reports that peer-facilitated initiatives can be successfully used in employment services. However, in Australia, there is little information about how to effectively deliver such services to motivate and encourage unemployed persons with a disability to explore work options and successfully gain employment. In this...

Background with rationale Traumatic spinal injuries (TSI) include column fractures, spinal cord injury, or both. They are among the most severe injuries with potential long-term physical, psychological, and social consequences. Primary causes of TSIs are falls and motor vehicle crashes, however, mental illness and substance use are known to signif...

Background: Health-related quality of life (HRQoL) is an important patient-reported outcome that warrants greater attention in individuals who sustained a non-catastrophic injury in a road traffic crash. Additional robust data on HRQoL outcomes after a non-catastrophic injury are needed to effectively identify potential targets for studies of tert...

Background Mental health symptoms, like depressive mood (DM) and post-traumatic stress (PTS), and pain-related disability, known as pain interference (PI) often co-occur following traffic injury and their comorbidity can complicate recovery. Clarification is required on mental health comorbidity and relationships with PI, to enhance care and outcom...

Background: Mental health symptoms, like depressive mood (DM) and post-traumatic stress (PTS), and pain interference (PI) with daily functioning often co-occur following traffic injury and their comorbidity can complicate recovery. This study aimed to map the course and overlapping trajectories of mental health symptoms, and associations with PI in...

Background: Mental health symptoms, like depressive mood (DM) and post-traumatic stress (PTS), and pain interference (PI) with daily functioning often co-occur following traffic injury and their comorbidity can complicate recovery. This study aimed to map the course and overlapping trajectories of mental health symptoms, and associations with PI in...

This paper presents the combination of clustering-based independent component analysis (ICASSO) and power spectral density (PSD) as a features extractor of mental fatigue from spinal cord injury (SCI) patients. Initially, the results show that SCI and abled-bodied groups have no differences in EEG for alert and mental fatigue states. Further, the c...

Objective: To pilot a novel email-based information package (Work and SCI) for job-seekers with an acquired spinal cord injury (SCI) or spinal cord dysfunction (SCI/D). Study design: Prospective, non-randomized, repeated measures trial. Setting: Community dwelling cohort in Australia. Participants: Five people with SCI (mean age 46.4 years, SD = 10...

Introduction Psychological distress is a prevalent condition often overlooked following a motor vehicle crash (MVC), particularly when injuries are not severe. The aim of this study is to examine whether biomarkers of autonomic regulation alone or in combination with other factors assessed shortly after MVC could predict risk of elevated psychologi...

Objective: To establish self-efficacy and depressive mood trajectories in adults with spinal cord injury (SCI), determine their interrelationship over time, and determine the influence that appraisals and co-morbid physical conditions have on the development of self-efficacy. Design: A prospective cohort design. Setting: Inpatient rehabilitati...

It is estimated that up to 50% of motor vehicle crash (MVC) survivors will develop significant psychological distress such as depressive mood and elevated anxiety within 6 months after the crash. Associated impacts include loss of employment, delayed return to work, financial and familial stress, and increased medical, legal and compensation costs....

PREFACE Rebecca Guest and Ashley Craig Motor vehicle crashes (MVCs) resulting in physical injury are an all too common experience world-wide that can have devastating outcomes, typified by physical, social and economic consequences for the individual, family and community (Nantulya & Reich, 2002; Ameratunga, Hijar, & Norton, 2006). We are pleased...

Psychological distress associated with a physical injury following a motor vehicle crash (MVC) is a common problem that has potential short, medium and long-term negative impacts. For example, elevated psychological distress can result in psychological disorder such as depression or post-traumatic stress disorder, social isolation, financial distre...

Motor vehicle crashes are associated with a high risk of physical injury that can result in life-long disability and lowered quality of life. Injuries following a motor vehicle crash can be classified as minor to moderate injuries versus severe injuries. Severe injuries include spinal cord injury, severe traumatic brain injury, amputation, permanen...

