Jennie Ponsford

• BA(Hons), MA(Clin Neuropsych), PhD, MAPsS
• Managing Director at Monash University (Australia)

Objective: Evaluate cost, effectiveness and cost-effectiveness of cognitive behavioural therapy for sleep and fatigue (CBT-SF) vs health education (HE) and of CBT-SF vs treatment as usual (TAU) for sleep disturbance and fatigue in acquired brain injury. Design: Economic evaluation from Australian health system and societal perspectives based on dat...

Purpose A recent randomised controlled trial demonstrated the efficacy of a cognitive behavioural therapy intervention for sleep disturbance and fatigue (CBT-SF) after acquired brain injury (ABI), leading to more rapid improvement than an active health education (HE) control intervention. This study qualitatively examined participants’ experiences...

Background: Sensory changes are commonly observed in individuals with moderate-severe traumatic brain injury (msTBI) but remain under-researched. Objectives: This study examined the prevalence of sensory changes after msTBI and relationships with emotional distress, functional disability, and life satisfaction. Methods: A cross-sectional survey w...

Cyberscams are a pervasive global issue with losses exceeding $1 trillion worldwide and resulting in significant psychosocial impacts, particularly shame. People with disabilities, such as acquired brain injury (ABI), may be additionally vulnerable due to cognitive impairments and social isolation. Increased scam vulnerability and risk factors for...

Objective: While psychiatric disorders (e.g., depression, anxiety) are well-established predictors of suicidal ideation in individuals with traumatic brain injury (TBI), the roles of other psychological and cognitive factors remain underexplored. This study examined associations between suicidal ideation and emotional-processing difficulties, copin...

Objective Evaluate efficacy of cognitive behavioural therapy for sleep and fatigue adapted for brain injury relative to health education control in alleviating sleep disturbance and fatigue after acquired brain injury. Design Parallel groups randomized controlled trial. Subjects 126 community dwelling adults with stroke or traumatic brain injury....

Background Traumatic injuries, defined as physical injuries with sudden onset, are a major cause of distress and disability, with far-reaching societal consequences. A significant proportion of trauma survivors report persistent symptoms and difficulties after the injury, and studies show unmet health care needs. Self-management programs delivered...

Psychopathology, including depression, anxiety, and post-traumatic stress, is a significant yet inadequately addressed feature of moderate-severe traumatic brain injury (TBI). Progress in understanding and treating post-TBI psychopathology may be hindered by limitations associated with conventional diagnostic approaches, specifically the Diagnostic...

Psychopathology, including depression, anxiety, and post-traumatic stress, is a significant yet inadequately addressed feature of moderate-severe traumatic brain injury (TBI). Progress in understanding and treating post-TBI psychopathology may be hindered by limitations associated with conventional diagnostic approaches, specifically the Diagnostic...

Objective The long‐term consequences of traumatic brain injury (TBI) on brain structure remain uncertain. Given evidence that a single significant brain injury event increases the risk of dementia, brain‐age estimation could provide a novel and efficient indexing of the long‐term consequences of TBI. Brain‐age procedures use predictive modeling to...

Background Acquired brain injury (ABI) often leads to persisting somatic, cognitive, and social impairments. Cognitive impairments of processing speed, sustained attention, and working memory are frequently reported and may negatively affect activities of daily living and quality of life. Rehabilitation efforts aiming to retrain these cognitive fun...

We used contemporary factor analytic procedures to assess whether the Depression Anxiety Stress Scales (DASS) can reliably differentiate depression, anxiety, and stress in individuals with TBI. One-hundred and thirty-six adults (Mage = 38.51 years; 77.94% male) with moderate-severe TBI completed the DASS42. Various confirmatory factor models were e...

The first aim of the Australian Traumatic Brain Injury Initiative (AUS-TBI) encompasses development of a set of measures that comprehensively predict outcomes for people with moderate-severe TBI across Australia. This process engaged diverse stakeholders and information sources across six areas: social, health, and clinical factors, biological mark...

Background Despite evidence of the efficacy of activities of daily living (ADL) retraining during post-traumatic amnesia (PTA) following traumatic brain injury (TBI), utilisation of this intervention in practice is unclear. Utilising an implementation science framework, the Consolidated Framework for Implementation Research, this study explored eff...

