{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:49:15Z","timestamp":1765885755751,"version":"3.48.0"},"reference-count":62,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001530","name":"Canterbury Medical Research Foundation","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100001530","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["16\/600"],"award-info":[{"award-number":["16\/600"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["19\/082"],"award-info":[{"award-number":["19\/082"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,7,21]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Our previous research has demonstrated significant cognitive effects of earthquake exposure 2\u20133 years following the Canterbury earthquake sequence of 2011. Such impairment has major implications for a population trying to recover, and to rebuild, a devastated city. This study aims to examine psychological, cognitive and biological factors that may contribute to subjective cognitive difficulties in a large group of individuals exposed to the Canterbury earthquake sequence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Two-hundred earthquake-exposed participants from an existing large cohort study (Christchurch Health and Development Study, CHDS) will be recruited. Inclusion is based on results of online screening of the CHDS cohort, using the Cognitive Failures Questionnaire. Individuals scoring the highest (n=100) and lowest (n=100), representing the highest and lowest levels of subjective cognitive impairment, are selected. Exclusions are: psychotic\/bipolar disorders, serious substance\/alcohol dependence, chronic medical conditions, pregnancy and previous serious head injury. Participants will undergo a half-day assessment including clinician-rated interviews, self-report measures, objective and subjective cognitive assessments, blood sample collection and physical measurements. The primary analysis will compare cognitive, psychological and biological measures in \u2018high\u2019 and \u2018low\u2019 subjective cognitive impairment groups. The study will have power (p&lt;0.05, \u03b1=0.8) to show a difference between groups of 0.4 SD on any variable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee. The online screening component of the study received ethical approval on 1 April 2021 (16\/STH\/188, PAF 7), and the main study (subsequent to screening) received approval on 16 August 2021 (Northern A 21\/NTA\/68). All participants provide written informed consent. Findings will be disseminated initially to the CHDS cohort members, the wider Canterbury community, and then by publication in scientific journals and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov Registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05090046\">NCT05090046<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-072195","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T13:40:57Z","timestamp":1691415657000},"page":"e072195","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["UNITE Project: understanding neurocognitive impairment after trauma exposure\u2013study protocol of an observational study in Christchurch, New Zealand"],"prefix":"10.1136","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct05090046","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5344-2959","authenticated-orcid":false,"given":"Katie","family":"Douglas","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine, University of Otago, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, University of Otago, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0648-5382","authenticated-orcid":false,"given":"Sandila","family":"Tanveer","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, University of Otago, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Eggleston","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, University of Otago, Christchurch, New Zealand"},{"name":"Specialist Mental Health Services, Te Whatu Ora Waitaha, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Porter","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, University of Otago, Christchurch, New Zealand"},{"name":"Specialist Mental Health Services, Te Whatu Ora Waitaha, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Boden","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, University of Otago, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"2025121603431858000_13.8.e072195.1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1995.03950240066012"},{"key":"2025121603431858000_13.8.e072195.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2012.01011.x"},{"key":"2025121603431858000_13.8.e072195.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.02.007"},{"key":"2025121603431858000_13.8.e072195.4","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.116.3.448"},{"key":"2025121603431858000_13.8.e072195.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(02)01413-0"},{"key":"2025121603431858000_13.8.e072195.6","doi-asserted-by":"crossref","unstructured":"Chung S , Tang S , Shie J , et al . Emotional memory and post-traumatic stress disorder: A preliminary neuropsychological study in female victims of domestic violence. J Psychiatry 2014;17(6). doi:10.4172\/1994-8220.1000148","DOI":"10.4172\/1994-8220.1000148"},{"key":"2025121603431858000_13.8.e072195.7","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1002\/jts.22830","article-title":"Posttraumatic stress disorder symptom severity is associated with reduced Montreal Cognitive Assessment scores in a sample of Vietnam war veterans","volume":"35","author":"Prieto","year":"2022","journal-title":"J Trauma Stress"},{"key":"2025121603431858000_13.8.e072195.8","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.dadm.2019.07.006","article-title":"Incidence of mild cognitive impairment in world trade center responders: long-term consequences of re-experiencing the events on 9\/11\/2001","volume":"11","author":"Clouston","year":"2019","journal-title":"Alzheimers Dement (Amst)"},{"key":"2025121603431858000_13.8.e072195.9","doi-asserted-by":"publisher","DOI":"10.1176\/appi.neuropsych.23.1.16"},{"key":"2025121603431858000_13.8.e072195.