Paul B. Perrin

• PhD
• Professor at University of Virginia

The COVID-19 pandemic resulted in a dramatic increase in the use of telemedicine, with heightened rates of use persisting postpandemic. This change in use created a need for a valid and reliable scale to assess telemedicine use and facilitators impacting its uptake. The current study developed and validated the Telemedicine Facilitators Scale (TFS)...

Despite decades of low utilization, telemedicine adoption expanded at an unprecedented rate during the COVID-19 pandemic. This study examined quantitative and qualitative data provided by a national online sample of 228 practicing physicians (64% were women, and 75% were White) to identify facilitators and barriers to the adoption of telemedicine i...

Purpose Traumatic brain injury (TBI) can lead to a host of challenges and negatively impacts Native Americans more than any other ethnic group in the U.S. Despite this, little research exists on Native Americans with TBI. The current study examined disparities in global outcome trajectories (overall level of function post-injury) between Native Ame...

Background: The Coronavirus disease (COVID-19) pandemic profoundly impacted education, causing uncertainty and constant changes for teachers, including new teaching modalities, increased workloads, and limited rest periods. Global studies have reported mental health issues such as anxiety and depression among educators during and after the pandemic...

This study used OpenAI’s GPT-4 large language model to (a) generate an initial item pool for a potential scale measuring internalized ableism, (b) involve disabled community stakeholders in refining the items and prompting additional artificial intelligence (AI)-generated items, and (c) psychometrically validate the scale in a large sample of disab...

Objectives: Religiosity has generally been shown to be a protective factor against adverse mental health in the general population. Transgender and gender non-conforming (TGNC) individuals, however, may not experience the same protective effects, as many religions are unsupportive of diverse gender identities. This study examined whether increased...

Objective This study examined: (a) longitudinal trajectories of participation over the 10 years after traumatic brain injury (TBI) in a group of Black individuals, and (b) demographic and injury-related predictors of those trajectories. Method This study included 1,989 Black individuals in the national TBI Model Systems (TBIMS) Database, who had a...

Purpose/Objective: Posttraumatic growth (PTG) refers to positive changes that individuals experience in the wake of a stressful or traumatic event. Though growth and adaptation are considered ideal outcomes of rehabilitation, the extent to which PTG captures the unique experience of individuals with traumatic brain injury (TBI) has not been empiric...

Objective: Explore the relationship between tree canopy coverage (TCC) in one's home neighborhood and mental health outcomes, and how these relationships differ by home neighborhood factors, among persons with traumatic brain injury (TBI) in the United States. Setting: Community. Participants: Enrolled in the TBI Model Systems National Databas...

Objective To estimate the relative causal influence of physical and mental health on pain in persons with traumatic brain injury (TBI) within the year following injury. Setting Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) was a multicenter study that collected data from 18 level 1 trauma centers around the United States. Partic...

Background Research on older adults who sustain a traumatic brain injury (TBI) has predominantly been on civilian, nonveteran populations. Military populations experience higher rates of TBI and often experience the additive effects of TBI and other comorbid disorders, including posttraumatic stress disorder and/or substance use that may increase d...

Objective: To describe the self-reported needs of family caregivers of service members and veterans (SMVs) with traumatic brain injury (TBI) at 10 to 15 years post-injury and to identify unique predictors of unmet family needs. Setting: Five Department of Veterans Affairs Polytrauma Rehabilitation Centers. Participants: A total of 209 family c...

Purpose/Objective This study examined (a) differences in demographic and injury‐related characteristics following traumatic brain injury (TBI) between Native American and White individuals; (b) differences in community participation between Native American and White individuals with TBI at 1, 2, and 5 years after TBI; and (c) whether demographic or...

The COVID-19 pandemic severely affected teaching and student outcomes throughout the world, yet the long-term impacts of the pandemic on teachers and students in Latin America and Spain remain largely underexamined. This study examined the experiences of 5416 teachers from 20 Spanish-speaking countries during and after the pandemic, with an emphasi...