Objective Whether concussion or mild traumatic brain injury (mTBI) in children causes persistent symptoms more than in children with mild extracranial injuries remains unclear. This study examined the symptom frequency and relative influence of injury and non-injury factors on symptoms in pre-school and primary school aged children, who sustained a...

Background People with acquired brain injury (ABI) may be more susceptible to scams owing to postinjury cognitive and psychosocial consequences. Cyberscams result in financial loss and debilitating psychological impacts such as shame and mistrust, interference with neurorehabilitation, and reduced independence. Despite these significant consequence...

Background: The Australian Traumatic Brain Injury Initiative (AUS-TBI) is developing a data resource to enable improved outcome prediction for people with moderate-severe TBI (msTBI) across Australia. Fundamental to this resource is the collaboratively designed data dictionary. This systematic review and consultation aimed to identify acute interv...

In this series of 8 papers, the AUS-TBI consortium describes the Australian approach used to select the common data elements collected acutely, that have been shown to predict longer term outcome following moderate-severe TBI across the lifespan. This paper presents the unified single data dictionary, together with additional measures chosen to fac...

Background: The objective of the Australian Traumatic Brain Injury (AUS-TBI) Initiative is to develop a data dictionary to inform data collection and facilitate prediction of outcomes of people who experience moderate-severe TBI in Australia. The aim of this systematic review was to summarise the evidence of the association between demographic, in...

The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to co-design a data resource to predict outcomes for people with moderate-severe traumatic brain injury (TBI) across Australia. Fundamental to this resource is the data dictionary, which is an ontology of data items. Here, we report the systematic review and consensus process for inclu...

Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there...

Objective: The objective of this study was to investigate clinical symptoms, cognitive performance and cortical activity following mild traumatic brain injury (mTBI). Methods: We recruited 30 individuals in the sub-acute phase post mTBI and 28 healthy controls with no history of head injury and compared these groups on clinical, cognitive and co...

Objective The long-term consequences of traumatic brain injury (TBI) on brain structure remain uncertain. In light of current evidence that even a single significant brain injury event increases the risk of dementia, brain-age estimation could provide a novel and efficient indexing of the long-term consequences of TBI. Brain-age procedures use pred...

Purpose: Many factors contribute to persisting post-concussion symptoms (PPCSs), necessitating multi-modal treatment. Quantitative investigations have shown the potential of interdisciplinary intervention to reduce the burden of PPCSs and facilitate return to activities. There are often varied responses to intervention, warranting further investig...

Background Progress in addressing depression after traumatic brain injury (TBI) has been limited. Traditional approaches to measuring depression classify individuals with diverse symptoms as having the same problem. We adopted a novel, symptom-oriented approach to characterize post-TBI depression, emphasizing specific symptoms rather than the numbe...

Purpose: To examine feasibility and acceptability of providing stepped collaborative care case management targeting posttraumatic stress disorder (PTSD) and pain symptoms after major traumatic injury. Materials and methods: Participants were major trauma survivors in Victoria, Australia, at risk of persistent pain or PTSD with high baseline symp...

Background Impairments in social cognition are common after traumatic brain injury (TBI) and may have severe negative consequences for patients and their families. Most tests of social cognition have limited ecological validity due to simplistic and contrived social stimuli with limited relevance to everyday social functioning. There is a need for...

Introduction Psychopathology following traumatic brain injury (TBI) is a common and debilitating consequence that is often associated with reduced functional and psychosocial outcomes. There is a lack of evidence regarding the neural underpinnings of psychopathology following TBI, and whether there may be transdiagnostic neural markers that are sha...

Emotional distress is a common, but poorly addressed, feature of moderate-severe traumatic brain injury (TBI). Previously identified sociodemographic, psychological, and injury-related factors account for only a small proportion of the variability in emotional distress post-TBI. Genetic factors may help to further understand emotional distress in t...

BACKGROUND People with acquired brain injury (ABI) may be more susceptible to scams owing to postinjury cognitive and psychosocial consequences. Cyberscams result in financial loss and debilitating psychological impacts such as shame and mistrust, interference with neurorehabilitation, and reduced independence. Despite these significant consequence...