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1447-0349.2011.00772.x"},{"key":"2025121603431858000_13.8.e072195.11","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/0004867418789498","article-title":"Earthquake brain: impairment of spatial memory following long-term earthquake-related stress","volume":"53","author":"Bell","year":"2019","journal-title":"Aust N Z J Psychiatry"},{"key":"2025121603431858000_13.8.e072195.12","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2017.00278","article-title":"Earthquake brain: altered recognition and misclassification of facial expressions are related to trauma exposure but not posttraumatic stress disorder","volume":"8","author":"Bell","year":"2017","journal-title":"Front Psychiatry"},{"key":"2025121603431858000_13.8.e072195.13","doi-asserted-by":"crossref","DOI":"10.1192\/bjo.2022.512","article-title":"Examining the long-term cognitive effects of exposure to the Canterbury earthquakes in a resilient cohort","volume":"8","author":"Bell","year":"2022","journal-title":"BJPsych Open"},{"key":"2025121603431858000_13.8.e072195.14","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2010.80"},{"key":"2025121603431858000_13.8.e072195.15","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2639"},{"key":"2025121603431858000_13.8.e072195.16","doi-asserted-by":"crossref","DOI":"10.1177\/2470547017692328","article-title":"Neurobiological and systemic effects of chronic stress","volume":"1","author":"McEwen","year":"2017","journal-title":"Chronic Stress (Thousand Oaks)"},{"key":"2025121603431858000_13.8.e072195.17","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23587"},{"key":"2025121603431858000_13.8.e072195.18","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2014.00375","article-title":"Obesity and cognitive decline: role of inflammation and vascular changes","volume":"8","author":"Nguyen","year":"2014","journal-title":"Front Neurosci"},{"key":"2025121603431858000_13.8.e072195.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2014.04.017"},{"key":"2025121603431858000_13.8.e072195.20","doi-asserted-by":"crossref","first-page":"S92","DOI":"10.1093\/schbul\/sbz022.011","article-title":"The inflammatory cascade and cognitive outcome in a transdiagnostic cohort","volume":"45","author":"Burdick","year":"2019","journal-title":"Schizophr Bull"},{"key":"2025121603431858000_13.8.e072195.21","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s00737-021-01158-9","article-title":"Free testosterone is related to aspects of cognitive function in women with and without polycystic ovary syndrome","volume":"25","author":"Sukhapure","year":"2022","journal-title":"Arch Womens Ment Health"},{"key":"2025121603431858000_13.8.e072195.22","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.resuscitation.2017.08.007","article-title":"Cognitive impairments and subjective cognitive complaints after survival of cardiac arrest: a prospective longitudinal cohort study","volume":"120","author":"Steinbusch","year":"2017","journal-title":"Resuscitation"},{"key":"2025121603431858000_13.8.e072195.23","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1682\/JRRD.2013.10.0226","article-title":"Subjective cognitive complaints and neuropsychological test performance following military-related traumatic brain injury","volume":"51","author":"French","year":"2014","journal-title":"J Rehabil Res Dev"},{"key":"2025121603431858000_13.8.e072195.24","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1001\/jamapsychiatry.2014.652","article-title":"Impact of a major disaster on the mental health of a well-studied cohort","volume":"71","author":"Fergusson","year":"2014","journal-title":"JAMA Psychiatry"},{"key":"2025121603431858000_13.8.e072195.25","doi-asserted-by":"publisher","DOI":"10.1037\/a0038039"},{"key":"2025121603431858000_13.8.e072195.26","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291713002535"},{"key":"2025121603431858000_13.8.e072195.27","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/acps.13127","article-title":"World trade center exposure, post-traumatic stress disorder, and subjective cognitive concerns in a cohort of rescue\/recovery workers","volume":"141","author":"Singh","year":"2020","journal-title":"Acta Psychiatr Scand"},{"key":"2025121603431858000_13.8.e072195.28","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17165683","article-title":"PTSD and depressive symptoms as potential mediators of the association between world trade center exposure and subjective cognitive concerns in rescue\/recovery workers","volume":"17","author":"Singh","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2025121603431858000_13.8.e072195.29","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1159\/000478785","article-title":"Cognitive impairments in unipolar depression: the impact of rumination","volume":"50","author":"Schwert","year":"2017","journal-title":"Psychopathology"},{"key":"2025121603431858000_13.8.e072195.30","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.117.1.182"},{"key":"2025121603431858000_13.8.e072195.31","doi-asserted-by":"publisher","DOI":"10.1001\/jama.296.5.519"},{"key":"2025121603431858000_13.8.e072195.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2015.05.022"},{"key":"2025121603431858000_13.8.e072195.