The HPV vaccine has the potential to prevent nearly 92% of HPV-related cancer cases, yet its uptake remains suboptimal. While well-documented barriers to HPV vaccine uptake include inadequate knowledge and lack of provider recommendation, religious preferences have emerged as another crucial factor influencing vaccination decisions. This study exam...

Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide and often leads to long-lasting emotional, physical, and cognitive changes and results in reduced functioning across multiple domains. These changes often lead to strain in marital relationships as the uninjured spouse grapples with adapting to the changes i...

This study evaluated the universality of the TOMM 2 and provided a reference sample of cognitively intact adults living in Spain whose native language was Spanish. A total of 203 adults completed the TOMM 2 from June 2019 to January 2020. When using the original TOMM cutoff scores derived from English speakers, all participants scored in a range th...

Background: This study provides a detailed examination of older Veterans with traumatic brain injury (TBI) and dementia and their caregivers, focusing on Veterans’ demographic, clinical, functional, safety risk, and behavioral characteristics and caregivers’ demographic, clinical, and care-related characteristics and well-being. Methods: Veterans’...

Background: The lack of standardized reporting for crucial organizational factors in rehabilitation poses a significant barrier to understanding their impact on patient outcomes in clinical trials and meta-analyses. Aim: Based on the categories in the International Classification of Service Organization in Rehabilitation (ICSO-R 2.0), we aimed t...

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...

BACKGROUND: Hispanics/Latinos are the largest racial/ethnic group among underrepresented populations in the U.S. and multiple sociodemographic, cultural, and linguistic factors have been found to impact their performances on cognitive testing. Despite this, few normative data are available for the heterogeneous Spanish-speaking population in the U....

Background: Hispanics are the largest growing ethnic minority group in the U.S. Despite significant progress in providing norms for this population, updated normative data are essential. Objective: To present the methodology for a study generating normative neuropsychological test data for Spanish-speaking adults living in the U.S. using Bayesian i...

BACKGROUND: Hispanics are a significant demographic in the U.S., with diverse cultures and languages. Assessing cognition in this group is complex as cultural and linguistic factors have been found to affect test performance. OBJECTIVE: To generate normative data on the World Health Organization-University of California Los Angeles Auditory Verbal...

Background: The Rey-Osterrieth Complex Figure Test (ROCFT) and the Clock Drawing Test (CDT) are commonly used in clinical practice. The ROCFT measures constructional praxis, visual perception, and visuospatial learning and memory, and the CDT assesses for visuospatial, constructional, and executive difficulties. Several neurological disorders are...

Background Veterans with substance use disorder (SUD) are at high risk for cognitive problems due to neurotoxic effects of chronic drug and alcohol use coupled in many cases with histories of traumatic brain injury (TBI). These problems may in turn result in proneness to SUD relapse and reduced adherence to medical self-care regimens and therefore...

Purpose/Objective: Psychometric network analysis (PNA) is an application of dynamic systems theory that can inform measurement of complex rehabilitation phenomena such as depressive symptom patterns in veterans and service members (V/SMs) after traumatic brain injury (TBI). This study applied PNA to the Patient Health Questionnaire-9 (PHQ-9), a com...

Background: Linguistic deficits are common across neurological and neurodegenerative disorders. Currently there are limited neuropsychological norms available for Spanish-speaking adults residing in the U.S. Objective: To generate norms for two verbal fluency tests and the Boston Naming Test (BNT) in a Spanish-speaking population in the U.S., wi...

Objective To create a census-based composite neighborhood socioeconomic deprivation index (NSDI) from geocoded residential addresses and to quantify how NSDI aligns with individual-level socioeconomic factors among people with traumatic brain injury (TBI). Setting Community Participants People enrolled in the TBI Model Systems National Database (...

Objective To describe the incidence of self-reported COVID-19 history in a longitudinal cohort of individuals with complicated mild to severe traumatic brain injury (TBI) and describe demographic, injury and functional differences based on history of COVID-19 infection. Design Individuals with complicated mild to severe TBI aged 16 or older at tim...

Background Seeking and obtaining effective health care for Long COVID remains a challenge in the USA. Women have particularly been impacted, as they are both at higher risk of developing Long COVID and of facing gendered barriers to having symptoms acknowledged. Long COVID clinics, which provide multidisciplinary and coordinated care, have emerged...