Background: Acquired brain injury (ABI) often leads to persisting somatic, cognitive and social impairments. Cognitive impairments of processing speed, sustained attention and working memory are frequently reported, and may negatively affect activities of daily living and quality of life. Rehabilitation efforts aiming to retrain these cognitive fun...

Objective: Traumatic brain injury (TBI) and its consequences can significantly impact an individual's identity and self-esteem. However, there is limited research with respect to the trajectory of change over time and factors that may influence self-esteem levels. This study aimed to investigate: (1) changes in self-esteem over 3 years post-TBI; a...

During the early recovery period after traumatic brain injury (TBI), referred to as post-traumatic amnesia (PTA), approximately 44% of individuals may exhibit agitated behaviours. Agitation can impede recovery and poses a significant management challenge for healthcare services. As families provide significant support for their injured relatives du...

We used network analysis to explore interrelationships between anxiety and depressive symptoms after traumatic brain injury (TBI). At one year post-injury, 882 adult civilians who received inpatient rehabilitation for moderate-severe TBI self-reported anxiety and depressive symptoms (Hospital Anxiety and Depression Scale). The severity of TBI was c...

Anxiety and depression symptoms are commonly experienced after traumatic brain injury (TBI). However, studies validating measures of anxiety and depression for this population are scarce. Using novel indices derived from symmetrical bifactor modeling, we evaluated whether the Hospital Anxiety and Depression Scale (HADS) reliably differentiated anxi...

The mechanisms that underpin recovery following mild traumatic brain injury (mTBI) remain poorly understood. Identifying neurophysiological markers and their functional significance is necessary to develop diagnostic and prognostic indicators of recovery. The current study assessed 30 participants in the subacute phase of mTBI (10-31 days post-inju...

Objective: To develop new diagnostic criteria for mild traumatic brain injury (TBI) that are appropriate for use across the lifespan and in sports, civilian trauma, and military settings. Design: Rapid evidence reviews on 12 clinical questions and Delphi method for expert consensus. Participants: The Mild Traumatic Brain Injury Task Force of t...

Objective: This study examined the relationship between cognitive reserve measured with the Cognitive Reserve Index questionnaire (CRIq) and cognitive and functional outcomes in a chronic traumatic brain injury (TBI) cohort compared to a non-TBI cohort. The utility of the CRIq was compared to common proxies of cognitive reserve (premorbid IQ and ye...

Objective: To characterize trajectories of emotional distress across the first decade after moderate-severe traumatic brain injury (TBI) and explore relationships with personal and injury-related factors. Design: Cohort study with follow-ups at 1, 2, 3, 5, and 10 years post-injury. Setting: Community. Participants: Participants were sampled...

Anxiety and depression are two of the most common forms of psychopathology experienced after traumatic brain injury (TBI), yet there is a scarcity of studies validating measures of anxiety and depression for use with this population. Using symmetrical bifactor modeling, we evaluated whether the Hospital Anxiety and Depression Scale (HADS) reliably...

Objective: The ability of the brain to recover following neurological insult is of interest for mild traumatic brain injury (mTBI) populations. Investigating whether non-invasive brain stimulation (NIBS) can modulate neurophysiology and cognition may lead to the development of therapeutic interventions post injury. The purpose of this study was to...

Introduction: Psychopathology following traumatic brain injury (TBI) is a common and debilitating consequence that is often associated with reduced functional and psychosocial outcomes. There is a lack of evidence regarding the neural underpinnings of psychopathology following TBI, and whether there may be transdiagnostic neural markers that are sh...

Purpose The delivery of healthcare services in rural locations can be challenging. From the perspectives of rural rehabilitation practitioners and compensation claims managers, this study explored the experience of providing and coordinating rehabilitation services for rural major traumatic injury survivors. Materials and Methods Semi-structured i...

Introduction: Memory impairments affecting encoding, acquisition, and retrieval of information after moderate-to-severe traumatic brain injury (TBI) have debilitating and enduring functional consequences. The interventional research reviewed primarily focused on mild to severe memory impairments in episodic and prospective memory. As memory is a c...

Introduction: Moderate to severe traumatic brain injury causes significant cognitive impairments, including impairments in social cognition, the ability to recognize others' emotions, and infer others' thoughts. These cognitive impairments can have profound negative effects on communication functions, resulting in a cognitive-communication disorde...

