Publications by category
Books
Jetten J, Haslam C, Haslam SA (In Press). The Social Cure: Identity, health and well-being., Psychology Press.
Williams, W.H. (2007). Encephalitis: Assessment and Rehabilitation across the Lifespan. Special Issue of Neuropsychological Rehabilitation. , Psychology Press.
Evans, J.J. (2003). Bio-psychosocial Approaches for Mood and Behaviour Disorders in Neuro-rehabilitation. Special Issue of Neuropsychological Rehabilitation. , Psychology Press.
Williams, W.H. (2002). Memory Booster Workout:10 steps for a better memory.
Journal articles
Yates, P.J. Williams, W.H. Slater, A.M. (In Press). Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood; comparisons between groups of children aged under and over 10 years of age. Journal of Experimental Child Psychology
Mounce LTA, Williams WH, Harris A, Yates PJ, Llewellyn D (In Press). Deprivation increases risk of head versus orthopaedic injury in children and young people.
Redpath SJ, Williams WH, Hanna D, Linden MA, Yates PY, Harris A (In Press). Healthcare professionals’ attitudes towards Traumatic Brain Injury (TBI): the influence of profession, experience, aetiology and blame on prejudice towards survivors of brain injury. Brain Injury
Williams WH, Cordan G, Mewse AJ, Tonks J, CNW B (In Press). Self-Reported Traumatic Brain Injury in Male Young Offenders:. A risk factor for re-offending, poor mental health and violence?.
Neuropsychological RehabilitationAbstract:
Self-Reported Traumatic Brain Injury in Male Young Offenders:. A risk factor for re-offending, poor mental health and violence?
Abstract
Background
Adolescence is a risk period for offending and for Traumatic Brain Injury (TBI). TBI is a risk factor for poor mental health and for offending. TBI has been largely neglected from guidance on managing mental health needs of young offenders.
Aims
We sought to determine the rate of self-reported TBI, of various severities, in a male, adolescent youth offending population. We also aimed to explore whether TBI was associated with number of convictions, violent offending, mental health problems and drug misuse.
Method
Young male offenders aged 11 to 19 years were recruited from a Young Offender Institute, a Youth Offending Team and a special needs school. A total of 197 participants were approached and 186 (94.4%) completed the study. They completed self-reports on TBI, crime history, mental health and drug use.
Results
TBI with a Loss of Consciousness (LOC) was reported by 46% of the sample. LOC consistent with Mild TBI was reported by 29.6% and 16.6% reported LOC consistent with Moderate-Severe TBI. Possible TBI was reported by a further 19.1%. Repeat injury was common – with 32% reporting more than one LOC. Frequency of self-reported TBI was associated with more convictions. Three or more self-reported TBIs were associated with greater violence in offences. Those with self-reported TBI were also at risk of greater mental health problems and of misuse of cannabis.
Conclusions
TBI may be associated with offending behaviour and worse mental health outcomes. Addressing TBI within adolescent offenders with neuro-rehabilitative input may be important for improving well-being and reducing re-offending.
Abstract.
Jones JM, Haslam SA, Jetten J, Williams WH, Morris R, Saroyan S (In Press). That which does not kill you can make you stronger (and more satisfied with life): the contribution of personal and social changes to well-being after brain injury. Psychology & Health
Tonks J, Slater A, Frampton I, Wall SE, yates PY, Williams WH (In Press). The development of emotion and empathy skills after childhood brain injury. Developmental Medicine and Child Neurology, 51, 8-16.
Chitsabesan, Prathiba, Lennox, Charlotte, Williams, Huw, Tariq, Omar, Shaw, Jenny WH (In Press). Traumatic Brain Injury in Juvenile Offenders: Findings from the Comprehensive Health Assessment Tool Study and the Development of a Specialist Linkworker Service.
Williams WH, Mewse AJ, Tonks J, Mills S, CNW B, Cordan G (In Press). Traumatic Brain injury in a Prison Population: Prevalence, and Risk for Re-Offending. Brain Injury
Smith NIJ, Gilmour S, Prescott-Mayling L, Hogarth L, Corrigan JD, Williams WH (2021). A pilot study of brain injury in police officers: a source of mental health problems?.
J Psychiatr Ment Health Nurs,
28(1), 43-55.
Abstract:
A pilot study of brain injury in police officers: a source of mental health problems?
WHAT IS KNOWN ON THE SUBJECT?: Traumatic brain injury (TBI) has been linked to poor outcomes in terms of mental health, specifically, PTSD, depression and alcohol abuse. A lack of research evidence exists relevant to exploring the presence and implications of TBI in the police in the UK and globally, despite the elevated risk of physical and emotional trauma specific to policing. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: the rate of traumatic brain injury is highly prevalent in a small sample of police officers. Traumatic brain injury is a major source of post-concussion symptoms (physical, cognitive and emotional deficits) in police officers, which, in general, are associated with greater mental health difficulties and drinking alcohol to cope. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Traditional mental health treatments should be supplemented with elements of concussion care to address any cognitive, emotional and physical issues due to head injury. Interventions should be made more accessible to those suffering from a mild brain injury. This can be done through regular reminders of appointments, pictograms and by providing a concrete follow-up. ABSTRACT: Introduction Police officers have a high risk of injury through assaults, road traffic incidents and attending domestic calls, with many officers developing post-traumatic stress disorder (PTSD) as a consequence. Traumatic brain injury (TBI) is a common injury in populations involved in conflict and has been extensively linked to mental health difficulties. However, current research has not explored the frequency and sequelae of TBI in police populations, despite the elevated risk of physical and emotional trauma specific to policing. Aim to explore self-reported TBI, PTSD, post-concussion symptoms, depression and drinking to cope in a small sample of UK police, to determine the frequency of these conditions and their relationships. Method Measures of TBI, mental health, and drinking alcohol to cope were administered to 54 police officers from a Midshire Police Constabulary. Results Mild TBI with loss of consciousness was reported by 38.9% of the sample. TBI was associated with increased post-concussion symptoms (PCS). PCS were associated with greater severity of PTSD, depression and drinking to cope. Discussion Exploring TBI in the police could identify a major factor contributing towards ongoing mental health difficulties in a population where, based on previous research, the implications of TBI should not be overlooked, highlighting the need for further research in this area. Implications for Practice This research spans to identify the importance of routine assessment and increasing awareness within mental health services. Mental health treatments should be made amenable to a population with potential memory, planning and impulse control deficits. Further work in mental health services is needed to understand the level of ongoing issues that are due to post-concussion symptoms and those that are due to other mental health difficulties, such as PTSD, thereby educating patients on the association between TBI and emotional difficulties. A graduated return-to-work plan should be developed to enable a safe transition back to work, whilst managing any ongoing symptoms.
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Kent H, Williams WH, Hogarth L, Mewse A, Kent H (2021). Poor Parental Supervision is Associated with Traumatic Brain Injury and Reactive Aggression in Young Offenders.
Journal of Head Trauma RehabilitationAbstract:
Poor Parental Supervision is Associated with Traumatic Brain Injury and Reactive Aggression in Young Offenders.
Objective. To establish whether poor parental supervision is associated with head injury and
self-reported reactive aggression (i.e. aggression in response to perceived provocation or
threat) in adolescents in a young offender’s institute, by examining correlations between
these variables. Understanding this population is important as they are at a key pivotal age for
intervention to prevent life-long re-offending.
Method. Ninety-six male participants aged 16-18 were recruited from a UK Young
Offender’s Institute. Self-report measures of remembered parenting, reactive aggression, and
head injury history were administered during individual interviews.
Results. 74% of participants reported having experienced a lifetime TBI, and 46% of
participants reported experiencing at least one TBI leading to a loss of consciousness (LOC).
We found that poor parental supervision, length of LOC following TBI, and self-reported
reactive aggression, were all positively correlated.
Conclusions. Findings show that there are correlational relationships between poor parental
supervision, length of LOC following lifetime TBI, and higher levels of self-reported reactive
aggression. This suggests there may be pathways resulting from poor parental supervision
leading to both TBI with LOC, and reactive aggression. We advocate for future research with
longitudinal designs and larger samples to examine the nature of these interactions, and to
establish whether poor parental supervision is a prospective risk factor for more TBIs leading
to LOC, and reactive aggression. This is key to understanding whether parenting
interventions could help to reduce the disabling effects of TBI in adolescents, and help to
prevent contact with the law.
Abstract.
Law C, Amore TL, Williams WH, Tonks J (2021). Training emotional recognition in a child with acquired brain injury: a single case study.
Appl Neuropsychol Child,
10(4), 384-392.
Abstract:
Training emotional recognition in a child with acquired brain injury: a single case study.
Emotional processing is affected by childhood brain injury. Ineffective emotional processing and poor understanding of social cues affect the development of social relationships leading to social isolation and a poorer quality of life in the long-term. Facial expression recognition is a non-verbal social cue that is used to interpret the thoughts and feelings of others. Children with brain injury have shown deficits identifying even basic emotions from facial expression, yet few intervention studies have explored how to develop facial expression recognition in children with brain injury. Enhancing the ability to recognize and interpret facial expressions for these children would have implications for their emotional processing and social-emotional behavior. In this paper we report on a short single case study intervention to increase facial expression recognition using the Facial Affect Recognition training (FAR) for a 10-year-old-child with brain injury. Following intervention, there was not only an increase in facial expression recognition but also changes in social-emotional behavior indicating some generalization to other contexts. The results suggest that rehabilitation of emotional processing difficulties may indeed be possible, and further intervention studies aimed at developing these skills in children with brain injury are warranted.
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Kirby A, Williams WH, Clasby B, Hughes N, Cleaton MAM (2021). Understanding the complexity of neurodevelopmental profiles of females in prison.
International Journal of Prisoner Health,
17(4), 425-438.
Abstract:
Understanding the complexity of neurodevelopmental profiles of females in prison
Purpose: This paper aims to examine the relationship between patterns of functioning in four domains (attention and concentration; social and communication; coordination and organisation; and literacy and numeracy) in women in prison. Also, to consider potential associations between functioning and previous Neurodevelopmental Disorder (NDD) diagnoses, previous mental health diagnoses and history of head injury, self-harm and attempted suicide. Design/methodology/approach: Women in one Scottish prison were invited to participate; 87 consented. Women were screened for functional difficulties and asked about their relevant educational and medical history. Findings: Half of participants reported difficulties in one or more domains. All possible combinations of functional difficulties were found. Only eight women reported previous NDD diagnoses. Functional difficulties were significantly associated with history of self-harm, history of attempted suicide and mental health diagnoses. In total, 32% of women reported at least one head injury, but this was not significantly associated with functional difficulties. Research limitations/implications: the sample was comparatively small and questions were self-report. Analyses were based on within-cohort comparisons due to a lack of appropriate general population data. Practical implications: There is a clear need for timely, practical and comprehensive profiling of females in the Justice System. Current systems do not appear to adequately identify women with functional difficulties or other adversity. Greater use of interdisciplinary working and shared training is indicated, as is a move from categorical diagnostic systems towards dimensional approaches. Originality/value: This study is the first to investigate associations between difficulties associated with NDDs, mental health difficulties and head injury in women in prison.
Abstract.
Tonks J, Whitfield CK, Williams WH, Slater AM, Frampton IJ (2020). "Must try harder." is effort and performance validity testing a necessary part of pediatric neuropsychological assessment?.
Appl Neuropsychol Child,
9(2), 97-105.
Abstract:
"Must try harder." is effort and performance validity testing a necessary part of pediatric neuropsychological assessment?
Neuropsychological assessments results have significant implications for pediatric populations, based upon the assumption that the young person has adopted an effortful approach and has engaged in assessment. There is a commonly-accepted risk to assuming the validity of neuropsychological assessment results with adults, and, therefore, performance validity testing (PVT) has become a major topic of research and investigation and has become an accepted part of routine assessment. The same approach has not been adopted in assessment with children and a paucity of studies has focused on PVT in children. We review studies that demonstrate that children are equal to adults in their ability to use deception and that clinicians cannot detect false-effort without use of validity tests. We explore how frequently such tests are used and how well they work in assessment with children, and the limits, complexities, and constraints of adapting adult tests. We advocate that adequate performance validity testing is essential in order to maximize confidence in the results and we hypothesize that assessment with pediatric populations should take into account a range of influences, such as neuro-developmental factors associated with age of the child and suitability of proposed measures according to the evidence-base.
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Hughes N, Sheahan F, Williams WH, Chitsabesan P (2020). Ensuring the rights of children with neurodevelopmental disabilities within child justice systems.
Lancet Child Adolesc Health,
4(2), 163-166.
Abstract:
Ensuring the rights of children with neurodevelopmental disabilities within child justice systems.
A recent UN general comment on criminal justice systems includes guidance to state parties regarding the implementation of the Convention on the Rights of the Child for children with developmental delays or neurodevelopmental disorders or disabilities. This guidance asserts that these children "should not be in the child justice system at all", but when present "should be individually assessed" to enable appropriate safeguards and accommodations to ensure the protection of their rights without discrimination. In this Viewpoint, we examine the significant barriers faced by children who are affected by neurodevelopmental disabilities to the realisation of their rights under international law and standards. These barriers include systemic and cultural barriers created by a lack of awareness among justice professionals about how to identify and work with children who have neurodevelopmental disabilities, as well as procedural barriers, which arise from the complexity and rigidity of many criminal justice processes. The effect of these barriers is that the child is denied their rights on an equal basis with other children without such disabilities.
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Cook MJ, Gardner AJ, Wojtowicz M, Williams WH, Iverson GL, Stanwell P (2020). Task-related functional magnetic resonance imaging activations in patients with acute and subacute mild traumatic brain injury: a coordinate-based meta-analysis.
Neuroimage Clin,
25Abstract:
Task-related functional magnetic resonance imaging activations in patients with acute and subacute mild traumatic brain injury: a coordinate-based meta-analysis.
Task-based functional magnetic resonance imaging (fMRI) has been used to examine neuroanatomical and functional changes following mild traumatic brain injury (mTBI). Prior studies have lacked consistency in identifying common regions of altered neural activity during cognitive tasks. This may be partly due to differences in task paradigm, patient heterogeneity, and methods of fMRI analysis. We conducted a meta-analysis using an activation likelihood estimation (ALE) method to identify regions of differential brain activation in patients with mTBI compared to healthy controls. We included experiments that performed scans from acute to subacute time points post-injury. The seven included studies recruited a total sample of 174 patients with mTBIs and 139 control participants. The results of our coordinate based meta-analysis revealed a single cluster of reduced activation within the right middle frontal gyrus (MFG) that differentiated mTBI from healthy controls. We conclude that the cognitive impairments in memory and attention typically reported in mTBI patients may be associated with a deficit in the right MFG, which impacts the recruitment of neural networks important for attentional control.
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Clasby B, Bennett M, Hughes N, Hodges E, Meadham H, Hinder D, Williams H, Mewse A (2020). The consequences of traumatic brain injury from the classroom to the courtroom: understanding pathways through structural equation modelling.
Disabil Rehabil,
42(17), 2412-2421.
Abstract:
The consequences of traumatic brain injury from the classroom to the courtroom: understanding pathways through structural equation modelling.
Purpose: Paediatric traumatic brain injury (TBI) can have resultant ongoing significant impairments which can impact life outcomes. The primary aim of this research was to explore whether TBI contributes to the relationship between poor educational outcomes and offending trajectories.Materials and methods: Through analysis of a dataset consisting of self-reported health, educational, and offending histories of 70 incarcerated young males, structural equation modelling was used to explore the mediation of educational outcomes and patterns in offending behaviour by chronic symptoms following TBI.Results: Symptoms related to TBI significantly mediated the relationship between decreased educational attainment and more frequent convictions. It did not mediate any relationships involving age at first conviction.Conclusions: Traumatic brain injury appears to have more influence over frequency of offending patterns than age at first conviction. However, TBI remains a pervasive factor in both higher rates of offending and poorer educational attainment. In order to tackle this effect on adverse social outcomes, greater attention to the impact of TBI is required in education and criminal justice systems.IMPLICATIONS FOR REHABILITATIONHighlights traumatic brain injury as a contributory factor in some education to offending pathways, suggesting that greater focus on rehabilitation within the education and criminal justice systems is required.Reinforces that greater understanding of educational pathways post-injury is needed to better facilitate rehabilitation within the school system.
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Kinner SA, Hughes N, Borschmann R, Southalan L, Clasby B, Janca E, Willoughby M, Williams H (2020). The health of children deprived of liberty: a human rights issue.
Lancet Child Adolesc Health,
4(1), 6-7.
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Nkoana W, Williams H, Steenkamp N, Clasby B, Knowler H, Schrieff L (2020). Understanding the educational needs of young offenders: a prevalence study of traumatic brain injury and learning disabilities.
