Overview

While most children and adolescents will recovery from concussion without complication, a sizeable minority will go on to experience persistent symptoms that last for months or even years after injury. Prolonged recovery typically results in difficulties with daily activities, such as going to school, work productivity, and familial and peer relationships. Pre-existing mental health problems, coping styles, and other psychosocial factors can hugely influence recovery following concussion. As such, our research seeks to identify and understand the psychological, social, and cognitive risk and resilience factors that affect recovery outcomes from concussion and use these discoveries to develop and evaluate accessible/scalable behavioral interventions.

Publications

Three-month Practice Effect of the National Institutes of Health Toolbox Cognition Battery in Young Healthy Adults
Canadian Journal of Neurological Sciences
DOI: 10.1017/cjn.2022.273
2023

Perceptions of Symptom Duration are Associated With Emotional Distress and Functioning in Adolescents With Protracted Concussion Recovery.
Journal of pediatric psychology
Plourde V and Silverberg ND and Cairncross M and Virani S and Brooks BL
DOI: 10.1093/jpepsy/jsac020
PubMed: 35348728
08/2022

Neuropsychiatric Treatment for Mild Traumatic Brain Injury: Nonpharmacological Approaches.
Seminars in neurology
Mollica A and Dey A and Cairncross M and Silverberg N and Burke MJ
DOI: 10.1055/s-0041-1742143
PubMed: 35114694
02/2022

Feasibility of Concussion Rehabilitation Approaches Tailored to Psychological Coping Styles: A Randomized Controlled Trial
Archives of Physical Medicine and Rehabilitation
Silverberg, N.D. and Cairncross, M. and Brasher, P.M.A. and Vranceanu, A.-M. and Snell, D.L. and Yeates, K.O. and Panenka, W.J. and Iverson, G.L. and Debert, C.T. and Bayley, M.T. and Hunt, C. and Baker, A. and Burke, M.J.
DOI: 10.1016/j.apmr.2021.12.005
2022

Criterion validity of the brief test of adult cognition by telephone (BTACT) for mild traumatic brain injury
Brain Injury
Cairncross, M. and Gindwani, H. and Rita Egbert, A. and Torres, I.J. and Hutchison, J.S. and Dams O?Connor, K. and Panenka, W.J. and Brubacher, J.R. and Meddings, L. and Kwan, L. and Yeates, K.O. and Green, R. and Silverberg, N.D.
DOI: 10.1080/02699052.2022.2109744
2022

Early Postinjury Screen Time and Concussion Recovery
Pediatrics
Cairncross, M. and Yeates, K.O. and Tang, K. and Madigan, S. and Beauchamp, M.H. and Craig, W. and Doan, Q. and Zemek, R. and Kowalski, K. and Silverberg, N.D.
DOI: 10.1542/peds.2022-056835
2022

Psychological mediators of avoidance and endurance behavior after concussion.
Rehabilitation Psychology
Alex R. Terpstra and Molly Cairncross and Keith O. Yeates and Ana-Maria Vranceanu and Jonathan Greenberg and Cindy Hunt and Noah D. Silverberg
DOI: 10.1037/rep0000390
11/2021

Normative Data for the Fear Avoidance Behavior After Traumatic Brain Injury Questionnaire in a Clinical Sample of Adults With Mild TBI.
The Journal of head trauma rehabilitation
Cairncross M and Debert CT and Hunt C and Bayley MT and Comper P and Chandra T and Silverberg ND
DOI: 10.1097/htr.0000000000000669
PubMed: 33741828
09/2021

Fear avoidance behavior in youth with poor recovery from concussion: measurement properties and correlates of a new scale.
Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence
Cairncross M and Brooks BL and Virani S and Silverberg ND
DOI: 10.1080/09297049.2021.1908533
PubMed: 33876703
04/2021

Normative data for the fear avoidance behavior after traumatic brain injury questionnaire in a clinical sample of adults with mild tbi
Journal of Head Trauma Rehabilitation
Cairncross, M. and Debert, C.T. and Hunt, C. and Bayley, M.T. and Comper, P. and Chandra, T. and Silverberg, N.D.
DOI: 10.1097/HTR.0000000000000669
2021