Introduction: Moderate to severe traumatic brain injury (TBI) results in complex cognitive sequelae. Despite hundreds of clinical trials in cognitive rehabilitation, the translation of these findings into clinical practice remains a challenge. Clinical practice guidelines are one solution. The objective of this initiative was to reconvene the inte...

Introduction: Moderate to severe traumatic brain injury (MS-TBI) commonly causes disruption in aspects of attention due to its diffuse nature and injury to frontotemporal and midbrain reticular activating systems. Attentional impairments are a common focus of cognitive rehabilitation, and increased awareness of evidence is needed to facilitate inf...

Introduction: Moderate-to-severe traumatic brain injury (MS-TBI) causes debilitating and enduring impairments of executive functioning and self-awareness, which clinicians often find challenging to address. Here, we provide an update to the INCOG 2014 guidelines for the clinical management of these impairments. Methods: An expert panel of clinic...

Introduction: Posttraumatic amnesia (PTA) is a common occurrence following moderate to severe traumatic brain injury (TBI) and emergence from coma. It is characterized by confusion, disorientation, retrograde and anterograde amnesia, poor attention and frequently, agitation. Clinicians and family need guidelines to support management practices dur...

IT HAS BEEN 8 years since the first iteration of the INCOG clinical practice guidelines (CPGs) were published. Much has happened since 2014, and a considerable body of evidence has been published in the various domains of cognitive rehabilitation research represented in this special issue. Over this time, significant developments in the science of...

IT IS CRITICAL TO KEEP clinical practice guidelines (CPGs) up to date through integration of the latest evidence. Therefore, it is with great excitement that the INCOG team presents the INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury (TBI). In this brief introduction, we provide an overview of changes in the evide...

Objective: To explore factors associated with stability and change in fatigue from 6 to 12 months following traumatic brain injury (TBI). Setting: Combined in- and outpatient acute care and postacute rehabilitation settings. Participants: A total of 103 patients with confirmed intracranial injury were assessed 6 and/or 12 months following TBI....

Research Objectives To evaluate whether scores on the Hospital Anxiety and Depression Scale (HADS) following traumatic brain injury (TBI) reliably reflect specific factors of anxiety and depression or instead a single factor of general distress. Design Survey. Participants completed the HADS at one year post-TBI. A subsample (21%) also completed t...

Background With improvements in injury control and advanced trauma care, increasing proportions of children survive major trauma, but population-based data on their long-term health and disability are scant. We investigated these outcomes in the five years following serious childhood injury in Victoria, Australia. Methods Using the Victorian State...

Purpose: Whilst anyone can be scammed, individuals with acquired brain injury (ABI) may have unique risk factors to cyberscams for which tailored interventions are required. To address this, a co-design approach was utilised to develop cybersafety resources with people with living experience of ABI and scams. This study aimed to evaluate the co-de...

Purpose: Agitated behaviours pose a significant challenge during early recovery following traumatic brain injury (TBI). This study aimed to gain a deeper understanding of how clinicians worldwide manage post-TBI agitation. Understanding the factors that influence how clinicians manage agitation can help inform the use of consistent and effective m...

Background Up to 25% of concussed individuals experience persistent post-concussion symptoms (PPCSs) which may interfere with the return to pre-injury activities and cause significant stress. Given that multiple etiological factors are thought to contribute to PPCSs, an interdisciplinary approach is recommended. This pilot study aims to primarily i...

Emotional distress is common following moderate-severe traumatic brain injury (TBI) and is associated with poorer post-injury outcomes. Previously investigated sociodemographic, psychological, and injury-related factors only account for a small proportion of variance in post-TBI emotional distress, highlighting a need to consider other factors such...

To document the development and clinician evaluation of a psychoeducational and support tool: the return to work after traumatic brain injury app (RTW after TBI app). Co-design of the app involved the collaboration of traumatic brain injury (TBI) /vocational rehabilitation (VR) expert researchers (n = 4) and lived experience co-designers (individua...

Agitation is common during post-traumatic amnesia (PTA) following traumatic brain injury (TBI) and is associated with risk of harm to patients and caregivers. Antipsychotics are frequently used to manage agitation in early TBI recovery despite limited evidence to support their efficacy, safety and impact upon patient outcomes. The sedating and cogn...

