Highlights
- •This study examined psychiatric moderators of cognitive rehabilitation intervention efficacy.
- •This was a secondary analysis of a randomized controlled trial of compensatory cognitive training.
- •Baseline mental health symptoms did not moderate intervention efficacy.
Abstract
Objective
To examine the potential moderating effects of mental health symptoms on the efficacy
of compensatory cognitive training (CCT) for Operation Enduring Freedom/Operation
Iraqi Freedom/Operation New Dawn veterans with a history of mild traumatic brain injury
(mTBI).
Design
Secondary analysis of a randomized controlled trial of CCT. Posttraumatic stress disorder,
depression, and substance dependence symptom severity were examined as potential moderators
of CCT efficacy for subjective cognitive complaints, use of cognitive strategies,
and objective neurocognitive performance.
Setting
Three Veterans Affairs medical centers.
Participants
Participants included veterans with history of mTBI (N=119): 50 participated in CCT
and 69 received usual care (UC).
Intervention
CCT is a 10-week group-based (90 minutes per session) manualized cognitive rehabilitation
intervention.
Main Outcome Measures
Objective (neuropsychological functioning) and subjective (self-report) cognitive
functioning and use of cognitive strategies.
Results
Baseline mental health symptoms did not moderate CCT efficacy: veterans who received
CCT reported significantly greater improvement in cognitive difficulties and use of
cognitive strategies compared with the UC group, regardless of baseline mental health
symptom severity. The CCT group also demonstrated significant improvements on neuropsychological
measures of attention, learning, and executive functioning compared with the UC group,
regardless of baseline mental health symptom severity.
Conclusions
CCT is efficacious for improving objective cognitive functioning and compensatory
strategy use for veterans with a history of mTBI, regardless of the severity of comorbid
psychiatric symptoms.
Keywords
List of abbreviations:
CCT (compensatory cognitive training), mTBI (mild traumatic brain injury), OEF (Operation Enduring Freedom), OIF (Operation Iraqi Freedom), OND (Operation New Dawn), PTSD (posttraumatic stress disorder), RCT (randomized controlled trial), TBI (traumatic brain injury), UC (usual care)To read this article in full you will need to make a payment
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References
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Article Info
Publication History
Published online: May 05, 2017
Footnotes
Supported by the U.S. Department of Veterans Affairs Merit Review (award no. D7217-R) from the U.S. Department of Veterans Affairs, Office of Research and Development Rehabilitation Research and Development Program (clinicaltrials.gov Identifier NCT01040858); the U.S. Department of Veterans Affairs, Office of Research and Development Clinical Science R & D Career Development Award Program (grant no. IK2CX000516); and the Agency for Healthcare Research & Quality-funded Patient-Centered Outcomes Research K-12 award (no. 1 K12 HS019456 01).
This material is the result of work supported with resources and the use of facilities at the Veterans Affairs Medical Centers in Portland, Oregon, San Diego, California, and Seattle, Washington. The contents do not represent the views of the U.S. Department of Veterans Affairs or the U.S. Government.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
