心理健康对有轻度创伤性脑损伤病史的退伍军人的代偿性认知训练效果无调节作用。

Mental Health Does Not Moderate Compensatory Cognitive Training Efficacy for Veterans With a History of Mild Traumatic Brain Injury.

作者信息

Pagulayan Kathleen F, O'Neil Maya, Williams Rhonda M, Turner Aaron P, Golshan Shahrokh, Roost Mai S, Laman-Maharg Benjamin, Huckans Marilyn, Storzbach Daniel, Twamley Elizabeth W

机构信息

U.S. Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA.

U.S. Department of Veterans Affairs Portland Health Care System, Portland, OR; Department of Psychiatry, Oregon Health & Science University, Portland, OR; Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR.

出版信息

Arch Phys Med Rehabil. 2017 Sep;98(9):1893-1896.e2. doi: 10.1016/j.apmr.2017.04.009. Epub 2017 May 5.

DOI:10.1016/j.apmr.2017.04.009

PMID:28483653

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.

摘要