International Journal of Educational Development,
78Abstract:
Understanding the educational needs of young offenders: a prevalence study of traumatic brain injury and learning disabilities
Offenders in custody are often disadvantaged in terms of education. Research shows that providing and improving education in custody can help reduce the possibility of recidivism and high crime rates in young offenders. Among various factors that can impact on youth's ability to engage effectively with education in custody, prevalence rates of neurodisabilities such as learning disabilities and traumatic brain injuries (TBI) remain high. Young offenders with neurodisabilities may present with various developmental, cognitive, intellectual, social functioning, language and communication deficits, that may impact on learner-teacher relationships and learning acquisition. For the purpose of this paper, we focused on learning disabilities and TBI given high prevalence rates for these neurodisabilities reported in the literature. We also report on general intellectual functioning given the association with specific learning disabilities. Despite contextual vulnerabilities, there is a dearth of literature on neurodisabilities and its associated impact on education for young offenders in South Africa. Our study sample included young offenders (n = 25) and controls (n = 56), aged 14–21 years. Measures of alcohol (AUDIT), substance use (MAP), learning disabilities and TBIs (CHAT), general intellectual functioning (WASI-II), and depression (BDI-II) were included for offenders and controls. Results show significant differences in TBI, alcohol use, substance use, and reported possible learning disabilities, with higher scores and rates for these factors, indicating poorer outcomes, in the young offender as compared to the control group. The young offender group also had significantly lower and therefore poorer verbal IQ (VIQ) scores than the control group. The results for VIQ were upheld even when the significant difference in age (young offenders were on average 5 years older) was controlled for. Results of this nature can potentially be used to inform rehabilitative efforts in our local youth centres for offenders in the hope of screening for various developmental and acquired neuro-disabilities so that rehabilitation strategies may be even more targeted for those with special education needs in of an already vulnerable population. Such results may also inform the schooling structures within such centres by providing profiles needs of offenders in custody based on screenings of neurodisabilities.
Abstract.
Williams WH, Chitsabesan P, Fazel S, McMillan T, Hughes N, Parsonage M, Tonks J (2018). Traumatic brain injury: a potential cause of violent crime?.
The Lancet Psychiatry,
5(10), 836-844.
Abstract:
Traumatic brain injury: a potential cause of violent crime?
Traumatic brain injury (TBI) is the biggest cause of death and disability in children and young people. TBI compromises important neurological functions for self-regulation and social behaviour and increases risk of behavioural disorder and psychiatric morbidity. Crime in young people is a major social issue. So-called early starters often continue for a lifetime. A substantial majority of young offenders are reconvicted soon after release. Multiple factors play a role in crime. We show how TBI is a risk factor for earlier, more violent, offending. TBI is linked to poor engagement in treatment, in-custody infractions, and reconviction. Schemes to assess and manage TBI are under development. These might improve engagement of offenders in forensic psychotherapeutic rehabilitation and reduce crime.
Abstract.
Tonks J, Williams WH, Slater A, Frampton I (2017). Is damage to the pre-frontal cortex dormant until adolescence, or difficult to detect? Looking for keys that unlock executive functions in children in the wrong place.
Medical Hypotheses,
108, 24-30.
Abstract:
Is damage to the pre-frontal cortex dormant until adolescence, or difficult to detect? Looking for keys that unlock executive functions in children in the wrong place
A range of functions can be negatively affected by pre-frontal cortex (PFC) injury, but observed behavioural and social changes are commonly linked to post-injury changes in executive function. Executive functioning is a complex neuropsychological construct which is further complicated by neuro-developmental processes when applied to children. There is a substantial and continuing evidence base that supports the view that early childhood pre-frontal cortex (PFC) injury results in hidden, dormant, or sleeping effects. In contrast, recent and rapidly accruing contemporary studies provide preliminary evidence that challenge the view that PFC associated impairments are completely ‘hidden’. Studies that examine the various functions of the PFC and differentiate these to provide preliminary evidence to indicate earlier EF development than that which develops upon reaching adolescence, are reviewed here, together with research that identifies early predictors of later EF impairments. It remains that studies of PFC function and/or structural brain-changes are substantially complicated by issues related to definition regarding functions of the PFC, measurement of EF and other PFC-related functions that may be better understood as meta-processes. These issues are discussed in the concluding sections of this paper.
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Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A, Bragge P, Brazinova A, Buerki A, Chesnut RM, et al (2017). Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research.
LANCET NEUROLOGY,
16(12), 987-1048.
Author URL.
Hughes N, Clasby B, Chitsabesan P, Williams H (2016). A systematic review of the prevalence of foetal alcohol syndrome disorders among young people in the criminal justice system.
Cogent Psychology,
3(1).
Abstract:
A systematic review of the prevalence of foetal alcohol syndrome disorders among young people in the criminal justice system
Given the established association between foetal alcohol spectrum disorders (FASD) and risk of criminality and criminalisation, this systematic review examines the prevalence of FASD within youth justice systems. Four relevant sources were identified. Each source suggests a disproportionate prevalence in comparison to the general youth population. However, this masks significant variation between studies, and a much-heightened prevalence of FASD among Aboriginal youth in custody. The continued lack of research establishing prevalence, limits the potential for strong conclusions and suggests an imperative for improved processes of identification. This highlights systematic deficits in the ability to assess or even screen for FASD, with particular challenges for the youth justice system. Until such challenges can be resolved, it is likely that young people with FASD will remain hidden within a system in which they are at great risk of inadequate support, discrimination and criminalisation.
Abstract.
Hughes N, Williams WH, Chitsabesan P, Walesby RC, Mounce LTA, Clasby B (2015). The prevalence of traumatic brain injury among young offenders in custody: a systematic review.
J Head Trauma Rehabil,
30(2), 94-105.
Abstract:
The prevalence of traumatic brain injury among young offenders in custody: a systematic review.
OBJECTIVES: to examine the prevalence of traumatic brain injury (TBI) among young people in custody and to compare this with estimates within the general youth population. DESIGN: Systematic review of research from various national contexts. Included studies were assessed for the relevance of the definition of TBI and the research population, and the quality of the study design. RESULTS: Ten studies were identified for inclusion in the review. Four of these studies included control groups. No studies examining comorbidity of TBI and other neurodevelopmental disorders among incarcerated young people were identified. CONCLUSION: Reported prevalence rates of brain injury among incarcerated youth range from 16.5% to 72.1%, with a rate of 100% reported among a sample of young people sentenced to death. This suggests considerable levels of need among incarcerated young people. Where control groups or directly comparable studies within the general population exist, there is strong and consistent evidence of a prevalence of TBI among incarcerated youth that is substantially greater than that in the general population. This disparity is seemingly more pronounced as the severity of the injury increases.
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Williams WH, McAuliffe KA, Cohen MH, Parsonage M, Ramsbotham J, General the Lord David (2015). Traumatic brain injury and juvenile offending: complex causal links offer multiple targets to reduce crime.
J Head Trauma Rehabil,
30(2), 69-74.
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Chitsabesan P, Lennox C, Williams H, Tariq O, Shaw J (2015). Traumatic brain injury in juvenile offenders: findings from the comprehensive health assessment tool study and the development of a specialist linkworker service.
J Head Trauma Rehabil,
30(2), 106-115.
Abstract:
Traumatic brain injury in juvenile offenders: findings from the comprehensive health assessment tool study and the development of a specialist linkworker service.
BACKGROUND: Young people in contact with the youth juvenile justice system have well-documented vulnerabilities including high rates of mental health and neurodevelopmental disorders. Studies have suggested that they may also be at increased risk of traumatic brain injury (TBI). OBJECTIVE: (1) to describe the profile of a cohort of juvenile offenders with TBI and associated comorbidity with other neurodevelopmental disorders, mental health needs, and offending behavior. (2) to describe the development of a specialist brain injury service for juvenile offenders with TBI within custody. METHODS: Ninety-three male participants aged 15 to 18 years were consecutively admitted to a custodial secure facility. They were evaluated using a range of different neurocognitive and mental health measures including the Rivermead Post-Concussion Symptoms Questionnaire and the Comprehensive Health Assessment Tool. RESULTS: Eight-two percent of those interviewed reported experiencing at least 1 TBI, and 44% reported ongoing neuropsychological symptoms. Eighteen percent of those sustaining a TBI reported moderate-severe postconcussion symptoms. CONCLUSIONS: There is a high prevalence of TBI in juvenile offenders in custody, with many experiencing multiple episodes. This study highlights the need for further research in this area. An example of a specialist brain injury linkworker service is described as one example of a model of service delivery for this group.
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Gardner AJ, Iverson GL, Williams WH, Baker S, Stanwell P (2014). A Systematic Review and Meta-Analysis of Concussion in Rugby Union. Sports Medicine
Gardner AJ, Iverson GL, Williams WH, Baker S, Stanwell P (2014). A systematic review and meta-analysis of concussion in Rugby Union.
Sports Medicine,
44(12), 1717-1731.
Abstract:
A systematic review and meta-analysis of concussion in Rugby Union
Objective: the aim of the current review was to systematically evaluate the available evidence on concussion in Rugby Union and to conduct a meta-analysis of findings regarding the incidence of concussion.
Abstract.
Tonks J, Yates PJ, Williams HW, Frampton I, Slater A (2014). Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift.
Child and Adolescent Mental Health,
19(2), 151-158.
Abstract:
Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift
Background and Scope: in this article, we provide a brief overview of the principles that guide paediatric neuropsychological assessment, the methods used and some examples of the measures available. Findings: We explore intellectual, adaptive and social functioning from a neuropsychological perspective and describe suitable measures for use in paediatric neuropsychological assessment in each domain. Conclusions: We provide an example of assessment and interpretation using a fictional character (Tom Swift) to demonstrate that neuropsychological assessment is important in understanding the everyday questions that arise in children's services around risk, needs, level of understanding and capacity to engage with services. © 2013 Association for Child and Adolescent Mental Health.
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Reuben A, Sampson P, Harris AR, Williams H, Yates P (2014). Postconcussion syndrome (PCS) in the emergency department: Predicting and pre-empting persistent symptoms following a mild traumatic brain injury.
Emergency Medicine Journal,
31(1), 72-77.
Abstract:
Postconcussion syndrome (PCS) in the emergency department: Predicting and pre-empting persistent symptoms following a mild traumatic brain injury
Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.
Abstract.
Reuben A, Sampson P, Harris AR, Williams H, Yates P (2014). Postconcussion syndrome (PCS) in the emergency department: predicting and pre-empting persistent symptoms following a mild traumatic brain injury.
Emerg Med J,
31(1), 72-77.
Abstract:
Postconcussion syndrome (PCS) in the emergency department: predicting and pre-empting persistent symptoms following a mild traumatic brain injury.
Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.
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Author URL.
Tonks J, Yates PJ, Williams HW, Frampton I, Slater A (2013). Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift. Child and Adolescent Mental Health
Mounce LTA, Jones JM, Jetten J, Haslam SA, Williams WH (2013). Neurogenic and Psychogenic Acute Postconcussion Symptoms can be Identified After Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 28, 397-405.
Mounce LTA, Williams WH, Jones JM, Harris A, Haslam SA, Jetten J (2013). Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury.
J Head Trauma Rehabil,
28(5), 397-405.
Abstract:
Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury.
OBJECTIVES: As provenance of postconcussion symptoms after mild traumatic brain injury (mTBI) is controversial, with similar rates found in other populations, we aimed to identify postconcussion symptoms specific to mTBI compared with controls. We also compared differences between complicated and uncomplicated mTBIs. SETTING: Hospital emergency department. PARTICIPANTS: Adult individuals (34 individuals with complicated mTBI, 76 individuals with uncomplicated mTBI, and 47 orthopedic controls) who sought care in the emergency department and were consecutively recruited by post at 2 weeks postinjury. MAIN MEASURES: Rivermead Postconcussion Symptom Questionnaire. Preinjury factors were used as covariates. RESULTS: Compared with orthopedic controls, complicated mTBI group reported greater severity of headaches, dizziness, and nausea, as well as concentration difficulties, suggesting that these are neurogenic. Severity of other symptoms measured on the Rivermead Postconcussion Symptom Questionnaire was not significantly different between these groups, suggesting that these are psychogenic. Differences were evident between the 2 mTBI samples on the items of dizziness, nausea, fatigue, sleep disturbance, and concentration difficulties. CONCLUSIONS: Neurogenic and psychogenic postconcussion symptoms were identified at the acute-phase postinjury. Findings suggest that treating persons with mTBI as a homogenous sample is not prudent. This should inform prognostic models and follow-up support offered after leaving the emergency department.
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Gardner A, Kay-Lambkin F, Stanwell P, Donnelly J, Williams WH, Hiles A, Schofield P, Levi C, Jones DK (2012). A systematic review of diffusion tensor imaging findings in sports-related concussion.
J Neurotrauma,
29(16), 2521-2538.
Abstract:
A systematic review of diffusion tensor imaging findings in sports-related concussion.
Sports-related concussion (SRC) is typically associated with functional, as opposed to structural, injury. The results of traditional structural neuroimaging techniques used to assess SRC tend to be normal in many athletes, and are only clinically helpful in ruling out a more serious injury. Diffusion tensor imaging (DTI) has increasingly been touted as a method offering greater clinical potential in mild traumatic brain injury (mTBI). Despite this, the utility of DTI as a clinical tool for diagnosing and managing SRC has received considerably less attention than it has in the general TBI research literature. The aim of this article is to conduct a systematic review of DTI in SRC, and to provide a focus and overview of research findings using this MRI technique in SRC. A systematic review of articles published in the English language, up to February 2012, was retrieved via PsycINFO(®), MEDLINE(®), EMBASE, SPORTDiscus(™), Scopus, Web of Science, and Informit; using the key search terms: diffusion tensor imaging, diffusion magnetic resonance imaging, diffusion weighted MRI, diffusion MRI, fractional anisotropy, tractography, apparent diffusion coefficient, magnetic resonance imaging, mild traumatic brain injury, mTBI, traumatic brain injury, concussion, sport, athletic and athlete. Observational, cohort, correlation, cross-sectional and longitudinal studies were all included in the current review. Results of the review found eight articles that met inclusion criteria, which included data on 214 athletes and 96 controls. Seven of eight studies reported some type of DTI abnormality, although the neuroanatomical sites involved varied. Although considerable methodological variations exist across studies, the current review suggests that DTI may possess adequate diagnostic sensitivity to detect SRC in affected athletes. Further longitudinal studies are required to demonstrate its discriminate validity and prognostic capacity within this field.
Abstract.
Author URL.
Jones JM, Jetten J, Haslam SA, Williams WH (2012). Deciding to disclose: the importance of maintaining social relationships for well-being after acquired brain injury. , 255-271.
Davies RC, Williams WH, Hinder D, Burgess CNW, Mounce LTA (2012). Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth.
J Head Trauma Rehabil,
27(3), E21-E27.
Abstract:
Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth.
OBJECTIVES: to determine the prevalence rate of traumatic brain injury (TBI) in incarcerated youth and whether frequency and severity of TBI are associated with postconcussion symptoms (PCS), violent offending behaviors, age of first conviction, and substance abuse. PARTICIPANTS: Sixty-one incarcerated male juvenile offenders with an average age of 16 years. MAIN MEASURES: Self-rated measures of head injury, TBI, PCS (Rivermead Post-concussion Symptoms Questionnaire), history of alcohol and drug use, and criminal history. RESULTS: More than 70% reported at least 1 head injury at some point in their lives, and 41% reported experiencing a head injury with loss of consciousness. Postconcussion symptoms reliably increased with the frequency and severity of TBI. The relation between frequency and symptoms was mostly accounted for by severity of TBI. Alcohol use reliably increased with the severity of TBI and was associated with PCS. Alcohol use did not account for the dose-response relation between TBI and PCS. CONCLUSIONS: Findings indicate a need to account for TBI in offender populations in managing care needs, which may contribute to reduction in offending behaviors.
Abstract.
Author URL.
Ryland H, Williams WH, Zeman A, Murray J, Turner M (2012). The impact of neurological indicators of severity of concussion on neurocognitive performance in a sports population.
BRAIN INJURY,
26(4-5), 627-628.
Author URL.
Jones JM, Williams WH, Jetten J, Haslam SA, Harris A, Gleibs IH (2012). The role of psychological symptoms and social group memberships in the development of post-traumatic stress after traumatic injury.
Br J Health Psychol,
17(4), 798-811.
Abstract:
The role of psychological symptoms and social group memberships in the development of post-traumatic stress after traumatic injury.
OBJECTIVES: the costs associated with traumatic injury are often exacerbated by the development of post-traumatic stress symptoms. However, it is unclear what decreases the development of post-traumatic symptoms over time. The aim of the present research was to examine the role of psychological symptoms and social group memberships in reducing the development of post-traumatic stress symptoms after orthopaedic injuries (OIs) and acquired brain injuries (ABIs). DESIGN AND METHODS: a longitudinal prospective study assessed self-reported general health symptoms, social group memberships, and post-traumatic stress symptoms among participants with mild or moderate ABI (n= 62) or upper limb OI (n= 31) at 2 weeks (T1) and 3 months (T2) after injury. RESULTS: Hierarchical regressions revealed that having fewer T1 general health symptoms predicted lower levels of T2 post-traumatic stress symptoms after OI but forming more new group memberships at T1 predicted lower levels of T2 post-traumatic stress symptoms after ABI. CONCLUSION: a focus on acquiring group memberships may be particularly important in reducing the development of post-traumatic stress symptoms after injuries, such as ABI, which result in long-term life changes.
Abstract.
Author URL.
