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Individuals living in Canterbury (New Zealand) have experienced significant stress related to the Canterbury earthquake sequence. Previous research conducted at the Department of Psychological Medicine (Christchurch, New Zealand) has shown significant cognitive difficulties in a group of Cantabrians exposed to high levels of earthquake trauma. A high proportion (30%) perceive themselves to have significant cognitive difficulties, even seven years post-earthquake. People who perceive that they have cognitive difficulties find this distressing and tend to function less well in work and parenting. Understanding pathways underlying cognitive difficulties in the population is vital for developing appropriate treatments and strategies to help with this.
This will be the first study to investigate rates of, and factors contributing to, perceived cognitive difficulties in a large population exposed to multiple stressors and is important for the population of Canterbury, and populations affected by natural and man-made disasters worldwide.
Four hundred and sixty people who were exposed to the Canterbury earthquake sequence will be recruited from the Christchurch Health and Development Study (CHDS). Psychological, cognitive, functional and biological factors will be compared between those with the greatest levels of perceived cognitive difficulty and those with the lowest levels of difficulty. This will determine what factors relate most strongly to perceived cognitive difficulties, which will in turn be used to develop treatments for this population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Christchurch Health and Development Study (CHDS) | The Christchurch Health and Development Study (CHDS) is a birth cohort study comprising 1265 people born in Christchurch in 1977. Participants have been followed to age 40, with 75-80% retention at data collection points. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Trauma exposure | Other | Exposure to the Canterbury earthquake sequence and other relevant psychological trauma |
|
| Measure | Description | Time Frame |
|---|---|---|
| Subjective cognitive function | Assessed with the Cognitive Failures Questionnaire Minimum score = 0, maximum score = 100, higher scores reflect worse subjective cognitive function | Past 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Global cognitive composite | Global cognitive composite will average Z-scores across the cognitive domains of (i) verbal learning and memory, (ii) visuospatial learning and memory, (iii) psychomotor speed, (iv) executive function, (v) working memory, (vi) sustained attention, and (vii) emotion processing. The Global cognitive composite score will be a single, averaged Z-value score, with a higher score reflecting better objective cognitive performance. |
| Measure | Description | Time Frame |
|---|---|---|
| Data already obtained | Data will already be available from the CHDS database from birth to present, on the following relevant factors:
|
Inclusion Criteria:
Exclusion Criteria:
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The Christchurch Health and Development Study (CHDS) is a birth cohort study comprising 1265 people born in Christchurch in 1977. Participants have been followed to age 40, with 75-80% retention at data collection points. At the time of the February 2011 earthquake, 460 participants were in Christchurch and were subject to earthquake-related stresses.
This study will recruit people from the CHDS who were exposed to the Canterbury earthquake sequence, based on results of an initial screening using the Cognitive Failures Questionnaire (CFQ): the quartile with the highest scores on the CFQ, and the quartile with the lowest scores will be selected and invited to attend a more comprehensive evaluation.
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| Name | Affiliation | Role |
|---|---|---|
| Katie M Douglas, PhD | University of Otago | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Psychological Medicine, University of Otago, Christchurch | Christchurch | Canterbury | 8011 | New Zealand |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37550025 | Derived | Douglas K, Bell C, Tanveer S, Eggleston K, Porter R, Boden J. UNITE Project: understanding neurocognitive impairment after trauma exposure-study protocol of an observational study in Christchurch, New Zealand. BMJ Open. 2023 Aug 7;13(8):e072195. doi: 10.1136/bmjopen-2023-072195. |
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| ID | Term |
|---|---|
| D000067073 | Psychological Trauma |
| D014947 | Wounds and Injuries |
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
| D003072 | Cognition Disorders |
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Blood samples will be collected to assess the following biological markers:
| Baseline |
| Verbal learning and memory | Z-scores from variables of the Rey Auditory Verbal Learning Test will be averaged to create a singe Z-score for the domain of 'Verbal Learning and Memory', with higher scores reflecting better performance. | Baseline |
| Visuospatial learning and memory | Z-scores from variables of the Groton Maze Learning Test (CogState) will be averaged to create a singe Z-score for the domain of 'Visuospatial Learning and Memory', with higher scores reflecting better performance. | Baseline |
| Psychomotor speed | Z-scores from variables of the Timed Chase Test (CogState), Trail Making Test - Part A, and Digit Symbol Coding Test will be averaged to create a singe Z-score for the domain of 'Psychomotor speed', with higher scores reflecting better performance. | Baseline |
| Executive function | Z-scores from variables of the Trail Making Test - Part B and Category Fluency will be averaged to create a singe Z-score for the domain of 'Executive function', with higher scores reflecting better performance. | Baseline |
| Working memory | Z-scores from variables of the Digit Span Test will be averaged to create a singe Z-score for the domain of 'Working memory', with higher scores reflecting better performance. | Baseline |
| Sustained attention | Z-scores from variables of the Continuous Performance Test will be averaged to create a singe Z-score for the domain of 'Sustained attention', with higher scores reflecting better performance. | Baseline |
| Facial emotion processing | Z-scores from variables of the Facial Expression Recognition Test and the Reading the Mind in the Eyes Test will be averaged to create a singe Z-score for the domain of 'Facial emotion processing', with higher scores reflecting better performance. | Baseline |
| Rumination | Assessed with the Ruminative Responses Scale Minimum score = 25, maximum score = 100, higher scores reflect more severe rumination | Baseline |
| Metacognitive beliefs | Assessed with the Metacognitions Questionnaire - 30-item version Minimum score = 30, maximum score = 120, higher scores reflect more problematic metacognitive beliefs Minimum score = 25, maximum score = 100, higher scores reflect more severe rumination | Baseline |
| Psychosocial functioning | Assessed with the Social Adjustment Scale Minimum score = 1, maximum score = 5, higher scores reflect worse psychosocial functioning | Past 2 weeks |
| Stressful life events | Number of stressful life events is assessed with the Life Events Scale (adapted from the Crisis in Family Systems - Revised Questionnaire) Minimum score = 0, higher score reflects more stressful life events | Past 5 years |
| COVID-19 impact | Assessed with the COVID Psychosocial Impacts Scale (CPIS) Minimum score = 0, maximum score = 135, higher scores reflect more severe impact of COVID | Past 3 years |
| Post-traumatic growth | Assessed with the Post-traumatic Growth Inventory (PTGI) | Past 12 years |
| Mental health diagnoses | Assessed with the Mini International Neuropsychiatric Interview (MINI) | Baseline |
| Metabolic markers | Blood levels of HbA1C, total cholesterol, HDL cholesterol, LDL cholesterol (calc), triglycerides | Baseline |
| Inflammation | Blood levels of CRP | Baseline |
| Sex hormones | Blood levels of progesterone, LH, FSH, testosterone, SHBG (females only) | Baseline |
| 1977 to current |
| D019965 | Neurocognitive Disorders |