This study developed and validated the Telepsychology Facilitators Scale (TFS), a novel measure that uses the theory of reasoned action and technology acceptance model as frameworks to assess factors that influence psychologists’ openness to using telepsychology. At the beginning of the COVID-19 pandemic, an online sample of 2,619 psychologists com...

Objective: To describe the needs for subacute inpatient rehabilitation and community-based healthcare services, rehabilitation, and social support in patients with moderate-to-severe traumatic injury in the first 6 months post-injury. Further, to explore associations between sociodemographic and clinical characteristics and unmet needs. Design: Mul...

Background: Given the aging of the overall U.S. population, the resulting changes in healthcare needs especially among veterans, and the high prevalence of traumatic brain injury (TBI) among older adults, additional research is needed on community participation after TBI in older veterans. The current study examined predictors of community particip...

Patients with physical traumatic injuries frequently require long-term rehabilitation services. To strengthen rehabilitation services in the post-acute phase, we need to assess characteristics of this population and their healthcare and rehabilitation needs in the community. This brief report summarizes the frequency of unmet rehabilitation needs i...

Introduction A better understanding of how to promote disease mitigation and prevention behaviors among vulnerable populations, such as cancer survivors, is needed. This study aimed to determine patterns of and factors associated with COVID-19-related preventive behaviors among cancer survivors and assess whether the COVID-19 preventive behaviors o...

Aim: Since the declaration of COVID-19 as a Public Health Emergency of International Concern on January 30, 2020, the disease escalated into a global pandemic forcing governments around the world to impose measures that affected all aspects of life. Among other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce trans...

Purpose/Objective: The aim of this article is to evaluate the measurement invariance (MI) of the Patient Health Questionnaire-9 (PHQ-9) in a sample of individuals during the first 2 years after traumatic brain injury (TBI). MI was examined among racial/ethnic groups and over time to determine the utility of the PHQ-9 across these dimensions. Resear...

Purpose: Traumatic brain injury (TBI) can lead to impairments in motor and cognitive function and reduced life satisfaction. TBI is one of the leading causes of death and disability worldwide and disproportionately affects Native Americans, who have the highest rates of TBI among all races in the United States and elevated likelihood for fatality a...

Objective To examine the association between participation and satisfaction with life at 1, 2, 5, and 10 years after traumatic brain injury (TBI) in older adults. Setting Community. Participants Participants ( N = 2362) who sustained complicated mild to severe TBI, requiring inpatient rehabilitation, at age 60 years or older and had follow-up dat...

Background The responsibility of care for Veterans and Service Members (V/SMs) with traumatic brain injury (TBI) often defaults to informal family caregivers. Caregiving demands considerable knowledge, skill, and support to facilitate the health and well-being of V/SMs and themselves. Persistent and common TBI caregiver issues include strain, depre...

BACKGROUND The responsibility of care for Veterans and Service Members (V/SMs) with traumatic brain injury (TBI) often defaults to informal family caregivers. Caregiving demands considerable knowledge, skill, and support to facilitate the health and well-being of V/SMs and themselves. Persistent and common TBI caregiver issues include strain, depre...

The study’s aim was to examine alcohol consumption patterns and predictors of consumption across time among Hispanics with traumatic brain injury (TBI) in the U.S. within ten years post-injury. This longitudinal cohort study included 1342 Hispanic individuals (77.6% males) from the multi-site, longitudinal TBI Model Systems (TBIMS) database. The ma...

Background Traumatic brain injury (TBI) is a major cause of death and disability worldwide and often leads to long-lasting emotional, physical, and cognitive changes and results in reduced functioning across multiple domains. These changes often lead to strain in marital relationships, as the uninjured spouse grapples with adapting to changes in th...

Background: Individuals with chronic health conditions (CHCs) have a higher risk for severe SARS-CoV-2 (COVID-19) infection and reported high rates of distress during the pandemic. However, research suggests individual characteristics distinguish those who are more likely to experience clinical levels of distress than others. We examined predicted...