Tonks J, Williams WH, Mounce L, Harris D, Frampton I, Yates P, Slater A (2011). 'Trails B or not Trails B?' is attention-switching a useful outcome measure?.
Brain Inj,
25(10), 958-964.
Abstract:
'Trails B or not Trails B?' is attention-switching a useful outcome measure?
PRIMARY OBJECTIVE: Difficulties with attention contribute to behavioural and cognitive problems during childhood and may reflect subtle deficits in executive functioning (EF). Attention problems in early childhood have also been found to predict higher levels of anxiety and depression symptoms at 10 years old. It has also been reported that attention problems during childhood may be differentially related to later-emerging distinct EF difficulties. Many of these findings, however, rely on teacher-ratings of attention difficulties. METHODS AND PROCEDURES: This study administered neuropsychological tests of attention-switching and EF to 67 healthy children aged 9-15 years of age. It additionally measured socio-emotional behavioural functioning. MAIN OUTCOMES AND RESULTS: a critical phase of improvement was found at 10 years of age. Correlations were found between attention-switching skills and EF. Attention-switching skills were also correlated with socio-emotional functioning. CONCLUSIONS: Attention-switching skills have some interdependence with EF, but in paediatric assessment such skills are easier to routinely assess than many of the currently available tests of EF. It is suggested that attention-switching ability may prove to be a useful predictor of EF performance in understanding long-term outcome after a neurological event such as traumatic brain injury.
Abstract.
Author URL.
Tonks J, Williams WH, Yates P, Slater A (2011). Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood: comparisons between groups of children aged under and over 10 years of age.
Clin Child Psychol Psychiatry,
16(2), 185-194.
Abstract:
Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood: comparisons between groups of children aged under and over 10 years of age.
Children with traumatic brain injuries (TBI) commonly present with socioemotional difficulties, as well as accompanying multiple cognitive impairments. Often difficulties worsen at around 10 years old. This change is associated with frontal system changes, and tests of executive function (EF) predict outcome. However, children with TBI sometimes present with socioemotional difficulties despite apparent cognitive recovery. Our aims were to explore potential cognitive and socioemotional effects following childhood TBI, before and after the age of 10 years. We also wanted to identify cognitive correlates of psychosocial dysfunction. Measures of cognitive function and socioemotional disturbance administered to 14 children with TBI aged 8-10 years, and 14 children with TBI aged 10-16 years, were compared to control data from 22 non-injured 8- to 10 year-olds and 67 non-injured 10- to 16-year-olds. Results indicated that only the older group of children with TBI were impaired in tests of EF, but significant socioemotional difficulties were commonly evident in both groups. Processing speed (as well as EF) was found to correlate with socioemotional disturbance. We conclude that poor processing speed may also index the risk of socioemotional difficulties, but our general findings indicate that cognitive functions relevant to socioemotional functioning are not readily testable in younger children and are not strongly associated with such outcomes as they may be in adults.
Abstract.
Author URL.
Tonks J, Yates P, Frampton I, Williams WH, Harris D, Slater A (2011). Resilience and the mediating effects of executive dysfunction after childhood brain injury: a comparison between children aged 9-15 years with brain injury and non-injured controls.
Brain Inj,
25(9), 870-881.
Abstract:
Resilience and the mediating effects of executive dysfunction after childhood brain injury: a comparison between children aged 9-15 years with brain injury and non-injured controls.
PRIMARY OBJECTIVE: Acquired brain injury (ABI) during childhood can be associated with enduring difficulties related to impairments to executive functioning (EF). EF impairments may detrimentally affect outcome by restricting an individual's ability to access 'resiliency' resources after ABI. RESEARCH DESIGN: the purpose of this study was to explore whether there is deterioration in children's resilience compared with peers after ABI and whether EF is influential in mediating relationships between resilience and behaviour. METHODS AND PROCEDURES: Measures of resilience, depression and anxiety were administered with 21 children with ABI and 70 matched healthy children aged 9-15 years. Parents completed measures of behaviour and EF. MAIN OUTCOMES AND RESULTS: Children with ABI were identified as less resilient and more depressed and anxious than controls. Resiliency measures were correlated with depression and anxiety in both groups. Relationships between resiliency and socio-emotional behaviour were mediated by EF. CONCLUSIONS: Assessment of resilience after ABI may be useful in supporting or defining the delivery of more individualized rehabilitation programmes according to the resources and vulnerabilities a young person has. However, an accurate understanding of the role of EF in the relationship between resilience and behavioural outcome after ABI is essential.
Abstract.
Author URL.
Wall SE, Williams WH, Morris R, Bramham J (2011). The Development of a New Measure of Social-Emotional Functioning for Young Adolescents. Clinical Child Psychology and Psychiatry, 16(3), 301-315.
Williams WH (2010). Advances in measuring outcome for Children and Adolescents with Brain Injury. Brain Impairment
Redpath S, Williams WH, Hanna D, Linden MA, Yates PJ, Harris A (2010). Healthcare professionals’ attitudes towards traumatic brain injury (TBI): the influence of profession, experience, aetiology and blame on prejudice towards survivors of brain injury.
Brain Injury,
24, 802-811.
Abstract:
Healthcare professionals’ attitudes towards traumatic brain injury (TBI): the influence of profession, experience, aetiology and blame on prejudice towards survivors of brain injury
Primary objective: to investigate the attitudes of healthcare professionals towards individuals with traumatic brain injury
(TBI) and their relationship to intended healthcare behaviour.
Research design: an independent groups design utilized four independent variables; aetiology, group, blame and gender to
explore attitudes towards survivors of brain injury. The dependent variables were measured using the Prejudicial Evaluation
and Social Interaction Scale (PESIS) and Helping Behaviour Scale (HBS).
Methods and procedures: a hypothetical vignette based methodology was used. Four hundred and sixty participants (131
trainee nurses, 94 qualified nurses, 174 trainee doctors, 61 qualified doctors) were randomly allocated to one of six possible
conditions.
Main outcomes and results: Regardless of aetiology, if an individual is to blame for their injury, qualified healthcare
professionals have more prejudicial attitudes than those entering the profession. There is a significant negative relationship
between prejudice and helping behaviour for qualified healthcare professionals.
Conclusions: Increased prejudicial attitudes of qualified staff are related to a decrease in intended helping behaviour, which
has the potential to impact negatively on an individual’s recovery post-injury.
Abstract.
Williams WH, Potter S, Ryland H (2010). Mild traumatic brain injury and Postconcussion Syndrome: a neuropsychological perspective.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY,
81(10), 1116-1122.
Author URL.
Tonks J, Williams WH, Yates P, Frampton I, Slater AM (2010). Peer-relationship difficulties in children with brain injuries: comparisons with children in mental health services and healthy controls. Neuropsychological Rehabilitation
Williams WH, Giray G, Mewse AJ, Tonks J, Burgess CNW (2010). Traumatic Brain Injury in Young Offenders: a modifiable risk factor for re-offending, poor mental health and violence.
Neuropsychological Rehabilitation an International Journal,
20(6), 801-812.
Abstract:
Traumatic Brain Injury in Young Offenders: a modifiable risk factor for re-offending, poor mental health and violence.
Background
Adolescence is a risk period for offending. Traumatic Brain Injury (TBI) a potential risk factor for poor mental health and for offending. TBI has been largely neglected from guidance on managing health needs of offenders.
Aims
We sought to determine the rate of self-reported TBI, of various severities, in a male, adolescent youth offending population. We also aimed to explore whether TBI was associated with number of convictions, violent offending, mental health problems and drug misuse.
Method
Young male offenders aged 11 to 19 years were recruited. A total of 197 participants were approached and 186 (94.4%) completed the study. They completed self-reports on TBI, mental health and drug use.
Results
Prevalence rate of TBI of all severities was 65%. Repeat injury was common – with 32% having had more than one episode of LOC. Frequency of TBI was associated with more convictions. Three or more TBIs were associated with greater violence in offences. Those with TBI were also at risk of greater mental health problems and of misuse of cannabis.
Conclusions
TBI may be associated with offending behaviour and worse mental health outcomes. Addressing TBI within adolescent offenders may be important for improving well-being and reducing re-offending.
Abstract.
Williams WH, Mewse AJ, Tonks J, Mills S, Burgess CNW, Cordan G (2010). Traumatic Brain injury in a Prison Population: Prevalence, and Risk for Re- Offending.
Brain Injury,
24(10), 1184-1188.
Abstract:
Traumatic Brain injury in a Prison Population: Prevalence, and Risk for Re- Offending.
Background: TBI can lead to cognitive, behavioural and emotional difficulties. Previous studies suggest that TBI is relatively elevated in offender populations. We aimed to establish the rate of TBI of various severities in a representative sample of adult offenders and patterns of custody associated with TBI.
Methods:. We conducted a self-report survey of adult, male, offenders within a prison. of 453 offenders, 196 (43%) responded.
Results: We found over 60% reported “Head Injuries”. Reports consistent with TBI of various severities were given by 64%. of the overall sample, 16%. had experienced moderate to severe TBI, and 48% Mild TBI. Adults with TBI were younger at entry into custodial systems and reported higher rates of repeat offending. They also reported greater time, in past 5 years, spent in prison.
Conclusions: These findings indicate that there is a need to account for TBI in the assessment and management of offenders.
Abstract.
Wilson BA, Evans JJ, Williams WH (2009). Memory Problems. , 136-165.
Williams, W.H. Frampton, I. Yates, P. (2009). The development of emotion and empathy skills after childhood brain injury.
Developmental Medicine and Child Neurology,
51(1), 8-16.
Abstract:
The development of emotion and empathy skills after childhood brain injury
Lasting socio-emotional behaviour difficulties are common among children who have suffered brain injuries. A proportion of difficulties may be attributed to impaired cognitive and/or executive skills after injury. A recent and rapidly accruing body of literature indicates that deficits in recognizing and responding to the emotions of others are also common. Little is known about the development of these skills after brain injury. In this paper we summarize emotion-processing systems, and review the development of these systems across the span of childhood and adolescence. We describe critical phases in the development of emotion recognition skills and the potential for delayed effects after brain injury in earlier childhood. We argue that it is important to identify the specific nature of deficits in reading and responding to emotions after brain injury, so that assessments and early intervention strategies can be devised.
Abstract.
Tonks J, Slater AM, Frampton I, Wall SE, Yates P, Williams WH (2009). The development of emotion and empathy skills after childhood brain injury. Developmental Medicine and Child Neurology, 51, 8-16.
Tonks J, Yates P, Slater A, Williams WH, Frampton I (2009). Visual-spatial functioning as an early indicator of socioemotional difficulties.
Developmental Neurorehabilitation,
12(5), 313-319.
Abstract:
Visual-spatial functioning as an early indicator of socioemotional difficulties
Primary objective: As children with acquired brain injuries (ABI) mature to become adolescents they develop a range of previously undetected social and emotional difficulties, which are commonly associated with executive dysfunctions. The authors wanted to determine whether visual-spatial performance is subject to age-related improvement, whether such skills can differentiate between children with ABI and healthy children and whether visual-spatial performance is a correlate of socioemotional functioning. Research design: the 'Cube analysis' and 'Dot discrimination' tests from the 'Visual Object Space Perception (VOSP)' battery and the Strengths and Difficulties Questionnaire (SDQ) were administered for 18 children, 915 years, with ABI and compared against 67 'healthy' children. Results: Cube analysis scores improved significantly at ∼10 years old in the control group. The ABI group performed the task significantly poorer than controls. Analysis indicated that visual discrimination skill did not account for performance difficulties. Visual-spatial performance was correlated with greater impact of reported difficulties on the SDQ. Conclusions: Visual-spatial tests are sensitive in differentiating between healthy children and children with ABI. Impairment of visuo-spatial skills may provide an index of psychosocial risk during later teenage years and adulthood. © 2009 Informa UK Ltd all rights reserved.
Abstract.
Tonks J, Yates P, Slater A, Williams WH, Frampton I (2009). Visual-spatial functioning as an early indicator of socioemotional difficulties.
Dev Neurorehabil,
12(5), 313-319.
Abstract:
Visual-spatial functioning as an early indicator of socioemotional difficulties.
PRIMARY OBJECTIVE: As children with acquired brain injuries (ABI) mature to become adolescents they develop a range of previously undetected social and emotional difficulties, which are commonly associated with executive dysfunctions. The authors wanted to determine whether visual-spatial performance is subject to age-related improvement, whether such skills can differentiate between children with ABI and healthy children and whether visual-spatial performance is a correlate of socioemotional functioning. RESEARCH DESIGN: the 'Cube analysis' and 'Dot discrimination' tests from the 'Visual Object Space Perception (VOSP)' battery and the Strengths and Difficulties Questionnaire (SDQ) were administered for 18 children, 9-15 years, with ABI and compared against 67 'healthy' children. RESULTS: Cube analysis scores improved significantly at approximately 10 years old in the control group. The ABI group performed the task significantly poorer than controls. Analysis indicated that visual discrimination skill did not account for performance difficulties. Visual-spatial performance was correlated with greater impact of reported difficulties on the SDQ. CONCLUSIONS: Visual-spatial tests are sensitive in differentiating between healthy children and children with ABI. Impairment of visuo-spatial skills may provide an index of psychosocial risk during later teenage years and adulthood.
Abstract.
Author URL.
Watkins, E.R. Williams, W.H. (2008). Depressive Rumination reduces specificity of Autobiographical Memory Recall in Acquired Brain Injury. Journal of the International Neuropsychological Society, 14(1), 63-70.
Haslam C, Holme A, Haslam SA, Iyer A, Jetten J, Williams WH (2008). Maintaining group memberships: Social identity continuity predicts well-being after stroke.
Neuropsychological Rehabilitation,
18(5-6), 671-691.
Abstract:
Maintaining group memberships: Social identity continuity predicts well-being after stroke
A survey study of patients recovering from stroke (N = 53) examined the extent to which belonging to multiple groups prior to stroke and the maintenance of those group memberships (as measured by the Exeter Identity Transitions Scales, EXITS) predicted well-being after stroke. Results of correlation analysis showed that life satisfaction was associated both with multiple group memberships prior to stroke and with the maintenance of group memberships. Path analysis indicated that belonging to multiple groups was associated with maintained well-being because there was a greater likelihood that some of those memberships would be preserved after stroke-related life transition. Furthermore, it was found that cognitive failures compromised well-being in part because they made it hard for individuals to maintain group memberships post-stroke. These findings highlight the importance of social identity continuity in facilitating well-being following stroke and, more broadly, show the theoretical contribution that a social identity approach to mental health can make in the context of neuropsychological rehabilitation. © 2007 Psychology Press.
Abstract.
Haslam C, Holme A, Haslam SA, Iyer A, Jetten J, Williams WH (2008). Maintaining group memberships: social identity continuity predicts well-being after stroke.
Neuropsychol Rehabil,
18(5-6), 671-691.
Abstract:
Maintaining group memberships: social identity continuity predicts well-being after stroke.
A survey study of patients recovering from stroke (N = 53) examined the extent to which belonging to multiple groups prior to stroke and the maintenance of those group memberships (as measured by the Exeter Identity Transitions Scales, EXITS) predicted well-being after stroke. Results of correlation analysis showed that life satisfaction was associated both with multiple group memberships prior to stroke and with the maintenance of group memberships. Path analysis indicated that belonging to multiple groups was associated with maintained well-being because there was a greater likelihood that some of those memberships would be preserved after stroke-related life transition. Furthermore, it was found that cognitive failures compromised well-being in part because they made it hard for individuals to maintain group memberships post-stroke. These findings highlight the importance of social identity continuity in facilitating well-being following stroke and, more broadly, show the theoretical contribution that a social identity approach to mental health can make in the context of neuropsychological rehabilitation.
Abstract.
Author URL.
Turkstra LS, Williams WH, Tonks J, Frampton I (2008). Measuring social cognition in adolescents: implications for students with TBI returning to school.
NeuroRehabilitation,
23(6), 501-509.
Abstract:
Measuring social cognition in adolescents: implications for students with TBI returning to school.
In everyday adolescent communication, the ability to empathise with the mental state of others, recognise or infer intentions, or make judgements about emotional state, is a non-conscious but vital prerequisite of relating. Execution of these skills in social interactions supports both the exchange of social knowledge and also the development and maintenance of personal relationships. Thus, adolescents with impairments in these skills are at risk for a variety of negative outcomes. In this paper, we present data to illustrate that adolescents with traumatic brain injury (TBI) are likely to have impairments in processes such as emotion recognition and mental state attribution, and that these might not be identified on standardised tests. This is considered from the perspective of clinical assessment and intervention in school contexts.
Abstract.
Author URL.
Williams, W.H. Frampton, I. Yates, P. (2008). Reading emotions after childhood brain injury: Case series evidence of dissociation between cognitive abilities and emotional expression processing skills. Brain Injury
Tonks J, Williams WH, Yates P, Frampton I, Wall SE, Slater AM (2008). Reading emotions after childhood brain injury: Case series evidence of dissociation between cognitive abilities and emotional expression processing skills. Brain Injury, 22, 325-332.
Chasey, R. Williams, W.H. (2008). The Role of schema and appraisals in the development of post-traumatic stress symptoms following birth. Journal of Reproductive and Infant Psychology, 26(2).