It is important to determine whether psychological distress associated with musculoskeletal injuries sustained in a motor vehicle crash (MVC), regardless of time of onset, has an impact on compensation outcomes such as claim settlement times and costs. It is equally important to identify factors routinely collected by insurance companies that may c...

The quest for reliable and sensitive biomarkers capable of predicting risk of psychological distress and adaptability following adversity is not a novel idea. Scientists have long speculated that links exist between biological, psychological and social factors that operate to result in resilience or distress. On one hand, the advent of a unifying m...

There is paucity of prospective studies that have examined rates and prognostic indicators of pain severity after a road traffic crash injury. This cohort study involved 1,854 participants aged ≥17 years with a noncatastrophic injury. Primary analyses of pain severity involved 1604 individuals who reported any pain since the injury at baseline Of t...

Physical injury sustained in a motor vehicle crash has a high risk of being associated with significant chronic pain that can last for many years, or for some, a lifetime. Consequently, disability coupled with chronic pain can be a very debilitating problem, as for example, quality of life will certainly be diminished, daily functioning reduced and...

Study design: A prospective, parallel randomized controlled trial (RCT). Objectives: To test the preliminary effects of an online resource targeted to job-seekers with spinal cord injury or disorder (SCI/D) and to determine the feasibility of proceeding to a full-scale RCT. Setting: A community cohort in Australia. Methods: Forty-eight adults (M= 4...

Persisting spinal cord injury (SCI) is a life changing neurological disorder that results in the loss of sensation, muscle paralysis and autonomic dysfunction, affecting the function of many body systems, and requires intensive interdisciplinary rehabilitation with ongoing medical and allied health follow up and interventions to promote and maintai...

Objective: To determine the extent of daytime sleepiness in adults with spinal cord injury (SCI) and investigate the contribution of fatigue and autonomic function to sleepiness status. Methods: Participants included 45 adults with SCI attending outpatient services or living in the community and 44 able-bodied controls. The Oxford Sleep Resistance...

The adverse long-term consequences following traumatic brain injury are poorly understood, particularly on the cerebral microvasculature. Retinal vessels are a surrogate marker of cerebral vascular changes. We therefore aimed to examine the cross-sectional association between serious head injury or being knocked unconscious, and/or concussion and r...

Blue Mountains Eye Study Description. Description of variables used in the analyses. (DOCX)

Blue Mountains Eye Study Database. Relevant data used to analyze associations between head injury and concussion with retinal vessel caliber. (XLSX)

Abstract Background The preliminary results of a randomised controlled trial are presented. The aim of the trial is to determine the efficacy, feasibility and acceptability of email-delivered psychological interventions with telephone support, for adults injured in a motor vehicle crash engaged in seeking compensation. The primary intention for thi...

Purpose: Many adults who stutter have elevated negative mood states like anxiety and depressive mood. Little is known about how mood states change over time. The purpose of this study was to determine the trajectories or sub-types of mood states in adults who stutter over a 6 month period, and establish factors that contribute to these sub-types....

Background Physical injury and psychological disorder following a motor vehicle crash (MVC) is a public health concern. The objective of this research was to determine rates of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) in adults with MVC-related injury engaged in compensation, and to determine the capacity (e.g. sens...

Objective. To provide a preliminary evaluation of the effectiveness of an on-line resource for job-seekers with multiple sclerosis. Design. Randomized controlled design. Setting. Community-dwelling cohort in Australia. Participants. Adults (N = 95) with relapsing-remitting or progressive MS were randomly assigned to one of two groups.Forty-five acc...

This chapter provides an overview on vocational rehabilitation services in rural Australia and New Zealand (Australasia), a region with significant geo-cultural diversity – ranging from extremely remote regions to highly urbanised areas. It surveys the work opportunity settings for residents of rural and remote Australasia and the types of vocation...