Objective To quantify the evolution, impact, and importance of normative data (ND) calculation by identifying trends in the research literature and what approaches need improvement. Methods A PRISMA-guideline systematic review was performed on literature from 2000 to 2022 in PubMed, Pub-Psych, and Web of Science. Inclusion criteria included scient...

This study developed and validated the Telepsychology Facilitators Scale (TFS), a novel measure that uses the theory of reasoned action and technology acceptance model as frameworks to assess factors that influence psychologists’ openness to using telepsychology. At the beginning of the COVID-19 pandemic, an online sample of N=2,619 psychologists c...

Objective To examine alcohol consumption patterns and predictors of consumption across time among Hispanics with Traumatic Brain Injury (TBI) in the United States (U.S.) within ten years post-injury. Methods Longitudinal cohort study. The sample included 1342 Hispanics (77.6% males) from the TBI Model Systems (TBIMS) database who had at least one...

The Impact of COVID-19 in Women in the U.S.

Objective This study compared rates of suicide attempt (SA) and suicidal ideation (SI) during the first 5 years after traumatic brain injury (TBI) among veterans and service members (V/SMs) in the Veterans Affairs (VA) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Model Systems National Database...

Postpartum depression (PPD), postpartum anxiety (PPA), and post-traumatic stress disorder (PTSD) among birthing people have increased substantially, contributing to adverse maternal/infant dyad outcomes, with a high prevalence in the neonatal intensive care unit (NICU). Despite calls for trauma-informed care in the NICU and high rates of post-traum...

Participation is of major importance for individuals with traumatic brain injury (TBI). This study evaluates participation over a period of one year among persons with TBI in the chronic phase and explores sociodemographic, psychological, and environmental predictors of levels and trajectories of participation. One hundred and twenty home-living su...

Purpose: To identify life satisfaction trajectories at 1-10 years post-traumatic brain injury (TBI) and examine which demographic and injury characteristics at the time of injury are associated with those trajectories. Methods: Participants included 1,051 Hispanic individuals from the multi-site, longitudinal TBI Model Systems (TBIMS) database....

Background: Older adults who sustain a traumatic brain injury (TBI) have been shown to have reduced functional independence and life satisfaction relative to younger individuals with TBI. The purpose of this study was to examine the covarying patterns of functional independence and life satisfaction over the 10 years after TBI in adults who were 6...

Aim The COVID-19 outbreak escalated into a global pandemic, pushing many governments around the world to impose measures affecting all aspects of life. Similar to other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person-to-person. This cross-sectional study investigated the association betwee...

The COVID-19 pandemic transformed the delivery of psychological services as many psychologists adopted telepsychology for the first time or dramatically increased their use of it. The current study examined qualitative and quantitative data provided by 2619 practicing psychologists to identify variables facilitating and impeding the adoption of tel...

Background: Cancer survivors are at greater risk for COVID-19 complications, emphasizing the importance of adherence to COVID-19 prevention. Active coping mechanisms can help manage pandemic stress but disengaged coping practices can have adverse effects. Objectives: 1) Identify differences in COVID-19 coping styles and COVID-19 preventive behav...

Objective: Although racial/ethnic disparities have been documented in numerous outcomes after traumatic brain injury (TBI), research has yet to explore differences in rehabilitation outcomes based upon nativity (foreign-born vs US-born individuals). The purpose of this study was to compare the functional outcomes over the first 10 years after TBI...

Background: Social media platforms have become a popular source for health information despite concerns about the quality of content shared. We examined how oral contraceptive pills and intrauterine devices are framed on the platform Pinterest using the Health Belief Model (HBM), as well as how fertility awareness methods are portrayed as an alter...

People’s risk perception of COVID-19 is an important predictor for adopting protective behavior. Although risk perceptions, and factors influencing these, may vary between countries, less attention has been paid to differences between adjacent regions from neighboring countries. In the midst of the first wave of the corona outbreak (March-April-May...

Objective: To examine the impact of the COVID-19 pandemic on societal participation in people with moderate-to-severe traumatic brain injury (TBI). Design: Cross-sectional retrospective cohort. Setting: National TBI Model Systems (TBIMS) centers, United States. Participants: TBIMS enrollees (N=7,003), ages 16 and older and 1-30 years post-in...