Roundhill, S.J. Williams, W.H. & Hughes, J.M. (2008). The experience of loss following traumatic brain injury: Applying a bereavement model to the process of adjustment. Qualitative Research in Psychology, 4
Edworthy Z, Chasey R, Williams H (2008). The role of schema and appraisals in the development of post-traumatic stress symptoms following birth.
JOURNAL OF REPRODUCTIVE AND INFANT PSYCHOLOGY,
26(2), 123-138.
Author URL.
Williams, H. Frampton, I. Yates, P.J. (2007). Assessing emotional recognition in 9 to 15 year olds: preliminary analysis of abilities in reading emotion from faces, voices and eyes. Brain Injury, 21, 623-629.
Hooper L, Williams WH, Sarah EW, Chua K-C (2007). Caregiver distress, coping and parenting styles in cases of childhood encephalitis.
Neuropsychol Rehabil,
17(4-5), 621-637.
Abstract:
Caregiver distress, coping and parenting styles in cases of childhood encephalitis.
This study presents an exploration of the impact of childhood encephalitis on parental mood, coping and disciplinary strategies. Thirty six parents of children aged between 10 and 17 years were recruited. They were split into groups of recent and remote cases (within or beyond 7 years). Group comparison revealed that neurobehavioural consequences of childhood encephalitis appear to persist over time. Higher levels of behavioural symptoms consistent with dysexecutive disorder were associated with greater parental distress. Parents remain distressed despite reporting proactive profiles of coping. There was an indication that severity of dysexecutive disorder was asscociated with less use of proactive parental management strategies. Support for parents, in particular focused on effective management of dysexecutive problems, is recommended.
Abstract.
Author URL.
Williams WH, Haslam C, Kay J, Pewter S (2007). Neuropsychological and psychiatric profiles in acute encephalitis in adults. Neuropsychological Rehabilitation, 17, 478-505.
Williams, H. Frampton, I. Yates, P.J. (2007). Reading emotions after child brain injury: a comparison between children with brain injury and non-injured controls. Brain Injury
Williams (2007). Stress, parental style and coping in children with encephalitis. Neuropsychological Rehabilitation
Williams, W.H. Frampton, I. Yates, P.J. (2007). The neurological bases of emotional dys-regulation arising from brain injury in childhood: a “when and where” heuristic. Brain Impairment, 8, 143-153
Williams WH, Harris A, Round A, Yates PJ (2006). An epidemiological study of head injuries in a UK population attending an emergency department. Journal of Neurology Neurosurgery & Psychiatry, 77(5), 699-701.
Williams WH, Cartwright-Hatton S, Kelly TP, Wall SE (2006). Neuropsychological dysfunction following repeat concussion in jockeys. Journal of Neurology Neurosurgery & Psychiatry, 77(4), 518-520.
Williams, W.H. Yates, P. Harris, A. (2006). Social emotional problem solving and carer stress in traumatic brain injured survivors. Neuropsychological Rehabilitation
Williams, W.H. Yates, P.J. Harris, A. (2006). Spousal relationship satisfaction following acquired brain injury: the role of insight and socio-emotional skill. Neuropsychological Rehabilitation, 17(1), 95-105.
Fleminger, S. Oiver, D. (2003). Assessment and Management of Depression in Acquired Brain Injury. Neuropsychological Rehabilitation, Special Issue, 65-89.
Williams WH, Evans JJ (2003). Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation.
Neuropsychological Rehabilitation,
13(1-2), 1-11.
Abstract:
Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation
Survivors of acquired brain injury (ABI) are at risk of a range of neuropsychiatric and behavioural disorders. Emotional disturbance, with reactive elements of mood disorder, such as depression and anxiety, appear particularly common. Specific anxiety disorders, such as post-traumatic stress disorder (PTSD) have also been identified. Pain syndromes are also common - particularly in those who have suffered Traumatic Brain Injuries (TBI). Survivors of ABI are often at risk of substance misuse and of irritability states. Their relationships may suffer from the stresses triggered by the aftermath of injury. Intimate, in particular, sexual relationships may be particularly affected. These effects are not, necessarily, only consequent of severe injuries, as mild TBI can also have, for some, significant neuropsychiatric effects. Assessment and management of such conditions are compromised by survivors of injury often having a limited insight into the sequelae of their injuries. Interventions for such disorders and forms of distress are increasingly available. This paper introduces the special issue of Neuropsychological Rehabilitation on biopsychosocial approaches in neurorehabilitation. A range of papers provide overviews for assessing and managing such neuropsychiatric, mood and behavioural (health and habit) disorders.
Abstract.
Williams WH, Evans JJ (2003). Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation.
Neuropsychol Rehabil,
13(1-2), 1-11.
Abstract:
Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation.
Survivors of acquired brain injury (ABI) are at risk of a range of neuropsychiatric and behavioural disorders. Emotional disturbance, with reactive elements of mood disorder, such as depression and anxiety, appear particularly common. Specific anxiety disorders, such as post-traumatic stress disorder (PTSD) have also been identified. Pain syndromes are also common-particularly in those who have suffered Traumatic Brain Injuries (TBI). Survivors of ABI are often atrisk of substance misuse and of irritability states. Their relationships may suffer from the stresses triggered by the aftermath of injury. Intimate, in particular, sexual relationships may be particularly affected. These effects are not, necessarily, only consequent of severe injuries, as mild TBI can also have, for some, significant neuropsychiatric effects. Assessment and management of such conditions are compromised by survivors of injury often having a limited insight into the sequelae of their injuries. Interventions for such disorders and forms of distress are increasingly available. This paper introduces the special issue of Neuropsychological Rehabilitation on biopsychosocial approaches in neurorehabilitation. A range of papers provide overviews for assessing and managing such neuropsychiatric, mood and behavioural (health and habit) disorders.
Abstract.
Author URL.
Williams WH, Evans JJ, Fleminger S (2003). Neurorehabilitation and cognitive-behaviour therapy of anxiety disorders after brain injury: an overview and a case illustration of obsessive-compulsive disorder.
Neuropsychol Rehabil,
13(1-2), 133-148.
Abstract:
Neurorehabilitation and cognitive-behaviour therapy of anxiety disorders after brain injury: an overview and a case illustration of obsessive-compulsive disorder.
Survivors of acquired and traumatic brain injuries may often experience anxiety states. Psychological reactions to neurological trauma may be caused by a complex interaction of a host of factors. We explore how anxiety states may be understood in terms of a biopsychosocial formulation of such factors. We also review the current evidence for the presence of specific anxiety disorders after brain injury. We then describe how cognitive-behaviour therapy (CBT), a treatment of choice for many anxiety disorders, may be integrated with cognitive rehabilitation (CR), for the management of anxiety disorders in brain injury. We illustrate how CBT and CR may be delivered with a case of a survivor of traumatic brain injury (TBI) who had developed obsessive compulsive disorder and health anxiety. We show how CBT plus CR allows a biopsychosocial formulation to be developed of the survivor's concerns for guiding a goal-based intervention. The survivor made significant gains from intervention in terms of goals achieved and changes on clinical measures. We argue that large-scale research is needed for developing an evidence base for managing emotional disorders in brain injury.
Abstract.
Author URL.
Williams WH, Evans JJ, Wilson BA (2003). Neurorehabilitation for two cases of post-traumatic stress disorder following traumatic brain injury.
Cogn Neuropsychiatry,
8(1), 1-18.
Abstract:
Neurorehabilitation for two cases of post-traumatic stress disorder following traumatic brain injury.
INTRODUCTION: We present two cases to illustrate the assessment and management of post-traumatic stress disorder (PtSD) in the context of traumatic brain injury (TBI). Case KE suffered a TBI in a road traffic accident (RTA) in which his girlfriend was killed. Case CM survived a penetrating neurological injury from a severe knife attack. Both suffered cognitive difficulties, primarily in attention and memory, and selective visual impairments, and had endured significant losses of social role. METHOD: Within a neurorehabilitation programme, goals were set regarding management of their cognitive difficulties for regaining social roles and for the management of their PtSD symptoms. Cognitive behavioural therapy (CBT) was provided for managing PtSD symptoms, which included use of a stress inoculation and graduated exposure to avoided situations and trauma re-experiences. RESULTS: Both survivors reported significant improvements in managing mood state, and in redeveloping social roles. Objective measures confirmed significant gains from intervention. CONCLUSIONS: CBT, set within a neurorehabilitation programme, can lead to improvement in PtSD symptoms and psychosocial outcome in TBI survivors.
Abstract.
Author URL.
Williams WH, Evans JJ, Fleminger S, Oliver D (2003). The neuropsychiatry of depression after brain injury. Neuropsychological Rehabilitation, 13(1-2), 65-87.
Evans, J.J. Wilson, B.A. (2002). Prevalence of Post-traumatic Stress Disorder after Severe Traumatic Brain Injury in a representative community sample. Brain Injury, 16(8), 673-679.
Evans, J.J. Fleminger, S. (2002). Assessment and Management of Anxiety Disorders in Acquired Brain Injury. Special issue of Neuropsychological Rehabilitation, 1, 133-148.
Evans, J.J. (2002). Bio-psychosocial Approaches for Mood and Behaviour Disorders in Neuro-rehabilitation: an overview of. Special issue of Neuropsychological Rehabilitation, 1-12.
Williams WH, Evans JJ, Wilson BA, Needham P (2002). Brief report: prevalence of post-traumatic stress disorder symptoms after severe traumatic brain injury in a representative community sample.
Brain Inj,
16(8), 673-679.
Abstract:
Brief report: prevalence of post-traumatic stress disorder symptoms after severe traumatic brain injury in a representative community sample.
PRIMARY OBJECTIVE: in this study, the authors investigated the prevalence of symptoms of post-traumatic stress disorder (PTSD) in a community sample of 66 survivors of severe traumatic brain injury (TBI). RESEARCH DESIGN, METHODS AND PROCEDURES: a representative sample of survivors of TBI were selected on the basis of having suffered significant disturbance in consciousness following their trauma event in the form of coma and/or post-traumatic amnesia. Neuropsychological testing confirmed that participants had suffered cognitive deficits consistent with severe brain injury. Participants were administered the Impact of Events inventory for symptoms of PTSD. MAIN OUTCOMES AND RESULTS: the authors found a prevalence rate of 18% for moderate-to-severe PTSD symptoms. CONCLUSIONS: PTSD symptoms are common following severe TBI. Further research is needed to establish protective and predictive factors for PTSD in TBI groups.
Abstract.
Author URL.
Evans, J.J. Wilson, B.A. (2002). Neurological Rehabilitation for Posttraumatic Stress symptoms after Traumatic Brain Injury. Cognitive Neuropsychiatry, 8(1), 1-18.
Williams WH, Evans JJ, Needham P, Wilson BA (2002). Neurological, cognitive and attributional predictors of reports of posttraumatic stress disorder symptoms after traumatic brain injury. Journal of Traumatic Stress, 15(5), 397-400.
Williams, W.H. Bryant, R. (2002). Post-traumatic Stress Disorder after Traumatic Brain Injury: a review of Causal mechanisms, assessment and treatment. Special issue of Neuropsychological Rehabilitation, 1, 149-164.
Williams WH, Evans JJ, Wilson BA (1999). Outcome Measures for Survivors of Acquired Brain Injury in Day and Outpatient Neurorehabilitation Programmes. Neuropsychological Rehabilitation, 9(3-4), 421-436.
Williams WH, Williams JMG, Ghadiali EJ (1998). Autobiographical memory in traumatic brain injury: Neuropsychological and mood predictors of recall.
Neuropsychological Rehabilitation,
8(1), 43-60.
Abstract:
Autobiographical memory in traumatic brain injury: Neuropsychological and mood predictors of recall
Survivors of traumatic brain injury are often impaired in their recall of specific events. Depressed, suicidal, and post-traumatically stressed patients also tend to be over-general in autobiographical recall. In this study we examined the extent to which neurological damage and disturbed mood converge to lead to problems in autobiographical recall for survivors of traumatic brain injury. Eighteen participants completed measures of depression and anxiety (HAD), tests of general memory and immediate recall (Rivermead), and of current and premorbid verbal IQ (SCOLP). In addition they completed a 20 cue word autobiographical memory test and made causal attributions for their trauma events. Correlational analyses revealed that difficulty in autobiographical recall was related to reduced immediate recall ability and mood disturbance. Remedial implications are discussed.
Abstract.
Chapters
Williams WH (2019). Neuropsychological Assessment of mTBI in Adults. In (Ed)
Traumatic Brain Injury a Clinician’s Guide to Diagnosis, Management, and Rehabilitation, Springer.
Abstract:
Neuropsychological Assessment of mTBI in Adults
Abstract.
McMillan TM, Williams H (2017). Neurobehavioural disability and the criminal justice system. In (Ed) Neurobehavioural Disability and Social Handicap Following Traumatic Brain Injury, Second Edition, 57-68.
Williams W (2012). Neurocognitive Assessment of mTBI. In (Ed) Traumatic Brain Injury. A Clinician's Guide to Diagnosis, Management, and Rehabilitation.
Easton A, Pewter S, Williams WH (2011). Neuroscience Nursing: Management of pateients with central system infecstions. In Woodward S (Ed)
Neuroscience Nursing, Wiley-Blackwell, 396-426.
Abstract:
Neuroscience Nursing: Management of pateients with central system infecstions
Abstract.
Evans JJ, Williams WH (2009). Caroline: Treating post-traumatic stress disorder after traumatic brain injury. In (Ed)
Neuropsychological Rehabilitation: Theory, Models, Therapy, 227-236.
Abstract:
Caroline: Treating post-traumatic stress disorder after traumatic brain injury
Abstract.
Evans JJ, Williams WH (2009). Neuropsychological Rehabilitation. In Wilson BA, Gracey F, Evans JJ, Bateman A (Eds.)
Neuropsychological Rehabilitation, Cambridge Univ Pr.
Abstract:
Neuropsychological Rehabilitation
Abstract.
wh W (2003). Neuropsychological rehabilitation. In Wilson BA, Zangwill OL (Eds.)
Neuropsychological rehabilitation, Psychology Press.
Abstract:
Neuropsychological rehabilitation
Abstract.
Williams WH, RSP J (1997). Cognitive-behaviour therapy for people with learning disabilities. In Kroese BS, Dagnan D, Loumidis K (Eds.)
Cognitive-behaviour therapy for people with learning disabilities, Brunner-Routledge.
Abstract:
Cognitive-behaviour therapy for people with learning disabilities
Abstract.
RSP J, Miller B, Williams WH, Goldthorp J (1997). Cognitive-behaviour therapy for people with learning disabilities. In Kroese BS, Dagnan D, Loumidis K (Eds.)
Cognitive-behaviour therapy for people with learning disabilities, Brunner-Routledge.
Abstract:
Cognitive-behaviour therapy for people with learning disabilities
Abstract.
Conferences
Frampton, I. Yates, P.J. Yates, P.J. (2005). A. Neuropsychological assessment of socio-emotional functioning in children.Presented at International Neuropsychological Rehabilitation Conference, University of Galway, Ireland, July 2005.
Roberts E, Goldman J, Williams WH, Egan D (2002). Can all COPD patients cope with pulmonary rehabilitation?.
Author URL.
Publications by year
In Press
Yates, P.J. Williams, W.H. Slater, A.M. (In Press). Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood; comparisons between groups of children aged under and over 10 years of age. Journal of Experimental Child Psychology
Mounce LTA, Williams WH, Harris A, Yates PJ, Llewellyn D (In Press). Deprivation increases risk of head versus orthopaedic injury in children and young people.
Redpath SJ, Williams WH, Hanna D, Linden MA, Yates PY, Harris A (In Press). Healthcare professionals’ attitudes towards Traumatic Brain Injury (TBI): the influence of profession, experience, aetiology and blame on prejudice towards survivors of brain injury. Brain Injury
Williams WH, Cordan G, Mewse AJ, Tonks J, CNW B (In Press). Self-Reported Traumatic Brain Injury in Male Young Offenders:. A risk factor for re-offending, poor mental health and violence?.
Neuropsychological RehabilitationAbstract:
Self-Reported Traumatic Brain Injury in Male Young Offenders:. A risk factor for re-offending, poor mental health and violence?
Abstract
Background
Adolescence is a risk period for offending and for Traumatic Brain Injury (TBI). TBI is a risk factor for poor mental health and for offending. TBI has been largely neglected from guidance on managing mental health needs of young offenders.
Aims
We sought to determine the rate of self-reported TBI, of various severities, in a male, adolescent youth offending population. We also aimed to explore whether TBI was associated with number of convictions, violent offending, mental health problems and drug misuse.
Method
Young male offenders aged 11 to 19 years were recruited from a Young Offender Institute, a Youth Offending Team and a special needs school. A total of 197 participants were approached and 186 (94.4%) completed the study. They completed self-reports on TBI, crime history, mental health and drug use.
Results
TBI with a Loss of Consciousness (LOC) was reported by 46% of the sample. LOC consistent with Mild TBI was reported by 29.6% and 16.6% reported LOC consistent with Moderate-Severe TBI. Possible TBI was reported by a further 19.1%. Repeat injury was common – with 32% reporting more than one LOC. Frequency of self-reported TBI was associated with more convictions. Three or more self-reported TBIs were associated with greater violence in offences. Those with self-reported TBI were also at risk of greater mental health problems and of misuse of cannabis.