Introduction Concussion may be sustained in the setting of injuries to multiple body regions and persistent effects of concussion may impact recovery. This project aimed to evaluate the association between concussion and 6-month and 12-month functional outcomes in survivors after major trauma. Methods This was a registry-based cohort study that in...

The ability of the brain to recover following neurological insult is of considerable interest in mild traumatic brain injury (mTBI) populations. To date, a limited amount of research has examined changes in brain function over time following mTBI. Investigating whether non-invasive brain stimulation (NIBS) can modulate neurophysiology and cognitive...

There has been little progress in development of evidence-based interventions to improve sexuality outcomes for individuals with traumatic brain injury (TBI). This study aimed to evaluate the preliminary efficacy of an individualised intervention using a cognitive behaviour therapy (CBT) framework to treat sexuality problems after TBI. A nonconcurr...

Background and Objectives Traumatic brain injury (TBI) has been promoted as a risk factor for Alzheimer’s disease. There is evidence of elevated amyloid-β and tau, the pathological hallmarks of Alzheimer’s disease, immediately following TBI. It is not clear whether amyloid-β and tau remain elevated in the chronic period. To address this issue, we a...

Symptoms of depression are common following traumatic brain injury (TBI), impacting survivors’ ability to return to work, participate in leisure activities, and placing strain on relationships. Depression symptoms post TBI are often managed with pharmacotherapy, however, there is little research evidence to guide clinical practice. There have been...

Agitation is common in the early recovery period following traumatic brain injury (TBI), known as post-traumatic amnesia (PTA). Non-pharmacological interventions are frequently used to manage agitation, yet their efficacy is largely unknown. This systematic review aims to synthesize current evidence on the effectiveness of non-pharmacological inter...

Predicting and optimizing outcomes after traumatic brain injury (TBI) remains a major challenge because of the breadth of injury characteristics and complexity of brain responses. AUS-TBI is a new Australian Government–funded initiative that aims to improve personalized care and treatment for children and adults who have sustained a TBI. The AUS-TB...

Background In psychological research, control conditions in the form of “treatment as usual” provide support for intervention efficacy, but do not allow the attribution of positive outcomes to the unique components of the treatment itself. Attentionally and structurally equivalent active control conditions, such as health education (HE), have been...

Objective To investigate clinical symptoms, cognitive performance and cortical activity following mild traumatic brain injury (mTBI). Methods Thirty individuals in the sub-acute phase post mTBI and 28 healthy controls with no history of head injury were compared on clinical, cognitive and cortical activity measures. Measures of cortical activity i...

The mechanisms that underpin recovery following mild traumatic brain injury (mTBI) remain poorly understood. Identifying neurophysiological markers and their functional significance is necessary to develop diagnostic and prognostic indicators of recovery. The current study assessed 30 participants in the subacute phase of mTBI (10-31 days post-inju...

Objective: To investigate the factor structure of the Agitated Behavior Scale (ABS) in patients with traumatic brain injury (TBI) in posttraumatic amnesia (PTA). Setting: Inpatient TBI rehabilitation ward in Victoria, Australia. Participants: A total of 364 patients aged 16 to 92 years meeting diagnostic criteria for TBI and PTA admitted betwe...

Cyberscams, such as romance scams, are prevalent and costly online hazards in the general community. People with Acquired Brain Injury (ABI) may be particularly vulnerable and have greater difficulty recovering from the resultant emotional and financial hardships. In order to build capacity in the neurorehabilitation sector, it is necessary to dete...

Traumatic brain injury (TBI) is associated with greater ‘brain age’ that may be caused by atrophy in grey and white matter. Here, we investigated ‘brain age’ in a chronic TBI (≥10 years) sample. We examined whether ‘brain age’ increases with years post injury, and whether it is associated with injury severity, cognition and functional outcome. We r...

Purpose: For the 30% of Australians who live in rural areas, access to rehabilitation services after sustaining a major traumatic injury can be challenging. This study aimed to explore the experience of rural major traumatic injury survivors accessing rehabilitation services. Materials and methods: Semi-structured interviews were conducted with...