Background: Previous research has found racial and ethnic disparities in life satisfaction, depression, and anxiety after traumatic brain injury (TBI). However, limited studies have examined differences in these variables between U.S.- and foreign-born individuals with TBI. The purpose of this study was to examine whether differences exist in ment...

Background: Almost one-third of the U.S. military population is comprised of service members and veterans (SMVs) of color. Research suggests poorer functional and psychosocial outcomes among Black and Hispanic/Latine vs. White civilians following traumatic brain injury (TBI). Objective: This study examined racial/ethnic differences in 5-year funct...

Objective: To examine the prevalence, severity, and correlates of depression, anxiety, and suicidal ideation in people with traumatic brain injury (TBI) assessed before and during the COVID-19 pandemic. Design: Retrospective cohort study using data collected through the TBI Model Systems (TBIMS) network at 1, 2, 5, 10, 15, 20, 25, or 30 years po...

Research on caregiving after neurotrauma and neurological disability critically extends the focus beyond individuals with neurological conditions to family, friends, and significant others who also are greatly impacted. This article introduces a thematic issue of NeuroRehabilitation on the topic with 10 articles that coalesce around the three appro...

Background: Despite the widespread international use of the Affiliate Stigma Scale in the context of disability, much research on its psychometric properties has taken dubious statistical approaches. Objective: The aim of this study was to examine the psychometric properties of the Affiliate Stigma Scale in a sample of Turkish spinal cord injury...

Background: Individuals with traumatic brain injury (TBI) in Latin America experience high levels of disability and extremely poor functional outcomes, and their informal caregivers play a key role in their rehabilitation and care. Objective: To improve TBI rehabilitation through stronger informal caregiving, this study developed and evaluated a...

Objective: Naming is commonly impaired in people with neurodegenerative diseases and brain injury, and as a result, its accurate assessment is essential. The aim of this study was to provide normative data for the 15-item Spanish version of the Boston Naming Test (BNT) for an adult population from eight Latin American countries/regions. Method: The...

(1) Background: Psychometric network analysis provides a novel statistical approach allowing researchers to model clusters of related symptoms as a dynamic system. This study applied network analysis to investigate the patterns of somatic, cognitive, and affective neurobehavioral symptoms in an international sample of Spanish-speaking individuals w...

Research Objectives To identify the trajectories of life satisfaction at 1 to 10 years post-TBI and to examine which demographic, injury and rehabilitation characteristics at the time of injury are associated with those trajectories. Design Hierarchical linear modeling (HLM) was used to examine baseline predictors of trajectories of life satisfact...

Objective: To determine Spanish-speaking school professionals' level of knowledge and attitudes regarding pediatric TBI. Methods: School professionals(n = 2,238) from 19 countries completed an online-survey regarding their training, knowledge and misconceptions, attitudes and perceptions about TBI. Results: Of the full sample 75% (n = 1689) kn...

Objective: The construct of participation after traumatic brain injury (TBI) can be difficult to operationalize. Psychometric network analysis offers an empirical approach to visualizing and quantifying the associations between activities that comprise participation, elucidating the relations among the construct's components without assuming the p...

Background: Previous literature has documented racial/ethnic differences in traumatic brain injury (TBI) risk, cause, treatment, and rehabilitation. The purpose of the current study was to investigate potential racial/ethnic differences in arrest probability trajectories over the first 10 years after TBI and whether injury and sociodemographic char...

Background: Older adults have the highest traumatic brain injury (TBI)-related morbidity and mortality, and rates in older adults are increasing, chiefly due to falls. Objective: This study used hierarchical linear modeling (HLM) to examine baseline predictors of functional independence trajectories across 1, 2, 5, and 10 years after TBI in olde...

(1) Background: Some people with COVID-19 develop a series of symptoms that last for several months after infection, known as Long COVID. Although these symptoms interfere with people’s daily functioning and quality of life, few studies have focused on neurobehavioral symptoms and the risk factors associated with their development; (2) Methods: 100...