Conclusions
TBI may be associated with offending behaviour and worse mental health outcomes. Addressing TBI within adolescent offenders with neuro-rehabilitative input may be important for improving well-being and reducing re-offending.
Abstract.
Jones JM, Haslam SA, Jetten J, Williams WH, Morris R, Saroyan S (In Press). That which does not kill you can make you stronger (and more satisfied with life): the contribution of personal and social changes to well-being after brain injury. Psychology & Health
Jetten J, Haslam C, Haslam SA (In Press). The Social Cure: Identity, health and well-being., Psychology Press.
Tonks J, Slater A, Frampton I, Wall SE, yates PY, Williams WH (In Press). The development of emotion and empathy skills after childhood brain injury. Developmental Medicine and Child Neurology, 51, 8-16.
Chitsabesan, Prathiba, Lennox, Charlotte, Williams, Huw, Tariq, Omar, Shaw, Jenny WH (In Press). Traumatic Brain Injury in Juvenile Offenders: Findings from the Comprehensive Health Assessment Tool Study and the Development of a Specialist Linkworker Service.
Williams WH, Mewse AJ, Tonks J, Mills S, CNW B, Cordan G (In Press). Traumatic Brain injury in a Prison Population: Prevalence, and Risk for Re-Offending. Brain Injury
2021
Smith NIJ, Gilmour S, Prescott-Mayling L, Hogarth L, Corrigan JD, Williams WH (2021). A pilot study of brain injury in police officers: a source of mental health problems?.
J Psychiatr Ment Health Nurs,
28(1), 43-55.
Abstract:
A pilot study of brain injury in police officers: a source of mental health problems?
WHAT IS KNOWN ON THE SUBJECT?: Traumatic brain injury (TBI) has been linked to poor outcomes in terms of mental health, specifically, PTSD, depression and alcohol abuse. A lack of research evidence exists relevant to exploring the presence and implications of TBI in the police in the UK and globally, despite the elevated risk of physical and emotional trauma specific to policing. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: the rate of traumatic brain injury is highly prevalent in a small sample of police officers. Traumatic brain injury is a major source of post-concussion symptoms (physical, cognitive and emotional deficits) in police officers, which, in general, are associated with greater mental health difficulties and drinking alcohol to cope. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Traditional mental health treatments should be supplemented with elements of concussion care to address any cognitive, emotional and physical issues due to head injury. Interventions should be made more accessible to those suffering from a mild brain injury. This can be done through regular reminders of appointments, pictograms and by providing a concrete follow-up. ABSTRACT: Introduction Police officers have a high risk of injury through assaults, road traffic incidents and attending domestic calls, with many officers developing post-traumatic stress disorder (PTSD) as a consequence. Traumatic brain injury (TBI) is a common injury in populations involved in conflict and has been extensively linked to mental health difficulties. However, current research has not explored the frequency and sequelae of TBI in police populations, despite the elevated risk of physical and emotional trauma specific to policing. Aim to explore self-reported TBI, PTSD, post-concussion symptoms, depression and drinking to cope in a small sample of UK police, to determine the frequency of these conditions and their relationships. Method Measures of TBI, mental health, and drinking alcohol to cope were administered to 54 police officers from a Midshire Police Constabulary. Results Mild TBI with loss of consciousness was reported by 38.9% of the sample. TBI was associated with increased post-concussion symptoms (PCS). PCS were associated with greater severity of PTSD, depression and drinking to cope. Discussion Exploring TBI in the police could identify a major factor contributing towards ongoing mental health difficulties in a population where, based on previous research, the implications of TBI should not be overlooked, highlighting the need for further research in this area. Implications for Practice This research spans to identify the importance of routine assessment and increasing awareness within mental health services. Mental health treatments should be made amenable to a population with potential memory, planning and impulse control deficits. Further work in mental health services is needed to understand the level of ongoing issues that are due to post-concussion symptoms and those that are due to other mental health difficulties, such as PTSD, thereby educating patients on the association between TBI and emotional difficulties. A graduated return-to-work plan should be developed to enable a safe transition back to work, whilst managing any ongoing symptoms.
Abstract.
Author URL.
Kent H, Williams WH, Hogarth L, Mewse A, Kent H (2021). Poor Parental Supervision is Associated with Traumatic Brain Injury and Reactive Aggression in Young Offenders.
Journal of Head Trauma RehabilitationAbstract:
Poor Parental Supervision is Associated with Traumatic Brain Injury and Reactive Aggression in Young Offenders.
Objective. To establish whether poor parental supervision is associated with head injury and
self-reported reactive aggression (i.e. aggression in response to perceived provocation or
threat) in adolescents in a young offender’s institute, by examining correlations between
these variables. Understanding this population is important as they are at a key pivotal age for
intervention to prevent life-long re-offending.
Method. Ninety-six male participants aged 16-18 were recruited from a UK Young
Offender’s Institute. Self-report measures of remembered parenting, reactive aggression, and
head injury history were administered during individual interviews.
Results. 74% of participants reported having experienced a lifetime TBI, and 46% of
participants reported experiencing at least one TBI leading to a loss of consciousness (LOC).
We found that poor parental supervision, length of LOC following TBI, and self-reported
reactive aggression, were all positively correlated.
Conclusions. Findings show that there are correlational relationships between poor parental
supervision, length of LOC following lifetime TBI, and higher levels of self-reported reactive
aggression. This suggests there may be pathways resulting from poor parental supervision
leading to both TBI with LOC, and reactive aggression. We advocate for future research with
longitudinal designs and larger samples to examine the nature of these interactions, and to
establish whether poor parental supervision is a prospective risk factor for more TBIs leading
to LOC, and reactive aggression. This is key to understanding whether parenting
interventions could help to reduce the disabling effects of TBI in adolescents, and help to
prevent contact with the law.
Abstract.
Law C, Amore TL, Williams WH, Tonks J (2021). Training emotional recognition in a child with acquired brain injury: a single case study.
Appl Neuropsychol Child,
10(4), 384-392.
Abstract:
Training emotional recognition in a child with acquired brain injury: a single case study.
Emotional processing is affected by childhood brain injury. Ineffective emotional processing and poor understanding of social cues affect the development of social relationships leading to social isolation and a poorer quality of life in the long-term. Facial expression recognition is a non-verbal social cue that is used to interpret the thoughts and feelings of others. Children with brain injury have shown deficits identifying even basic emotions from facial expression, yet few intervention studies have explored how to develop facial expression recognition in children with brain injury. Enhancing the ability to recognize and interpret facial expressions for these children would have implications for their emotional processing and social-emotional behavior. In this paper we report on a short single case study intervention to increase facial expression recognition using the Facial Affect Recognition training (FAR) for a 10-year-old-child with brain injury. Following intervention, there was not only an increase in facial expression recognition but also changes in social-emotional behavior indicating some generalization to other contexts. The results suggest that rehabilitation of emotional processing difficulties may indeed be possible, and further intervention studies aimed at developing these skills in children with brain injury are warranted.
Abstract.
Author URL.
Kirby A, Williams WH, Clasby B, Hughes N, Cleaton MAM (2021). Understanding the complexity of neurodevelopmental profiles of females in prison.
International Journal of Prisoner Health,
17(4), 425-438.
Abstract:
Understanding the complexity of neurodevelopmental profiles of females in prison
Purpose: This paper aims to examine the relationship between patterns of functioning in four domains (attention and concentration; social and communication; coordination and organisation; and literacy and numeracy) in women in prison. Also, to consider potential associations between functioning and previous Neurodevelopmental Disorder (NDD) diagnoses, previous mental health diagnoses and history of head injury, self-harm and attempted suicide. Design/methodology/approach: Women in one Scottish prison were invited to participate; 87 consented. Women were screened for functional difficulties and asked about their relevant educational and medical history. Findings: Half of participants reported difficulties in one or more domains. All possible combinations of functional difficulties were found. Only eight women reported previous NDD diagnoses. Functional difficulties were significantly associated with history of self-harm, history of attempted suicide and mental health diagnoses. In total, 32% of women reported at least one head injury, but this was not significantly associated with functional difficulties. Research limitations/implications: the sample was comparatively small and questions were self-report. Analyses were based on within-cohort comparisons due to a lack of appropriate general population data. Practical implications: There is a clear need for timely, practical and comprehensive profiling of females in the Justice System. Current systems do not appear to adequately identify women with functional difficulties or other adversity. Greater use of interdisciplinary working and shared training is indicated, as is a move from categorical diagnostic systems towards dimensional approaches. Originality/value: This study is the first to investigate associations between difficulties associated with NDDs, mental health difficulties and head injury in women in prison.
Abstract.
2020
Tonks J, Whitfield CK, Williams WH, Slater AM, Frampton IJ (2020). "Must try harder." is effort and performance validity testing a necessary part of pediatric neuropsychological assessment?.
Appl Neuropsychol Child,
9(2), 97-105.
Abstract:
"Must try harder." is effort and performance validity testing a necessary part of pediatric neuropsychological assessment?
Neuropsychological assessments results have significant implications for pediatric populations, based upon the assumption that the young person has adopted an effortful approach and has engaged in assessment. There is a commonly-accepted risk to assuming the validity of neuropsychological assessment results with adults, and, therefore, performance validity testing (PVT) has become a major topic of research and investigation and has become an accepted part of routine assessment. The same approach has not been adopted in assessment with children and a paucity of studies has focused on PVT in children. We review studies that demonstrate that children are equal to adults in their ability to use deception and that clinicians cannot detect false-effort without use of validity tests. We explore how frequently such tests are used and how well they work in assessment with children, and the limits, complexities, and constraints of adapting adult tests. We advocate that adequate performance validity testing is essential in order to maximize confidence in the results and we hypothesize that assessment with pediatric populations should take into account a range of influences, such as neuro-developmental factors associated with age of the child and suitability of proposed measures according to the evidence-base.
Abstract.
Author URL.
Hughes N, Sheahan F, Williams WH, Chitsabesan P (2020). Ensuring the rights of children with neurodevelopmental disabilities within child justice systems.
Lancet Child Adolesc Health,
4(2), 163-166.
Abstract:
Ensuring the rights of children with neurodevelopmental disabilities within child justice systems.
A recent UN general comment on criminal justice systems includes guidance to state parties regarding the implementation of the Convention on the Rights of the Child for children with developmental delays or neurodevelopmental disorders or disabilities. This guidance asserts that these children "should not be in the child justice system at all", but when present "should be individually assessed" to enable appropriate safeguards and accommodations to ensure the protection of their rights without discrimination. In this Viewpoint, we examine the significant barriers faced by children who are affected by neurodevelopmental disabilities to the realisation of their rights under international law and standards. These barriers include systemic and cultural barriers created by a lack of awareness among justice professionals about how to identify and work with children who have neurodevelopmental disabilities, as well as procedural barriers, which arise from the complexity and rigidity of many criminal justice processes. The effect of these barriers is that the child is denied their rights on an equal basis with other children without such disabilities.
Abstract.
Author URL.
Cook MJ, Gardner AJ, Wojtowicz M, Williams WH, Iverson GL, Stanwell P (2020). Task-related functional magnetic resonance imaging activations in patients with acute and subacute mild traumatic brain injury: a coordinate-based meta-analysis.
Neuroimage Clin,
25Abstract:
Task-related functional magnetic resonance imaging activations in patients with acute and subacute mild traumatic brain injury: a coordinate-based meta-analysis.
Task-based functional magnetic resonance imaging (fMRI) has been used to examine neuroanatomical and functional changes following mild traumatic brain injury (mTBI). Prior studies have lacked consistency in identifying common regions of altered neural activity during cognitive tasks. This may be partly due to differences in task paradigm, patient heterogeneity, and methods of fMRI analysis. We conducted a meta-analysis using an activation likelihood estimation (ALE) method to identify regions of differential brain activation in patients with mTBI compared to healthy controls. We included experiments that performed scans from acute to subacute time points post-injury. The seven included studies recruited a total sample of 174 patients with mTBIs and 139 control participants. The results of our coordinate based meta-analysis revealed a single cluster of reduced activation within the right middle frontal gyrus (MFG) that differentiated mTBI from healthy controls. We conclude that the cognitive impairments in memory and attention typically reported in mTBI patients may be associated with a deficit in the right MFG, which impacts the recruitment of neural networks important for attentional control.
Abstract.
Author URL.
Clasby B, Bennett M, Hughes N, Hodges E, Meadham H, Hinder D, Williams H, Mewse A (2020). The consequences of traumatic brain injury from the classroom to the courtroom: understanding pathways through structural equation modelling.
Disabil Rehabil,
42(17), 2412-2421.
Abstract:
The consequences of traumatic brain injury from the classroom to the courtroom: understanding pathways through structural equation modelling.
Purpose: Paediatric traumatic brain injury (TBI) can have resultant ongoing significant impairments which can impact life outcomes. The primary aim of this research was to explore whether TBI contributes to the relationship between poor educational outcomes and offending trajectories.Materials and methods: Through analysis of a dataset consisting of self-reported health, educational, and offending histories of 70 incarcerated young males, structural equation modelling was used to explore the mediation of educational outcomes and patterns in offending behaviour by chronic symptoms following TBI.Results: Symptoms related to TBI significantly mediated the relationship between decreased educational attainment and more frequent convictions. It did not mediate any relationships involving age at first conviction.Conclusions: Traumatic brain injury appears to have more influence over frequency of offending patterns than age at first conviction. However, TBI remains a pervasive factor in both higher rates of offending and poorer educational attainment. In order to tackle this effect on adverse social outcomes, greater attention to the impact of TBI is required in education and criminal justice systems.IMPLICATIONS FOR REHABILITATIONHighlights traumatic brain injury as a contributory factor in some education to offending pathways, suggesting that greater focus on rehabilitation within the education and criminal justice systems is required.Reinforces that greater understanding of educational pathways post-injury is needed to better facilitate rehabilitation within the school system.
Abstract.
Author URL.
Kinner SA, Hughes N, Borschmann R, Southalan L, Clasby B, Janca E, Willoughby M, Williams H (2020). The health of children deprived of liberty: a human rights issue.
Lancet Child Adolesc Health,
4(1), 6-7.
Author URL.
Nkoana W, Williams H, Steenkamp N, Clasby B, Knowler H, Schrieff L (2020). Understanding the educational needs of young offenders: a prevalence study of traumatic brain injury and learning disabilities.
International Journal of Educational Development,
78Abstract:
Understanding the educational needs of young offenders: a prevalence study of traumatic brain injury and learning disabilities
Offenders in custody are often disadvantaged in terms of education. Research shows that providing and improving education in custody can help reduce the possibility of recidivism and high crime rates in young offenders. Among various factors that can impact on youth's ability to engage effectively with education in custody, prevalence rates of neurodisabilities such as learning disabilities and traumatic brain injuries (TBI) remain high. Young offenders with neurodisabilities may present with various developmental, cognitive, intellectual, social functioning, language and communication deficits, that may impact on learner-teacher relationships and learning acquisition. For the purpose of this paper, we focused on learning disabilities and TBI given high prevalence rates for these neurodisabilities reported in the literature. We also report on general intellectual functioning given the association with specific learning disabilities. Despite contextual vulnerabilities, there is a dearth of literature on neurodisabilities and its associated impact on education for young offenders in South Africa. Our study sample included young offenders (n = 25) and controls (n = 56), aged 14–21 years. Measures of alcohol (AUDIT), substance use (MAP), learning disabilities and TBIs (CHAT), general intellectual functioning (WASI-II), and depression (BDI-II) were included for offenders and controls. Results show significant differences in TBI, alcohol use, substance use, and reported possible learning disabilities, with higher scores and rates for these factors, indicating poorer outcomes, in the young offender as compared to the control group. The young offender group also had significantly lower and therefore poorer verbal IQ (VIQ) scores than the control group. The results for VIQ were upheld even when the significant difference in age (young offenders were on average 5 years older) was controlled for. Results of this nature can potentially be used to inform rehabilitative efforts in our local youth centres for offenders in the hope of screening for various developmental and acquired neuro-disabilities so that rehabilitation strategies may be even more targeted for those with special education needs in of an already vulnerable population. Such results may also inform the schooling structures within such centres by providing profiles needs of offenders in custody based on screenings of neurodisabilities.
Abstract.
2019
Williams WH (2019). Neuropsychological Assessment of mTBI in Adults. In (Ed)
Traumatic Brain Injury a Clinician’s Guide to Diagnosis, Management, and Rehabilitation, Springer.
Abstract:
Neuropsychological Assessment of mTBI in Adults
Abstract.
2018
Gerdes S (2018). Post Traumatic Stress Disorder and Psychological Therapies.