Fatigue is a common symptom after traumatic brain injuries (TBI) and a crucial target of rehabilitation. The subjective and multifactorial nature of fatigue necessitates a biopsychosocial approach in understanding the mechanisms involved in its development. The aim of this study is to provide a comprehensive exploration of factors relevant to ident...

Background Pediatric acquired brain injury (pABI) is associated with long-term cognitive, behavioral, social, and emotional problems, which may affect the quality of life, school, and family functioning. Yet, there is a lack of evidence-based community-centered rehabilitation programs for chronic pABI and these children do not systematically receiv...

Individuals with acquired brain injury (ABI) may be vulnerable to cyberscams due to their cognitive and psychosocial impairments. However, the lived experiences of cyberscam survivors with ABI and their close others is not understood, and no effective intervention has been identified. This qualitative study aimed to explore the perspectives of cybe...

Purpose Studies indicate that up to 50% of survivors of acquired brain injury (ABI) experience persistent changes in sexuality. However, research on clinicians’ perspectives in addressing sexuality issues post-ABI is limited. This study explored the attitudes and approaches, barriers and facilitators, and training preferences of Australian clinicia...

Challenging behaviours are distressing sequelae for people with acquired brain injury (ABI) and their families. Positive Behaviour Support (PBS) is a collaborative approach focussing on improving quality of life for individuals with ABI presenting with challenging behaviours. This qualitative study explored clinicians’ experiences of a 12-month int...

Purpose There is limited qualitative research exploring challenges experienced following severe traumatic brain injury (TBI). We investigated challenges to recovery identified by individuals who sustained severe TBI three years earlier or their close others (COs), as well as suggestions for managing these challenges. Materials and methods Nine par...

Purpose Paediatric acquired brain injury (ABI) negatively impacts parental wellbeing and family functioning. Adaptive coping, that is behaviours promoting emotional wellbeing and addressing distressing problems, may support wellbeing and family functioning. This study compared wellbeing, coping, and family functioning between parents of a child wit...

Background: Challenging behaviours are common and disabling consequences of acquired brain injury (ABI), causing stress for close-others and disrupting community integration. Positive Behaviour Support (PBS) interventions have support from case studies as a means of reducing these behaviours, but controlled trials are lacking. Objectives: This s...

Purpose The aim of this study was to explore older adults’ experiences of and approaches to managing their long-term health and mobility after traumatic injury. Methods A longitudinal qualitative study was undertaken with older adults following traumatic injury in Victoria, Australia. Fifteen participants (≥65 years) were interviewed at three year...

Road trauma remains a significant public health problem. We aimed to identify sub-groups of motor vehicle collisions in Victoria, Australia, and the association between collision characteristics and outcomes up to 24 months post-injury. Data were extracted from the Victorian State Trauma Registry for injured drivers aged ≥16 years, from 2010 to 201...

Purpose To extend the authors’ previous research by investigating the maintenance of work performance over time and the long-term experience of employment following traumatic brain injury (TBI). Materials and methods Semi-structured interviews were conducted with a sample of 72 individuals with predominantly severe TBI, up to 10-years post-injury....

Background and purpose: Physical therapy is important in the management of traumatic brain injury (TBI) and associated multitrauma. Providing therapy during the posttraumatic amnesia (PTA) phase is challenging, given that hallmark features including confusion, amnesia, agitation, and fatigue may impede the person's ability to engage in and benefit...

The temporal lobes are critical for encoding and retrieving episodic memories. The temporal lobes are preferentially disrupted following a traumatic brain injury (TBI), likely contributing to the difficulties observed in episodic memory. However, the underlying neural changes that precipitate or maintain these difficulties in individuals with TBI r...

Background and Objectives: Fatigue and sleep disturbance negatively impact quality of life following brain injury and there are no established treatments. Building on research showing efficacy of blue light therapy delivered via a lightbox in reducing fatigue and daytime sleepiness after traumatic brain injury (TBI), this paper describes the develo...

Purpose To quantify employment stability of individuals with traumatic brain injury (TBI) who received comprehensive vocational rehabilitation (VR) using different measures to identify difficulties experienced and factors associated with employment stability. Materials and methods 72 individuals with predominantly moderate-severe TBI were intervie...