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.07.039"},{"key":"2025121603431858000_13.8.e072195.34","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2010.10060855"},{"key":"2025121603431858000_13.8.e072195.35","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.2174\/1871527313666141130223248","article-title":"Psychological treatments for cognitive dysfunction in major depressive disorder: Current evidence and perspectives","volume":"13","author":"Porter","year":"2014","journal-title":"CNS Neurol Disord Drug Targets"},{"key":"2025121603431858000_13.8.e072195.36","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1007\/s40501-016-0092-7","article-title":"Current treatment options for cognitive impairment in bipolar disorder: a review","volume":"3","author":"Douglas","year":"2016","journal-title":"Curr Treat Options Psych"},{"key":"2025121603431858000_13.8.e072195.37","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/bdi.13021","article-title":"Effect of action-based cognitive remediation on cognitive impairment in patients with remitted bipolar disorder: A randomized controlled trial","volume":"23","author":"Ott","year":"2021","journal-title":"Bipolar Disord"},{"key":"2025121603431858000_13.8.e072195.38","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1002\/da.22341","article-title":"Changes in neuropsychological function after treatment with metacognitive therapy or cognitive behavior therapy for depression","volume":"32","author":"Groves","year":"2015","journal-title":"Depress Anxiety"},{"key":"2025121603431858000_13.8.e072195.39","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000128"},{"key":"2025121603431858000_13.8.e072195.40","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1614.2001.00902.x"},{"key":"2025121603431858000_13.8.e072195.41","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2025121603431858000_13.8.e072195.42","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8260.1982.tb01421.x"},{"key":"2025121603431858000_13.8.e072195.43","unstructured":"Rey A . L\u2019examen Clinique en Psychologie. Paris: Presses Universitaires de France, 1964."},{"key":"2025121603431858000_13.8.e072195.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2006.10.010"},{"key":"2025121603431858000_13.8.e072195.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2007.07.011"},{"key":"2025121603431858000_13.8.e072195.46","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2007.07010042"},{"key":"2025121603431858000_13.8.e072195.47","doi-asserted-by":"crossref","unstructured":"Wechsler D . Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV). San Antonio, Texas: Pearson Education Inc, 2008.","DOI":"10.1037\/t15169-000"},{"key":"2025121603431858000_13.8.e072195.48","doi-asserted-by":"crossref","unstructured":"Delis DC , Kaplan E , Kramer JH . Delis-Kaplan Executive Function System (D-KEFS). San Antonio, Texas: The Psychological Corporation, 2001.","DOI":"10.1037\/t15082-000"},{"key":"2025121603431858000_13.8.e072195.49","doi-asserted-by":"publisher","DOI":"10.1017\/S0021963001006643"},{"key":"2025121603431858000_13.8.e072195.50","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1300004"},{"key":"2025121603431858000_13.8.e072195.51","doi-asserted-by":"crossref","first-page":"2602","DOI":"10.1017\/S0033291717000939","article-title":"Neurocognitive deficits in schizophrenia. are we making mountains out of molehills.","volume":"47","author":"Moritz","year":"2017","journal-title":"Psychol Med"},{"key":"2025121603431858000_13.8.e072195.52","unstructured":"Nelson HE . National Adult Reading Test, NART. Windsor: Nelson Publishing Company, 1982."},{"key":"2025121603431858000_13.8.e072195.53","article-title":"Addenbrooke\u2019s Cognitive Examination III (ACE-III) and mini-ACE for the detection of dementia and mild cognitive impairment","volume":"12","author":"Beishon","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2025121603431858000_13.8.e072195.54","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-9338(99)80239-9"},{"key":"2025121603431858000_13.8.e072195.55","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-022-03747-z","article-title":"Randomised controlled trial of interpersonal and social rhythm therapy and group-based cognitive remediation versus interpersonal and social rhythm therapy alone for mood disorders: study protocol","volume":"22","author":"Douglas","year":"2022","journal-title":"BMC Psychiatry"},{"key":"2025121603431858000_13.8.e072195.56","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(03)00147-5"},{"key":"2025121603431858000_13.8.e072195.57","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1976.01770090101010"},{"key":"2025121603431858000_13.8.e072195.58","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.61.1.115"},{"key":"2025121603431858000_13.8.e072195.59","first-page":"1381","article-title":"A new measure of contemporary life stress: development, validation, and reliability of the CRISYS","volume":"33","author":"Shalowitz","year":"1998","journal-title":"Health Serv Res"},{"key":"2025121603431858000_13.8.e072195.60","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20115990","article-title":"The COVID Psychosocial Impacts Scale: A reliable and valid tool to examine the psychosocial impacts of the COVID-19 pandemic","volume":"20","author":"Tanveer","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2025121603431858000_13.8.e072195.61","doi-asserted-by":"publisher","DOI":"10.1007\/BF02103658"},{"key":"2025121603431858000_13.8.e072195.62","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.182.3.214"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-072195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T11:43:25Z","timestamp":1765885405000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-072195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":62,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,7]]},"published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1136\/bmjopen-2023-072195"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-072195","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}