Abstract:
Post Traumatic Stress Disorder and Psychological Therapies
Literature Review:
The current review presents a recent review of the effectiveness of psychological therapies to treat sleep difficulties (such as insomnia and nightmares) in sufferers of posttraumatic stress disorder (PTSD). The review also aimed to investigate whether there are differences in the effectiveness of specific psychological therapies to treat sleep disturbances in PTSD, such as between the different types of psychological therapies such as cognitive behavioural therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT). Eleven studies were included in the review that met the inclusion and exclusion criteria. Results are presented in tables and a descriptive account is included. The review demonstrates that psychological therapies are effective for the treatment of insomnia and other sleep difficulties such as nightmares. However, firm conclusions cannot be drawn about the effectiveness of different types of psychological therapies as studies predominantly used CBT and only one non-CBT study was included in the review. Comparisons between the effectiveness of different CBT approaches is also not possible as there was a large range of diversity in the study characteristics and also there were only a small number of studies for each intervention, which therefore limits the generalisability of results in the current review. It may be that different CBT interventions such as CBT-I or EERT and IRT may be better suited to treat insomnia and nightmares respectively, but further research needs to be conducted into which of these approaches are beneficial for different PTSD specific sleep difficulties.
Empirical Paper:
Initial studies demonstrate that self-compassion reduces symptoms of PTSD in Armed Forces Veterans (AFV), however the use of self-compassion approaches in AFV is under-researched. The current study utilised self-report and psychophysiological measures to investigate whether a single self-compassion experimental induction reduced hyperarousal symptoms (PTSD Cluster E symptoms) and increased feelings of social connectedness in AFV. The study hypothesised that there would be a decrease in hyperarousal symptoms and an increase in social connectedness, which would be associated with PTSD severity. Fifty-three AFV who had been deployed to a combat zone took part in the study, of which n = 15 (28.3%) currently met criteria for PTSD and n = 4 (7.5%) met criteria for Subsyndromal PTSD. on the PCL-5. Participants listened to a recording of a Loving Kindness Meditation for self-compassion (LKM-S) and psychophysiological recordings were taken throughout. Participants completed state measures of hyperarousal and social connectedness before and after the LKM-S. Findings partially demonstrated that self-compassion can be elicited in an AFV population. However, changes on the self-report measures were largely not supported by psychophysiological measures, apart from skin conductance levels (SCL). The longevity of the effects observed in the study were not measured and should be investigated in future studies. Although this study has demonstrated that self-compassion can be elicited within the AFV population, further research is needed including to test a longer self-compassion intervention.
Abstract.
Williams WH, Chitsabesan P, Fazel S, McMillan T, Hughes N, Parsonage M, Tonks J (2018). Traumatic brain injury: a potential cause of violent crime?.
The Lancet Psychiatry,
5(10), 836-844.
Abstract:
Traumatic brain injury: a potential cause of violent crime?
Traumatic brain injury (TBI) is the biggest cause of death and disability in children and young people. TBI compromises important neurological functions for self-regulation and social behaviour and increases risk of behavioural disorder and psychiatric morbidity. Crime in young people is a major social issue. So-called early starters often continue for a lifetime. A substantial majority of young offenders are reconvicted soon after release. Multiple factors play a role in crime. We show how TBI is a risk factor for earlier, more violent, offending. TBI is linked to poor engagement in treatment, in-custody infractions, and reconviction. Schemes to assess and manage TBI are under development. These might improve engagement of offenders in forensic psychotherapeutic rehabilitation and reduce crime.
Abstract.
2017
Tonks J, Williams WH, Slater A, Frampton I (2017). Is damage to the pre-frontal cortex dormant until adolescence, or difficult to detect? Looking for keys that unlock executive functions in children in the wrong place.
Medical Hypotheses,
108, 24-30.
Abstract:
Is damage to the pre-frontal cortex dormant until adolescence, or difficult to detect? Looking for keys that unlock executive functions in children in the wrong place
A range of functions can be negatively affected by pre-frontal cortex (PFC) injury, but observed behavioural and social changes are commonly linked to post-injury changes in executive function. Executive functioning is a complex neuropsychological construct which is further complicated by neuro-developmental processes when applied to children. There is a substantial and continuing evidence base that supports the view that early childhood pre-frontal cortex (PFC) injury results in hidden, dormant, or sleeping effects. In contrast, recent and rapidly accruing contemporary studies provide preliminary evidence that challenge the view that PFC associated impairments are completely ‘hidden’. Studies that examine the various functions of the PFC and differentiate these to provide preliminary evidence to indicate earlier EF development than that which develops upon reaching adolescence, are reviewed here, together with research that identifies early predictors of later EF impairments. It remains that studies of PFC function and/or structural brain-changes are substantially complicated by issues related to definition regarding functions of the PFC, measurement of EF and other PFC-related functions that may be better understood as meta-processes. These issues are discussed in the concluding sections of this paper.
Abstract.
McMillan TM, Williams H (2017). Neurobehavioural disability and the criminal justice system. In (Ed) Neurobehavioural Disability and Social Handicap Following Traumatic Brain Injury, Second Edition, 57-68.
Maas AIR, Menon DK, Adelson PD, Andelic N, Bell MJ, Belli A, Bragge P, Brazinova A, Buerki A, Chesnut RM, et al (2017). Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research.
LANCET NEUROLOGY,
16(12), 987-1048.
Author URL.
2016
Hughes N, Clasby B, Chitsabesan P, Williams H (2016). A systematic review of the prevalence of foetal alcohol syndrome disorders among young people in the criminal justice system.
Cogent Psychology,
3(1).
Abstract:
A systematic review of the prevalence of foetal alcohol syndrome disorders among young people in the criminal justice system
Given the established association between foetal alcohol spectrum disorders (FASD) and risk of criminality and criminalisation, this systematic review examines the prevalence of FASD within youth justice systems. Four relevant sources were identified. Each source suggests a disproportionate prevalence in comparison to the general youth population. However, this masks significant variation between studies, and a much-heightened prevalence of FASD among Aboriginal youth in custody. The continued lack of research establishing prevalence, limits the potential for strong conclusions and suggests an imperative for improved processes of identification. This highlights systematic deficits in the ability to assess or even screen for FASD, with particular challenges for the youth justice system. Until such challenges can be resolved, it is likely that young people with FASD will remain hidden within a system in which they are at great risk of inadequate support, discrimination and criminalisation.
Abstract.
2015
Hughes N, Williams WH, Chitsabesan P, Walesby RC, Mounce LTA, Clasby B (2015). The prevalence of traumatic brain injury among young offenders in custody: a systematic review.
J Head Trauma Rehabil,
30(2), 94-105.
Abstract:
The prevalence of traumatic brain injury among young offenders in custody: a systematic review.
OBJECTIVES: to examine the prevalence of traumatic brain injury (TBI) among young people in custody and to compare this with estimates within the general youth population. DESIGN: Systematic review of research from various national contexts. Included studies were assessed for the relevance of the definition of TBI and the research population, and the quality of the study design. RESULTS: Ten studies were identified for inclusion in the review. Four of these studies included control groups. No studies examining comorbidity of TBI and other neurodevelopmental disorders among incarcerated young people were identified. CONCLUSION: Reported prevalence rates of brain injury among incarcerated youth range from 16.5% to 72.1%, with a rate of 100% reported among a sample of young people sentenced to death. This suggests considerable levels of need among incarcerated young people. Where control groups or directly comparable studies within the general population exist, there is strong and consistent evidence of a prevalence of TBI among incarcerated youth that is substantially greater than that in the general population. This disparity is seemingly more pronounced as the severity of the injury increases.
Abstract.
Author URL.
Williams WH, McAuliffe KA, Cohen MH, Parsonage M, Ramsbotham J, General the Lord David (2015). Traumatic brain injury and juvenile offending: complex causal links offer multiple targets to reduce crime.
J Head Trauma Rehabil,
30(2), 69-74.
Author URL.
Chitsabesan P, Lennox C, Williams H, Tariq O, Shaw J (2015). Traumatic brain injury in juvenile offenders: findings from the comprehensive health assessment tool study and the development of a specialist linkworker service.
J Head Trauma Rehabil,
30(2), 106-115.
Abstract:
Traumatic brain injury in juvenile offenders: findings from the comprehensive health assessment tool study and the development of a specialist linkworker service.
BACKGROUND: Young people in contact with the youth juvenile justice system have well-documented vulnerabilities including high rates of mental health and neurodevelopmental disorders. Studies have suggested that they may also be at increased risk of traumatic brain injury (TBI). OBJECTIVE: (1) to describe the profile of a cohort of juvenile offenders with TBI and associated comorbidity with other neurodevelopmental disorders, mental health needs, and offending behavior. (2) to describe the development of a specialist brain injury service for juvenile offenders with TBI within custody. METHODS: Ninety-three male participants aged 15 to 18 years were consecutively admitted to a custodial secure facility. They were evaluated using a range of different neurocognitive and mental health measures including the Rivermead Post-Concussion Symptoms Questionnaire and the Comprehensive Health Assessment Tool. RESULTS: Eight-two percent of those interviewed reported experiencing at least 1 TBI, and 44% reported ongoing neuropsychological symptoms. Eighteen percent of those sustaining a TBI reported moderate-severe postconcussion symptoms. CONCLUSIONS: There is a high prevalence of TBI in juvenile offenders in custody, with many experiencing multiple episodes. This study highlights the need for further research in this area. An example of a specialist brain injury linkworker service is described as one example of a model of service delivery for this group.
Abstract.
Author URL.
2014
Gardner AJ, Iverson GL, Williams WH, Baker S, Stanwell P (2014). A Systematic Review and Meta-Analysis of Concussion in Rugby Union. Sports Medicine
Gardner AJ, Iverson GL, Williams WH, Baker S, Stanwell P (2014). A systematic review and meta-analysis of concussion in Rugby Union.
Sports Medicine,
44(12), 1717-1731.
Abstract:
A systematic review and meta-analysis of concussion in Rugby Union
Objective: the aim of the current review was to systematically evaluate the available evidence on concussion in Rugby Union and to conduct a meta-analysis of findings regarding the incidence of concussion.
Abstract.
Tonks J, Yates PJ, Williams HW, Frampton I, Slater A (2014). Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift.
Child and Adolescent Mental Health,
19(2), 151-158.
Abstract:
Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift
Background and Scope: in this article, we provide a brief overview of the principles that guide paediatric neuropsychological assessment, the methods used and some examples of the measures available. Findings: We explore intellectual, adaptive and social functioning from a neuropsychological perspective and describe suitable measures for use in paediatric neuropsychological assessment in each domain. Conclusions: We provide an example of assessment and interpretation using a fictional character (Tom Swift) to demonstrate that neuropsychological assessment is important in understanding the everyday questions that arise in children's services around risk, needs, level of understanding and capacity to engage with services. © 2013 Association for Child and Adolescent Mental Health.
Abstract.
Reuben A, Sampson P, Harris AR, Williams H, Yates P (2014). Postconcussion syndrome (PCS) in the emergency department: Predicting and pre-empting persistent symptoms following a mild traumatic brain injury.
Emergency Medicine Journal,
31(1), 72-77.
Abstract:
Postconcussion syndrome (PCS) in the emergency department: Predicting and pre-empting persistent symptoms following a mild traumatic brain injury
Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.
Abstract.
Reuben A, Sampson P, Harris AR, Williams H, Yates P (2014). Postconcussion syndrome (PCS) in the emergency department: predicting and pre-empting persistent symptoms following a mild traumatic brain injury.
Emerg Med J,
31(1), 72-77.
Abstract:
Postconcussion syndrome (PCS) in the emergency department: predicting and pre-empting persistent symptoms following a mild traumatic brain injury.
Head injuries across all age groups represent an extremely common emergency department (ED) presentation. The main focus of initial assessment and management rightly concentrates on the need to exclude significant pathology, that may or may not require neurosurgical intervention. Relatively little focus, however, is given to the potential for development of post-concussion syndrome (PCS), a constellation of symptoms of varying severity, which may bear little correlation to the nature or magnitude of the precipitating insult. This review aims to clarify the aetiology and terminology surrounding PCS and to examine the mechanisms for diagnosing and treating.
Abstract.
Author URL.
2013
Tonks J, Yates PJ, Williams HW, Frampton I, Slater A (2013). Measurement Issues: Neuropsychological assessment with children and adolescents; unlocking the mysticism, methods and measures with the help of Tom Swift. Child and Adolescent Mental Health
Mounce LTA, Jones JM, Jetten J, Haslam SA, Williams WH (2013). Neurogenic and Psychogenic Acute Postconcussion Symptoms can be Identified After Mild Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 28, 397-405.
Mounce LTA, Williams WH, Jones JM, Harris A, Haslam SA, Jetten J (2013). Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury.
J Head Trauma Rehabil,
28(5), 397-405.
Abstract:
Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury.
OBJECTIVES: As provenance of postconcussion symptoms after mild traumatic brain injury (mTBI) is controversial, with similar rates found in other populations, we aimed to identify postconcussion symptoms specific to mTBI compared with controls. We also compared differences between complicated and uncomplicated mTBIs. SETTING: Hospital emergency department. PARTICIPANTS: Adult individuals (34 individuals with complicated mTBI, 76 individuals with uncomplicated mTBI, and 47 orthopedic controls) who sought care in the emergency department and were consecutively recruited by post at 2 weeks postinjury. MAIN MEASURES: Rivermead Postconcussion Symptom Questionnaire. Preinjury factors were used as covariates. RESULTS: Compared with orthopedic controls, complicated mTBI group reported greater severity of headaches, dizziness, and nausea, as well as concentration difficulties, suggesting that these are neurogenic. Severity of other symptoms measured on the Rivermead Postconcussion Symptom Questionnaire was not significantly different between these groups, suggesting that these are psychogenic. Differences were evident between the 2 mTBI samples on the items of dizziness, nausea, fatigue, sleep disturbance, and concentration difficulties. CONCLUSIONS: Neurogenic and psychogenic postconcussion symptoms were identified at the acute-phase postinjury. Findings suggest that treating persons with mTBI as a homogenous sample is not prudent. This should inform prognostic models and follow-up support offered after leaving the emergency department.
Abstract.
Author URL.
2012
Gardner A, Kay-Lambkin F, Stanwell P, Donnelly J, Williams WH, Hiles A, Schofield P, Levi C, Jones DK (2012). A systematic review of diffusion tensor imaging findings in sports-related concussion.
J Neurotrauma,
29(16), 2521-2538.
Abstract:
A systematic review of diffusion tensor imaging findings in sports-related concussion.
Sports-related concussion (SRC) is typically associated with functional, as opposed to structural, injury. The results of traditional structural neuroimaging techniques used to assess SRC tend to be normal in many athletes, and are only clinically helpful in ruling out a more serious injury. Diffusion tensor imaging (DTI) has increasingly been touted as a method offering greater clinical potential in mild traumatic brain injury (mTBI). Despite this, the utility of DTI as a clinical tool for diagnosing and managing SRC has received considerably less attention than it has in the general TBI research literature. The aim of this article is to conduct a systematic review of DTI in SRC, and to provide a focus and overview of research findings using this MRI technique in SRC. A systematic review of articles published in the English language, up to February 2012, was retrieved via PsycINFO(®), MEDLINE(®), EMBASE, SPORTDiscus(™), Scopus, Web of Science, and Informit; using the key search terms: diffusion tensor imaging, diffusion magnetic resonance imaging, diffusion weighted MRI, diffusion MRI, fractional anisotropy, tractography, apparent diffusion coefficient, magnetic resonance imaging, mild traumatic brain injury, mTBI, traumatic brain injury, concussion, sport, athletic and athlete. Observational, cohort, correlation, cross-sectional and longitudinal studies were all included in the current review. Results of the review found eight articles that met inclusion criteria, which included data on 214 athletes and 96 controls. Seven of eight studies reported some type of DTI abnormality, although the neuroanatomical sites involved varied. Although considerable methodological variations exist across studies, the current review suggests that DTI may possess adequate diagnostic sensitivity to detect SRC in affected athletes. Further longitudinal studies are required to demonstrate its discriminate validity and prognostic capacity within this field.
Abstract.
Author URL.
Jones JM, Jetten J, Haslam SA, Williams WH (2012). Deciding to disclose: the importance of maintaining social relationships for well-being after acquired brain injury. , 255-271.
Williams W (2012). Neurocognitive Assessment of mTBI. In (Ed) Traumatic Brain Injury. A Clinician's Guide to Diagnosis, Management, and Rehabilitation.
Davies RC, Williams WH, Hinder D, Burgess CNW, Mounce LTA (2012). Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth.
J Head Trauma Rehabil,
27(3), E21-E27.
Abstract:
Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth.
OBJECTIVES: to determine the prevalence rate of traumatic brain injury (TBI) in incarcerated youth and whether frequency and severity of TBI are associated with postconcussion symptoms (PCS), violent offending behaviors, age of first conviction, and substance abuse. PARTICIPANTS: Sixty-one incarcerated male juvenile offenders with an average age of 16 years. MAIN MEASURES: Self-rated measures of head injury, TBI, PCS (Rivermead Post-concussion Symptoms Questionnaire), history of alcohol and drug use, and criminal history. RESULTS: More than 70% reported at least 1 head injury at some point in their lives, and 41% reported experiencing a head injury with loss of consciousness. Postconcussion symptoms reliably increased with the frequency and severity of TBI. The relation between frequency and symptoms was mostly accounted for by severity of TBI. Alcohol use reliably increased with the severity of TBI and was associated with PCS. Alcohol use did not account for the dose-response relation between TBI and PCS. CONCLUSIONS: Findings indicate a need to account for TBI in offender populations in managing care needs, which may contribute to reduction in offending behaviors.