Background: Research has found that Hispanics with traumatic brain injury (TBI) have reduced functional outcomes compared to non-Hispanic Whites, including lower probabilities of post-injury employment. However, previous studies were cross-sectional, combined racial/ethnic minority groups, and did not examine the factors that predict return to wor...

Background Sexual changes are an area of primary concern for individuals with spinal cord injury (SCI) and their partners, but the topic has gone largely unexplored in the research literature. Objectives This study examined how individuals with SCI in Latin America experience their sexuality and what issues they and their partners face in this are...

Introduction: The United States (U.S.) hosts the most international students worldwide; however, little research exists on international students’ tobacco use behaviors and predictors of use, despite harmful tobacco-related health consequences. We sought to investigate tobacco use rates and factors associated with susceptibility to cigarette and el...

Objective: This study examined demographic and injury-related predictors of cognitive and motor functional independence in Hispanics with TBI at years 1, 2, 5, and 10 after hospital discharge. Design: Hispanic participants (n = 1,360) from the TBI Model Systems Study were included in if they had at least one Functional Independence Measure (FIM)...

Objectives: COVID-19 has infected millions of people worldwide with growing evidence showing that individuals with a history of infection may continue to show persistent post-COVID symptoms (long COVID). The aim of this study was to investigate sleep health in an international sample of individuals who reported previously testing positive for COVID...

Background: Research has found that Hispanics with traumatic brain injury (TBI) show a host of reduced functional outcomes compared to non-Hispanic Whites, including lower probabilities of post-injury employment. However, previous studies on post-TBI employment outcomes in Hispanics were cross-sectional, combined racial/ethnic minority groups, and...

Purpose/Objective: The Modified Mini-Mental State Exam (3MS) is a brief, widely-used cognitive screening tool. This study examined differences in 3MS performance between Blacks and Whites undergoing acute brain injury rehabilitation.Research Method/Design: Participants were Black (44.1%; n=78) and White (55.9%; n=99) individuals admitted over a two...

Background: Sexual changes are an area of primary concern for individuals with spinal cord injury (SCI) and their partners, but the topic has gone largely unexplored in the research literature and particularly with a focus on Latin America. This study examined how individuals with SCI in Latin America experience their sexuality and what issues they...

BACKGROUND: Individuals with traumatic brain injury (TBI) in Latin America experience high levels of disability and extremely poor functional outcomes, and their informal caregivers play a key role in their rehabilitation and care. OBJECTIVE: To improve TBI rehabilitation through stronger informal caregiving, this study developed and evaluated an e...

Objective: To determine Spanish-speaking school professionals’ level of knowledge and attitudes regarding pediatric TBI.Methods: School professionals (n=2,238) from 19 countries completed an online-survey regarding their training, knowledge and misconceptions, attitudes and perceptions about TBI.Results: Of the full sample, 75% (n=1689) knew what T...

BACKGROUND: Older adults have the highest traumatic brain injury (TBI)-related morbidity and mortality, and rates in older adults are increasing, chiefly due to falls.OBJECTIVE: This study used hierarchical linear modeling (HLM) to examine baseline predictors of functional independence trajectories across 1, 2, 5, and 10 years after TBI in older ad...

Purpose/objective: The Modified Mini-Mental State Exam (3MS) is a brief, widely used cognitive screening tool. This study examined differences in 3MS performance between Black and White individuals undergoing acute brain injury rehabilitation. Research method/design: Participants were Black (44.1%; n = 78) and White (55.9%; n = 99) individuals a...

Evangelical Christians are among the most hesitant to get the COVID-19 vaccine. This study examined the extent to which COVID-19 vaccination uptake among Evangelicals is explained by demographic characteristics, Health Belief Model constructs, and faith-based support factors. Survey research firm Qualtrics recruited 531 U.S. adults and conducted a...

To examine rehabilitation professionals’ training and education, attitudes, beliefs or misconceptions, and assessment of issues related to sexuality in individuals with Spinal Cord Injury (SCI) and their romantic partners. 318 healthcare professionals from Latin America (LA) who worked with individuals with SCI completed an online survey. 99.0% aff...