Contingency management for individuals with chronic health conditions: A systematic review and meta-analysis of randomized controlled trials
Behaviour Research and Therapy
Ellis, J.D. and Struble, C.A. and Fodor, M.C. and Cairncross, M. and Lundahl, L.H. and Ledgerwood, D.M.
DOI: 10.1016/j.brat.2020.103781
2021

Avoidance and Endurance Coping After Mild Traumatic Brain Injury Are Associated With Disability Outcomes
Rehabilitation Psychology
Cassetta, B.D. and Cairncross, M. and Brasher, P.M.A. and Panenka, W.J. and Silverberg, N.D.
DOI: 10.1037/rep0000372
2021

History of functional somatic syndromes and persistent symptoms after mild traumatic brain injury
Journal of Neuropsychiatry and Clinical Neurosciences
Green, K. and Cairncross, M. and Panenka, W.J. and Stubbs, J.L. and Silverberg, N.D.
DOI: 10.1176/appi.neuropsych.20060159
2021

Assessment of Prorated Scoring of an Abbreviated Protocol for the National Institutes of Health Toolbox Cognition Battery.
Journal of the International Neuropsychological Society : JINS
Rebchuk AD and Alimohammadi A and Yuan M and Cairncross M and Torres IJ and Silverberg ND and Field TS
DOI: 10.1017/s1355617720001010
PubMed: 33081872
11/2020

Evaluation of the Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire.
Journal of neurotrauma
Snell DL and Siegert RJ and Debert C and Cairncross M and Silverberg ND
DOI: 10.1089/neu.2019.6729
PubMed: 32041472
04/2020

The Effectiveness of Mindfulness-Based Therapies for ADHD: A Meta-Analytic Review
Journal of Attention Disorders
Cairncross, M. and Miller, C.J.
DOI: 10.1177/1087054715625301
2020

Assessment of Prorated Scoring of an Abbreviated Protocol for the National Institutes of Health Toolbox Cognition Battery
Journal of the International Neuropsychological Society
Rebchuk, A.D. and Alimohammadi, A. and Yuan, M. and Cairncross, M. and Torres, I.J. and Silverberg, N.D. and Field, T.S.
DOI: 10.1017/S1355617720001010
2020

Demographic, Cannabis Use, and Depressive Correlates of Cannabis Use Consequences in Regular Cannabis Users.
The American journal on addictions
Struble CA and Ellis JD and Cairncross M and Lister JJ and Lundahl LH
DOI: 10.1111/ajad.12889
PubMed: 31016818
04/2019

Clinical and Personality Characteristics of Problem and Pathological Gamblers With and Without Symptoms of Adult ADHD.
The Journal of nervous and mental disease
Cairncross M and Milosevic A and Struble CA and Ellis JD and Ledgerwood DM
DOI: 10.1097/nmd.0000000000000959
PubMed: 30882557
04/2019

Correlates of Treatment Retention and Opioid Misuse Among Postpartum Women in Methadone Treatment.
Journal of addiction medicine
Ellis JD and Cairncross M and Struble CA and Carr MM and Ledgerwood DM and Lundahl LH
DOI: 10.1097/adm.0000000000000467
PubMed: 30418335
03/2019

Correlates of Treatment Retention and Opioid Misuse Among Postpartum Women in Methadone Treatment
Journal of Addiction Medicine
Ellis, J.D. and Cairncross, M. and Struble, C.A. and Carr, M.M. and Ledgerwood, D.M. and Lundahl, L.H.
DOI: 10.1097/ADM.0000000000000467
2019

Clinical and personality characteristics of problem and pathological gamblers with and without symptoms of adult ADHD
Journal of Nervous and Mental Disease
Cairncross, M. and Milosevic, A. and Struble, C.A. and Ellis, J.D. and Ledgerwood, D.M.
DOI: 10.1097/NMD.0000000000000959
2019

Client and clinician-rated characteristics of problem gamblers with and without history of gambling-related illegal behaviors.
Addictive behaviors
Ellis JD and Lister JJ and Struble CA and Cairncross M and Carr MM and Ledgerwood DM
DOI: 10.1016/j.addbeh.2018.03.017
PubMed: 29587172
03/2018