Abstract.
Author URL.
Ryland H, Williams WH, Zeman A, Murray J, Turner M (2012). The impact of neurological indicators of severity of concussion on neurocognitive performance in a sports population.
BRAIN INJURY,
26(4-5), 627-628.
Author URL.
Jones JM, Williams WH, Jetten J, Haslam SA, Harris A, Gleibs IH (2012). The role of psychological symptoms and social group memberships in the development of post-traumatic stress after traumatic injury.
Br J Health Psychol,
17(4), 798-811.
Abstract:
The role of psychological symptoms and social group memberships in the development of post-traumatic stress after traumatic injury.
OBJECTIVES: the costs associated with traumatic injury are often exacerbated by the development of post-traumatic stress symptoms. However, it is unclear what decreases the development of post-traumatic symptoms over time. The aim of the present research was to examine the role of psychological symptoms and social group memberships in reducing the development of post-traumatic stress symptoms after orthopaedic injuries (OIs) and acquired brain injuries (ABIs). DESIGN AND METHODS: a longitudinal prospective study assessed self-reported general health symptoms, social group memberships, and post-traumatic stress symptoms among participants with mild or moderate ABI (n= 62) or upper limb OI (n= 31) at 2 weeks (T1) and 3 months (T2) after injury. RESULTS: Hierarchical regressions revealed that having fewer T1 general health symptoms predicted lower levels of T2 post-traumatic stress symptoms after OI but forming more new group memberships at T1 predicted lower levels of T2 post-traumatic stress symptoms after ABI. CONCLUSION: a focus on acquiring group memberships may be particularly important in reducing the development of post-traumatic stress symptoms after injuries, such as ABI, which result in long-term life changes.
Abstract.
Author URL.
2011
Tonks J, Williams WH, Mounce L, Harris D, Frampton I, Yates P, Slater A (2011). 'Trails B or not Trails B?' is attention-switching a useful outcome measure?.
Brain Inj,
25(10), 958-964.
Abstract:
'Trails B or not Trails B?' is attention-switching a useful outcome measure?
PRIMARY OBJECTIVE: Difficulties with attention contribute to behavioural and cognitive problems during childhood and may reflect subtle deficits in executive functioning (EF). Attention problems in early childhood have also been found to predict higher levels of anxiety and depression symptoms at 10 years old. It has also been reported that attention problems during childhood may be differentially related to later-emerging distinct EF difficulties. Many of these findings, however, rely on teacher-ratings of attention difficulties. METHODS AND PROCEDURES: This study administered neuropsychological tests of attention-switching and EF to 67 healthy children aged 9-15 years of age. It additionally measured socio-emotional behavioural functioning. MAIN OUTCOMES AND RESULTS: a critical phase of improvement was found at 10 years of age. Correlations were found between attention-switching skills and EF. Attention-switching skills were also correlated with socio-emotional functioning. CONCLUSIONS: Attention-switching skills have some interdependence with EF, but in paediatric assessment such skills are easier to routinely assess than many of the currently available tests of EF. It is suggested that attention-switching ability may prove to be a useful predictor of EF performance in understanding long-term outcome after a neurological event such as traumatic brain injury.
Abstract.
Author URL.
Tonks J, Williams WH, Yates P, Slater A (2011). Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood: comparisons between groups of children aged under and over 10 years of age.
Clin Child Psychol Psychiatry,
16(2), 185-194.
Abstract:
Cognitive correlates of psychosocial outcome following traumatic brain injury in early childhood: comparisons between groups of children aged under and over 10 years of age.
Children with traumatic brain injuries (TBI) commonly present with socioemotional difficulties, as well as accompanying multiple cognitive impairments. Often difficulties worsen at around 10 years old. This change is associated with frontal system changes, and tests of executive function (EF) predict outcome. However, children with TBI sometimes present with socioemotional difficulties despite apparent cognitive recovery. Our aims were to explore potential cognitive and socioemotional effects following childhood TBI, before and after the age of 10 years. We also wanted to identify cognitive correlates of psychosocial dysfunction. Measures of cognitive function and socioemotional disturbance administered to 14 children with TBI aged 8-10 years, and 14 children with TBI aged 10-16 years, were compared to control data from 22 non-injured 8- to 10 year-olds and 67 non-injured 10- to 16-year-olds. Results indicated that only the older group of children with TBI were impaired in tests of EF, but significant socioemotional difficulties were commonly evident in both groups. Processing speed (as well as EF) was found to correlate with socioemotional disturbance. We conclude that poor processing speed may also index the risk of socioemotional difficulties, but our general findings indicate that cognitive functions relevant to socioemotional functioning are not readily testable in younger children and are not strongly associated with such outcomes as they may be in adults.
Abstract.
Author URL.
Easton A, Pewter S, Williams WH (2011). Neuroscience Nursing: Management of pateients with central system infecstions. In Woodward S (Ed)
Neuroscience Nursing, Wiley-Blackwell, 396-426.
Abstract:
Neuroscience Nursing: Management of pateients with central system infecstions
Abstract.
Tonks J, Yates P, Frampton I, Williams WH, Harris D, Slater A (2011). Resilience and the mediating effects of executive dysfunction after childhood brain injury: a comparison between children aged 9-15 years with brain injury and non-injured controls.
Brain Inj,
25(9), 870-881.
Abstract:
Resilience and the mediating effects of executive dysfunction after childhood brain injury: a comparison between children aged 9-15 years with brain injury and non-injured controls.
PRIMARY OBJECTIVE: Acquired brain injury (ABI) during childhood can be associated with enduring difficulties related to impairments to executive functioning (EF). EF impairments may detrimentally affect outcome by restricting an individual's ability to access 'resiliency' resources after ABI. RESEARCH DESIGN: the purpose of this study was to explore whether there is deterioration in children's resilience compared with peers after ABI and whether EF is influential in mediating relationships between resilience and behaviour. METHODS AND PROCEDURES: Measures of resilience, depression and anxiety were administered with 21 children with ABI and 70 matched healthy children aged 9-15 years. Parents completed measures of behaviour and EF. MAIN OUTCOMES AND RESULTS: Children with ABI were identified as less resilient and more depressed and anxious than controls. Resiliency measures were correlated with depression and anxiety in both groups. Relationships between resiliency and socio-emotional behaviour were mediated by EF. CONCLUSIONS: Assessment of resilience after ABI may be useful in supporting or defining the delivery of more individualized rehabilitation programmes according to the resources and vulnerabilities a young person has. However, an accurate understanding of the role of EF in the relationship between resilience and behavioural outcome after ABI is essential.
Abstract.
Author URL.
Wall SE, Williams WH, Morris R, Bramham J (2011). The Development of a New Measure of Social-Emotional Functioning for Young Adolescents. Clinical Child Psychology and Psychiatry, 16(3), 301-315.
2010
Williams WH (2010). Advances in measuring outcome for Children and Adolescents with Brain Injury. Brain Impairment
Redpath S, Williams WH, Hanna D, Linden MA, Yates PJ, Harris A (2010). Healthcare professionals’ attitudes towards traumatic brain injury (TBI): the influence of profession, experience, aetiology and blame on prejudice towards survivors of brain injury.
Brain Injury,
24, 802-811.
Abstract:
Healthcare professionals’ attitudes towards traumatic brain injury (TBI): the influence of profession, experience, aetiology and blame on prejudice towards survivors of brain injury
Primary objective: to investigate the attitudes of healthcare professionals towards individuals with traumatic brain injury
(TBI) and their relationship to intended healthcare behaviour.
Research design: an independent groups design utilized four independent variables; aetiology, group, blame and gender to
explore attitudes towards survivors of brain injury. The dependent variables were measured using the Prejudicial Evaluation
and Social Interaction Scale (PESIS) and Helping Behaviour Scale (HBS).
Methods and procedures: a hypothetical vignette based methodology was used. Four hundred and sixty participants (131
trainee nurses, 94 qualified nurses, 174 trainee doctors, 61 qualified doctors) were randomly allocated to one of six possible
conditions.
Main outcomes and results: Regardless of aetiology, if an individual is to blame for their injury, qualified healthcare
professionals have more prejudicial attitudes than those entering the profession. There is a significant negative relationship
between prejudice and helping behaviour for qualified healthcare professionals.
Conclusions: Increased prejudicial attitudes of qualified staff are related to a decrease in intended helping behaviour, which
has the potential to impact negatively on an individual’s recovery post-injury.
Abstract.
Williams WH, Potter S, Ryland H (2010). Mild traumatic brain injury and Postconcussion Syndrome: a neuropsychological perspective.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY,
81(10), 1116-1122.
Author URL.
Tonks J, Williams WH, Yates P, Frampton I, Slater AM (2010). Peer-relationship difficulties in children with brain injuries: comparisons with children in mental health services and healthy controls. Neuropsychological Rehabilitation
Williams WH, Giray G, Mewse AJ, Tonks J, Burgess CNW (2010). Traumatic Brain Injury in Young Offenders: a modifiable risk factor for re-offending, poor mental health and violence.
Neuropsychological Rehabilitation an International Journal,
20(6), 801-812.
Abstract:
Traumatic Brain Injury in Young Offenders: a modifiable risk factor for re-offending, poor mental health and violence.
Background
Adolescence is a risk period for offending. Traumatic Brain Injury (TBI) a potential risk factor for poor mental health and for offending. TBI has been largely neglected from guidance on managing health needs of offenders.
Aims
We sought to determine the rate of self-reported TBI, of various severities, in a male, adolescent youth offending population. We also aimed to explore whether TBI was associated with number of convictions, violent offending, mental health problems and drug misuse.
Method
Young male offenders aged 11 to 19 years were recruited. A total of 197 participants were approached and 186 (94.4%) completed the study. They completed self-reports on TBI, mental health and drug use.
Results
Prevalence rate of TBI of all severities was 65%. Repeat injury was common – with 32% having had more than one episode of LOC. Frequency of TBI was associated with more convictions. Three or more TBIs were associated with greater violence in offences. Those with TBI were also at risk of greater mental health problems and of misuse of cannabis.
Conclusions
TBI may be associated with offending behaviour and worse mental health outcomes. Addressing TBI within adolescent offenders may be important for improving well-being and reducing re-offending.
Abstract.
Williams WH, Mewse AJ, Tonks J, Mills S, Burgess CNW, Cordan G (2010). Traumatic Brain injury in a Prison Population: Prevalence, and Risk for Re- Offending.
Brain Injury,
24(10), 1184-1188.
Abstract:
Traumatic Brain injury in a Prison Population: Prevalence, and Risk for Re- Offending.
Background: TBI can lead to cognitive, behavioural and emotional difficulties. Previous studies suggest that TBI is relatively elevated in offender populations. We aimed to establish the rate of TBI of various severities in a representative sample of adult offenders and patterns of custody associated with TBI.
Methods:. We conducted a self-report survey of adult, male, offenders within a prison. of 453 offenders, 196 (43%) responded.
Results: We found over 60% reported “Head Injuries”. Reports consistent with TBI of various severities were given by 64%. of the overall sample, 16%. had experienced moderate to severe TBI, and 48% Mild TBI. Adults with TBI were younger at entry into custodial systems and reported higher rates of repeat offending. They also reported greater time, in past 5 years, spent in prison.
Conclusions: These findings indicate that there is a need to account for TBI in the assessment and management of offenders.
Abstract.
2009
Evans JJ, Williams WH (2009). Caroline: Treating post-traumatic stress disorder after traumatic brain injury. In (Ed)
Neuropsychological Rehabilitation: Theory, Models, Therapy, 227-236.
Abstract:
Caroline: Treating post-traumatic stress disorder after traumatic brain injury
Abstract.
Wilson BA, Evans JJ, Williams WH (2009). Memory Problems. , 136-165.
Evans JJ, Williams WH (2009). Neuropsychological Rehabilitation. In Wilson BA, Gracey F, Evans JJ, Bateman A (Eds.)
Neuropsychological Rehabilitation, Cambridge Univ Pr.
Abstract:
Neuropsychological Rehabilitation
Abstract.
Williams, W.H. Frampton, I. Yates, P. (2009). The development of emotion and empathy skills after childhood brain injury.
Developmental Medicine and Child Neurology,
51(1), 8-16.
Abstract:
The development of emotion and empathy skills after childhood brain injury
Lasting socio-emotional behaviour difficulties are common among children who have suffered brain injuries. A proportion of difficulties may be attributed to impaired cognitive and/or executive skills after injury. A recent and rapidly accruing body of literature indicates that deficits in recognizing and responding to the emotions of others are also common. Little is known about the development of these skills after brain injury. In this paper we summarize emotion-processing systems, and review the development of these systems across the span of childhood and adolescence. We describe critical phases in the development of emotion recognition skills and the potential for delayed effects after brain injury in earlier childhood. We argue that it is important to identify the specific nature of deficits in reading and responding to emotions after brain injury, so that assessments and early intervention strategies can be devised.
Abstract.
Tonks J, Slater AM, Frampton I, Wall SE, Yates P, Williams WH (2009). The development of emotion and empathy skills after childhood brain injury. Developmental Medicine and Child Neurology, 51, 8-16.
Tonks J, Yates P, Slater A, Williams WH, Frampton I (2009). Visual-spatial functioning as an early indicator of socioemotional difficulties.
Developmental Neurorehabilitation,
12(5), 313-319.
Abstract:
Visual-spatial functioning as an early indicator of socioemotional difficulties
Primary objective: As children with acquired brain injuries (ABI) mature to become adolescents they develop a range of previously undetected social and emotional difficulties, which are commonly associated with executive dysfunctions. The authors wanted to determine whether visual-spatial performance is subject to age-related improvement, whether such skills can differentiate between children with ABI and healthy children and whether visual-spatial performance is a correlate of socioemotional functioning. Research design: the 'Cube analysis' and 'Dot discrimination' tests from the 'Visual Object Space Perception (VOSP)' battery and the Strengths and Difficulties Questionnaire (SDQ) were administered for 18 children, 915 years, with ABI and compared against 67 'healthy' children. Results: Cube analysis scores improved significantly at ∼10 years old in the control group. The ABI group performed the task significantly poorer than controls. Analysis indicated that visual discrimination skill did not account for performance difficulties. Visual-spatial performance was correlated with greater impact of reported difficulties on the SDQ. Conclusions: Visual-spatial tests are sensitive in differentiating between healthy children and children with ABI. Impairment of visuo-spatial skills may provide an index of psychosocial risk during later teenage years and adulthood. © 2009 Informa UK Ltd all rights reserved.
Abstract.
Tonks J, Yates P, Slater A, Williams WH, Frampton I (2009). Visual-spatial functioning as an early indicator of socioemotional difficulties.
Dev Neurorehabil,
12(5), 313-319.
Abstract:
Visual-spatial functioning as an early indicator of socioemotional difficulties.
PRIMARY OBJECTIVE: As children with acquired brain injuries (ABI) mature to become adolescents they develop a range of previously undetected social and emotional difficulties, which are commonly associated with executive dysfunctions. The authors wanted to determine whether visual-spatial performance is subject to age-related improvement, whether such skills can differentiate between children with ABI and healthy children and whether visual-spatial performance is a correlate of socioemotional functioning. RESEARCH DESIGN: the 'Cube analysis' and 'Dot discrimination' tests from the 'Visual Object Space Perception (VOSP)' battery and the Strengths and Difficulties Questionnaire (SDQ) were administered for 18 children, 9-15 years, with ABI and compared against 67 'healthy' children. RESULTS: Cube analysis scores improved significantly at approximately 10 years old in the control group. The ABI group performed the task significantly poorer than controls. Analysis indicated that visual discrimination skill did not account for performance difficulties. Visual-spatial performance was correlated with greater impact of reported difficulties on the SDQ. CONCLUSIONS: Visual-spatial tests are sensitive in differentiating between healthy children and children with ABI. Impairment of visuo-spatial skills may provide an index of psychosocial risk during later teenage years and adulthood.
Abstract.
Author URL.
2008
Watkins, E.R. Williams, W.H. (2008). Depressive Rumination reduces specificity of Autobiographical Memory Recall in Acquired Brain Injury. Journal of the International Neuropsychological Society, 14(1), 63-70.
Haslam C, Holme A, Haslam SA, Iyer A, Jetten J, Williams WH (2008). Maintaining group memberships: Social identity continuity predicts well-being after stroke.
Neuropsychological Rehabilitation,
18(5-6), 671-691.
Abstract:
Maintaining group memberships: Social identity continuity predicts well-being after stroke
A survey study of patients recovering from stroke (N = 53) examined the extent to which belonging to multiple groups prior to stroke and the maintenance of those group memberships (as measured by the Exeter Identity Transitions Scales, EXITS) predicted well-being after stroke. Results of correlation analysis showed that life satisfaction was associated both with multiple group memberships prior to stroke and with the maintenance of group memberships. Path analysis indicated that belonging to multiple groups was associated with maintained well-being because there was a greater likelihood that some of those memberships would be preserved after stroke-related life transition. Furthermore, it was found that cognitive failures compromised well-being in part because they made it hard for individuals to maintain group memberships post-stroke. These findings highlight the importance of social identity continuity in facilitating well-being following stroke and, more broadly, show the theoretical contribution that a social identity approach to mental health can make in the context of neuropsychological rehabilitation. © 2007 Psychology Press.
Abstract.
Haslam C, Holme A, Haslam SA, Iyer A, Jetten J, Williams WH (2008). Maintaining group memberships: social identity continuity predicts well-being after stroke.
Neuropsychol Rehabil,
18(5-6), 671-691.
Abstract:
Maintaining group memberships: social identity continuity predicts well-being after stroke.
A survey study of patients recovering from stroke (N = 53) examined the extent to which belonging to multiple groups prior to stroke and the maintenance of those group memberships (as measured by the Exeter Identity Transitions Scales, EXITS) predicted well-being after stroke. Results of correlation analysis showed that life satisfaction was associated both with multiple group memberships prior to stroke and with the maintenance of group memberships. Path analysis indicated that belonging to multiple groups was associated with maintained well-being because there was a greater likelihood that some of those memberships would be preserved after stroke-related life transition. Furthermore, it was found that cognitive failures compromised well-being in part because they made it hard for individuals to maintain group memberships post-stroke. These findings highlight the importance of social identity continuity in facilitating well-being following stroke and, more broadly, show the theoretical contribution that a social identity approach to mental health can make in the context of neuropsychological rehabilitation.
Abstract.
Author URL.
Turkstra LS, Williams WH, Tonks J, Frampton I (2008). Measuring social cognition in adolescents: implications for students with TBI returning to school.
NeuroRehabilitation,
23(6), 501-509.
Abstract:
Measuring social cognition in adolescents: implications for students with TBI returning to school.
In everyday adolescent communication, the ability to empathise with the mental state of others, recognise or infer intentions, or make judgements about emotional state, is a non-conscious but vital prerequisite of relating. Execution of these skills in social interactions supports both the exchange of social knowledge and also the development and maintenance of personal relationships. Thus, adolescents with impairments in these skills are at risk for a variety of negative outcomes. In this paper, we present data to illustrate that adolescents with traumatic brain injury (TBI) are likely to have impairments in processes such as emotion recognition and mental state attribution, and that these might not be identified on standardised tests. This is considered from the perspective of clinical assessment and intervention in school contexts.
Abstract.
Author URL.
Williams, W.H. Frampton, I. Yates, P. (2008). Reading emotions after childhood brain injury: Case series evidence of dissociation between cognitive abilities and emotional expression processing skills. Brain Injury
Tonks J, Williams WH, Yates P, Frampton I, Wall SE, Slater AM (2008). Reading emotions after childhood brain injury: Case series evidence of dissociation between cognitive abilities and emotional expression processing skills. Brain Injury, 22, 325-332.
Chasey, R. Williams, W.H. (2008). The Role of schema and appraisals in the development of post-traumatic stress symptoms following birth. Journal of Reproductive and Infant Psychology, 26(2).
Roundhill, S.J. Williams, W.H. & Hughes, J.M. (2008). The experience of loss following traumatic brain injury: Applying a bereavement model to the process of adjustment. Qualitative Research in Psychology, 4
Edworthy Z, Chasey R, Williams H (2008). The role of schema and appraisals in the development of post-traumatic stress symptoms following birth.
JOURNAL OF REPRODUCTIVE AND INFANT PSYCHOLOGY,
26(2), 123-138.
Author URL.
2007
Williams, H. Frampton, I. Yates, P.J. (2007). Assessing emotional recognition in 9 to 15 year olds: preliminary analysis of abilities in reading emotion from faces, voices and eyes. Brain Injury, 21, 623-629.
Hooper L, Williams WH, Sarah EW, Chua K-C (2007). Caregiver distress, coping and parenting styles in cases of childhood encephalitis.
Neuropsychol Rehabil,
17(4-5), 621-637.
Abstract:
Caregiver distress, coping and parenting styles in cases of childhood encephalitis.
This study presents an exploration of the impact of childhood encephalitis on parental mood, coping and disciplinary strategies. Thirty six parents of children aged between 10 and 17 years were recruited. They were split into groups of recent and remote cases (within or beyond 7 years). Group comparison revealed that neurobehavioural consequences of childhood encephalitis appear to persist over time. Higher levels of behavioural symptoms consistent with dysexecutive disorder were associated with greater parental distress. Parents remain distressed despite reporting proactive profiles of coping. There was an indication that severity of dysexecutive disorder was asscociated with less use of proactive parental management strategies. Support for parents, in particular focused on effective management of dysexecutive problems, is recommended.
Abstract.
Author URL.
Williams, W.H. (2007). Encephalitis: Assessment and Rehabilitation across the Lifespan. Special Issue of Neuropsychological Rehabilitation. , Psychology Press.
Williams WH, Haslam C, Kay J, Pewter S (2007). Neuropsychological and psychiatric profiles in acute encephalitis in adults. Neuropsychological Rehabilitation, 17, 478-505.
Williams, H. Frampton, I. Yates, P.J. (2007). Reading emotions after child brain injury: a comparison between children with brain injury and non-injured controls. Brain Injury
Williams (2007). Stress, parental style and coping in children with encephalitis. Neuropsychological Rehabilitation
Williams, W.H. Frampton, I. Yates, P.J. (2007). The neurological bases of emotional dys-regulation arising from brain injury in childhood: a “when and where” heuristic. Brain Impairment, 8, 143-153
2006
Williams WH, Harris A, Round A, Yates PJ (2006). An epidemiological study of head injuries in a UK population attending an emergency department. Journal of Neurology Neurosurgery & Psychiatry, 77(5), 699-701.
Williams WH, Cartwright-Hatton S, Kelly TP, Wall SE (2006). Neuropsychological dysfunction following repeat concussion in jockeys. Journal of Neurology Neurosurgery & Psychiatry, 77(4), 518-520.
Williams, W.H. Yates, P. Harris, A. (2006). Social emotional problem solving and carer stress in traumatic brain injured survivors. Neuropsychological Rehabilitation
Williams, W.H. Yates, P.J. Harris, A. (2006). Spousal relationship satisfaction following acquired brain injury: the role of insight and socio-emotional skill. Neuropsychological Rehabilitation, 17(1), 95-105.
2005
Frampton, I. Yates, P.J. Yates, P.J. (2005). A. Neuropsychological assessment of socio-emotional functioning in children.Presented at International Neuropsychological Rehabilitation Conference, University of Galway, Ireland, July 2005.
2003
Fleminger, S. Oiver, D. (2003). Assessment and Management of Depression in Acquired Brain Injury. Neuropsychological Rehabilitation, Special Issue, 65-89.
Evans, J.J. (2003). Bio-psychosocial Approaches for Mood and Behaviour Disorders in Neuro-rehabilitation. Special Issue of Neuropsychological Rehabilitation. , Psychology Press.
Williams WH, Evans JJ (2003). Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation.
Neuropsychological Rehabilitation,
13(1-2), 1-11.
Abstract:
Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation
Survivors of acquired brain injury (ABI) are at risk of a range of neuropsychiatric and behavioural disorders. Emotional disturbance, with reactive elements of mood disorder, such as depression and anxiety, appear particularly common. Specific anxiety disorders, such as post-traumatic stress disorder (PTSD) have also been identified. Pain syndromes are also common - particularly in those who have suffered Traumatic Brain Injuries (TBI). Survivors of ABI are often at risk of substance misuse and of irritability states. Their relationships may suffer from the stresses triggered by the aftermath of injury. Intimate, in particular, sexual relationships may be particularly affected. These effects are not, necessarily, only consequent of severe injuries, as mild TBI can also have, for some, significant neuropsychiatric effects. Assessment and management of such conditions are compromised by survivors of injury often having a limited insight into the sequelae of their injuries. Interventions for such disorders and forms of distress are increasingly available. This paper introduces the special issue of Neuropsychological Rehabilitation on biopsychosocial approaches in neurorehabilitation. A range of papers provide overviews for assessing and managing such neuropsychiatric, mood and behavioural (health and habit) disorders.
Abstract.
Williams WH, Evans JJ (2003). Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation.
Neuropsychol Rehabil,
13(1-2), 1-11.
Abstract:
Brain injury and emotion: an overview to a special issue on biopsychosocial approaches in neurorehabilitation.
Survivors of acquired brain injury (ABI) are at risk of a range of neuropsychiatric and behavioural disorders. Emotional disturbance, with reactive elements of mood disorder, such as depression and anxiety, appear particularly common. Specific anxiety disorders, such as post-traumatic stress disorder (PTSD) have also been identified. Pain syndromes are also common-particularly in those who have suffered Traumatic Brain Injuries (TBI). Survivors of ABI are often atrisk of substance misuse and of irritability states. Their relationships may suffer from the stresses triggered by the aftermath of injury. Intimate, in particular, sexual relationships may be particularly affected. These effects are not, necessarily, only consequent of severe injuries, as mild TBI can also have, for some, significant neuropsychiatric effects. Assessment and management of such conditions are compromised by survivors of injury often having a limited insight into the sequelae of their injuries. Interventions for such disorders and forms of distress are increasingly available. This paper introduces the special issue of Neuropsychological Rehabilitation on biopsychosocial approaches in neurorehabilitation. A range of papers provide overviews for assessing and managing such neuropsychiatric, mood and behavioural (health and habit) disorders.
Abstract.
Author URL.
wh W (2003). Neuropsychological rehabilitation. In Wilson BA, Zangwill OL (Eds.)
Neuropsychological rehabilitation, Psychology Press.
Abstract:
Neuropsychological rehabilitation
Abstract.
Williams WH, Evans JJ, Fleminger S (2003). Neurorehabilitation and cognitive-behaviour therapy of anxiety disorders after brain injury: an overview and a case illustration of obsessive-compulsive disorder.
Neuropsychol Rehabil,
13(1-2), 133-148.
Abstract:
Neurorehabilitation and cognitive-behaviour therapy of anxiety disorders after brain injury: an overview and a case illustration of obsessive-compulsive disorder.
Survivors of acquired and traumatic brain injuries may often experience anxiety states. Psychological reactions to neurological trauma may be caused by a complex interaction of a host of factors. We explore how anxiety states may be understood in terms of a biopsychosocial formulation of such factors. We also review the current evidence for the presence of specific anxiety disorders after brain injury. We then describe how cognitive-behaviour therapy (CBT), a treatment of choice for many anxiety disorders, may be integrated with cognitive rehabilitation (CR), for the management of anxiety disorders in brain injury. We illustrate how CBT and CR may be delivered with a case of a survivor of traumatic brain injury (TBI) who had developed obsessive compulsive disorder and health anxiety. We show how CBT plus CR allows a biopsychosocial formulation to be developed of the survivor's concerns for guiding a goal-based intervention. The survivor made significant gains from intervention in terms of goals achieved and changes on clinical measures. We argue that large-scale research is needed for developing an evidence base for managing emotional disorders in brain injury.
Abstract.
Author URL.
Williams WH, Evans JJ, Wilson BA (2003). Neurorehabilitation for two cases of post-traumatic stress disorder following traumatic brain injury.
Cogn Neuropsychiatry,
8(1), 1-18.
Abstract:
Neurorehabilitation for two cases of post-traumatic stress disorder following traumatic brain injury.
INTRODUCTION: We present two cases to illustrate the assessment and management of post-traumatic stress disorder (PtSD) in the context of traumatic brain injury (TBI). Case KE suffered a TBI in a road traffic accident (RTA) in which his girlfriend was killed. Case CM survived a penetrating neurological injury from a severe knife attack. Both suffered cognitive difficulties, primarily in attention and memory, and selective visual impairments, and had endured significant losses of social role. METHOD: Within a neurorehabilitation programme, goals were set regarding management of their cognitive difficulties for regaining social roles and for the management of their PtSD symptoms. Cognitive behavioural therapy (CBT) was provided for managing PtSD symptoms, which included use of a stress inoculation and graduated exposure to avoided situations and trauma re-experiences. RESULTS: Both survivors reported significant improvements in managing mood state, and in redeveloping social roles. Objective measures confirmed significant gains from intervention. CONCLUSIONS: CBT, set within a neurorehabilitation programme, can lead to improvement in PtSD symptoms and psychosocial outcome in TBI survivors.
Abstract.
Author URL.
Williams WH, Evans JJ, Fleminger S, Oliver D (2003). The neuropsychiatry of depression after brain injury. Neuropsychological Rehabilitation, 13(1-2), 65-87.
2002
Evans, J.J. Wilson, B.A. (2002). Prevalence of Post-traumatic Stress Disorder after Severe Traumatic Brain Injury in a representative community sample. Brain Injury, 16(8), 673-679.
Evans, J.J. Fleminger, S. (2002). Assessment and Management of Anxiety Disorders in Acquired Brain Injury. Special issue of Neuropsychological Rehabilitation, 1, 133-148.
Evans, J.J. (2002). Bio-psychosocial Approaches for Mood and Behaviour Disorders in Neuro-rehabilitation: an overview of. Special issue of Neuropsychological Rehabilitation, 1-12.
Williams WH, Evans JJ, Wilson BA, Needham P (2002). Brief report: prevalence of post-traumatic stress disorder symptoms after severe traumatic brain injury in a representative community sample.
Brain Inj,
16(8), 673-679.
Abstract:
Brief report: prevalence of post-traumatic stress disorder symptoms after severe traumatic brain injury in a representative community sample.
PRIMARY OBJECTIVE: in this study, the authors investigated the prevalence of symptoms of post-traumatic stress disorder (PTSD) in a community sample of 66 survivors of severe traumatic brain injury (TBI). RESEARCH DESIGN, METHODS AND PROCEDURES: a representative sample of survivors of TBI were selected on the basis of having suffered significant disturbance in consciousness following their trauma event in the form of coma and/or post-traumatic amnesia. Neuropsychological testing confirmed that participants had suffered cognitive deficits consistent with severe brain injury. Participants were administered the Impact of Events inventory for symptoms of PTSD. MAIN OUTCOMES AND RESULTS: the authors found a prevalence rate of 18% for moderate-to-severe PTSD symptoms. CONCLUSIONS: PTSD symptoms are common following severe TBI. Further research is needed to establish protective and predictive factors for PTSD in TBI groups.
Abstract.
Author URL.
Roberts E, Goldman J, Williams WH, Egan D (2002). Can all COPD patients cope with pulmonary rehabilitation?.
Author URL.
Williams, W.H. (2002). Memory Booster Workout:10 steps for a better memory.
Evans, J.J. Wilson, B.A. (2002). Neurological Rehabilitation for Posttraumatic Stress symptoms after Traumatic Brain Injury. Cognitive Neuropsychiatry, 8(1), 1-18.
Williams WH, Evans JJ, Needham P, Wilson BA (2002). Neurological, cognitive and attributional predictors of reports of posttraumatic stress disorder symptoms after traumatic brain injury. Journal of Traumatic Stress, 15(5), 397-400.
Williams, W.H. Bryant, R. (2002). Post-traumatic Stress Disorder after Traumatic Brain Injury: a review of Causal mechanisms, assessment and treatment. Special issue of Neuropsychological Rehabilitation, 1, 149-164.
1999
Williams WH, Evans JJ, Wilson BA (1999). Outcome Measures for Survivors of Acquired Brain Injury in Day and Outpatient Neurorehabilitation Programmes. Neuropsychological Rehabilitation, 9(3-4), 421-436.
1998
Williams WH, Williams JMG, Ghadiali EJ (1998). Autobiographical memory in traumatic brain injury: Neuropsychological and mood predictors of recall.
Neuropsychological Rehabilitation,
8(1), 43-60.
Abstract:
Autobiographical memory in traumatic brain injury: Neuropsychological and mood predictors of recall
Survivors of traumatic brain injury are often impaired in their recall of specific events. Depressed, suicidal, and post-traumatically stressed patients also tend to be over-general in autobiographical recall. In this study we examined the extent to which neurological damage and disturbed mood converge to lead to problems in autobiographical recall for survivors of traumatic brain injury. Eighteen participants completed measures of depression and anxiety (HAD), tests of general memory and immediate recall (Rivermead), and of current and premorbid verbal IQ (SCOLP). In addition they completed a 20 cue word autobiographical memory test and made causal attributions for their trauma events. Correlational analyses revealed that difficulty in autobiographical recall was related to reduced immediate recall ability and mood disturbance. Remedial implications are discussed.
Abstract.
1997
Williams WH, RSP J (1997). Cognitive-behaviour therapy for people with learning disabilities. In Kroese BS, Dagnan D, Loumidis K (Eds.)
Cognitive-behaviour therapy for people with learning disabilities, Brunner-Routledge.
Abstract:
Cognitive-behaviour therapy for people with learning disabilities
Abstract.
RSP J, Miller B, Williams WH, Goldthorp J (1997). Cognitive-behaviour therapy for people with learning disabilities. In Kroese BS, Dagnan D, Loumidis K (Eds.)
Cognitive-behaviour therapy for people with learning disabilities, Brunner-Routledge.
Abstract:
Cognitive-behaviour therapy for people with learning disabilities
Abstract.