Assessing Decision-Making Capacity in Patients with Communication Impairments.
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees
Cairncross M and Peterson A and Lazosky A and Gofton T and Weijer C
DOI: 10.1017/s0963180116000414
PubMed: 27634720
10/2016

Psychosocial Status in emerging adult females: Impact of pubertal timing and ADHD symptoms
Psychology and Education
Ostojic, D. and Brooker, B. and Cairncross, M. and Miller, C.J.
2016

Assessing decision-making capacity in patients with communication impairments
Cambridge Quarterly of Healthcare Ethics
Cairncross, M. and Peterson, A. and Lazosky, A. and Gofton, T. and Weijer, C.
DOI: 10.1017/S0963180116000414
2016

A behavioral genetic analysis of alexithymia and the Dark Triad traits of personality.
Twin research and human genetics : the official journal of the International Society for Twin Studies
Cairncross M and Veselka L and Schermer JA and Vernon PA
DOI: 10.1017/thg.2013.19
PubMed: 23561050
04/2013

Research

MBI-4-mTBI Adolescents (Mindfulness-based Intervention for mild traumatic brain injury)
Our lab recently completed a small pilot (N=10) of a mindfulness-based intervention (MBI) for adolescents following concussion in collaboration with a team at the Children’s Hospital of Eastern Ontario. We found that the mindfulness-based intervention, delivered via smartphone app, was viewed as credible and was well tolerated by patients with acute and chronic concussion symptoms. We are now planning for a multi-centre randomized controlled feasibility trial of the mindfulness-based intervention for adolescents with persistent post-concussion symptoms (N=70). Participants will be randomized to receive the mindfulness-based intervention or an active control intervention. We will assess feasibility related to recruitment methods, intervention and control credibility, adherence to the intervention, and trial retention. This feasibility trial will lay the necessary ground work for a large-scale multi-centre efficacy trial.

Digital Connections
Given the poor adherence and attrition rates associated with digital interventions, and increased interest in delivering therapy online, it is of great importance to understand how best to maximize factors that may increase patient engagement with treatment. Social presence, or the extent to which a digital encounter feels like it is occurring in-person and has a sense of human connection to it, may be relevant to therapeutic alliance and engagement in self-guided digital interventions. Using a qualitative exploratory design (N=10), we will identify the factors that may be relevant to adolescents’ experience of social presence in self-guided digital interventions and determine if these factors are important for user experience and adherence to treatment. These findings will inform design changes to our digital intervention for concussion.

ABC (Attentional Bias in Concussion)
Pain catastrophizing and avoidance of pain-related stimuli can lead to disability in patients with chronic pain conditions. Attentional bias (measured via eye-tracking) plays a role in pain-catastrophizing, offering potential understanding of mechanisms that could be targeted to improve outcomes for this group. Pain catastrophizing and avoidance behaviour similarly lead to poorer outcomes from concussion. No previous research has examined the role of attentional bias in pain catastrophizing and fear avoidance behaviour in adolescents post-concussion. We will assess whether attentional bias to symptom-related stimuli is associated with pain-catastrophizing and fear-avoidance behaviour in adolescents post-concussion.

Grants

2022 – 2023, SFU Psychology Department Research Grant, Mindfulness-based intervention for adults with persisting post-concussion symptoms, Principal Investigator, $7500 (CAD)

2021 – 2025, Canadian Institute of Health Research, Graded exposure therapy for fear avoidance behavior (GET FAB) after concussion, Co-Investigator, $761,176 (CAD)

2022 – 2024, uOttawa Brain and Mind Research Institute Team Grant, Mindfulness-Based Intervention for Mild Traumatic Brain Injury+MRI a Pilot study, Co-Investigator, $50,000 (CAD)

2021 – uOttawa Brain and Mind Research Institute Team Grant, Mindfulness-Based Intervention for Mild Traumatic Brain Injury+MRI a Pilot study, Co-Investigator, $75,000 (CAD)

2020/1 - 2022/1 Children's Hospital of Eastern Ontario Research Institute Research Growth Award, Mindfulness-Based Intervention for Mild Traumatic Brain Injury, Co-Investigator, $29,995 (CAD)

Research Group Members

Medha Amarnath Nair, Graduate Student
Justine Harris-Owen, Research Assistant
Kyle Yeung, Research Volunteer