移动技术认知康复联合社会支持治疗创伤性脑损伤合并 PTSD 退伍军人：一项随机临床试验。
Cognitive Rehabilitation With Mobile Technology and Social Support for Veterans With TBI and PTSD: A Randomized Clinical Trial.
机构信息
Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham, North Carolina (Drs Elbogen, Dennis, Van Voorhees, Wagner, and Beckham); Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina (Drs Elbogen, Dennis, Van Voorhees, Wagner, and Beckham); Departments of Psychology and Neuroscience (Ms Blakey) and Psychiatry (Drs S. C. Johnson, Hamer, and Belger), University of North Carolina, Chapel Hill; Rho, Inc, Chapel Hill, North Carolina (Dr J. Johnson); and Department of Neuroscience, University of Cambridge, Cambridge, United Kingdom (Dr Manly).
出版信息
J Head Trauma Rehabil. 2019 Jan/Feb;34(1):1-10. doi: 10.1097/HTR.0000000000000435.
OBJECTIVE
To investigate effects of cognitive rehabilitation with mobile technology and social support on veterans with traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD).
PARTICIPANTS
There were 112 dyads, comprised by a veteran and a family member or friend (224 participants in total).
DESIGN
Dyads were randomized to the following: (1) a novel intervention, Cognitive Applications for Life Management (CALM), involving goal management training plus mobile devices for cueing and training attentional control; or (2) Brain Health Training, involving psychoeducation plus mobile devices to train visual memory.
MAIN MEASURES
Executive dysfunction (disinhibition, impulsivity) and emotional dysregulation (anger, maladaptive interpersonal behaviors) collected prior to randomization and following intervention completion at 6 months.
RESULTS
The clinical trial yielded negative findings regarding executive dysfunction but positive findings on measures of emotion dysregulation. Veterans randomized to CALM reported a 25% decrease in anger over 6 months compared with 8% reduction in the control (B = -5.27, P = .008). Family/friends reported that veterans randomized to CALM engaged in 26% fewer maladaptive interpersonal behaviors (eg, aggression) over 6 months compared with 6% reduction in the control (B = -2.08, P = .016). An unanticipated result was clinically meaningful change in reduced PTSD symptoms among veterans randomized to CALM (P < .001).
CONCLUSION
This preliminary study demonstrated effectiveness of CALM for reducing emotional dysregulation in veterans with TBI and PTSD.
目的
研究移动技术和社会支持认知康复对创伤性脑损伤（TBI）和创伤后应激障碍（PTSD）退伍军人的影响。
参与者
共有 112 对参与者，由一名退伍军人及其家庭成员或朋友组成（共 224 名参与者）。
设计
将参与者随机分为以下两组：（1）一种新的干预措施，认知应用生活管理（CALM），包括目标管理训练和移动设备提示和训练注意力控制；或（2）大脑健康训练，包括心理教育和移动设备训练视觉记忆。
主要措施
在随机分组前和干预完成后 6 个月时收集执行功能障碍（抑制、冲动）和情绪调节障碍（愤怒、适应不良的人际行为）。
结果
临床试验对执行功能障碍的结果为阴性，但对情绪调节障碍的测量结果为阳性。与对照组相比，接受 CALM 治疗的退伍军人在 6 个月内的愤怒情绪降低了 25%（B = -5.27，P =.008）。家属/朋友报告说，在 6 个月的时间里，接受 CALM 治疗的退伍军人的适应不良人际行为（如攻击行为）减少了 26%（B = -2.08，P =.016）。一个意外的结果是，接受 CALM 治疗的退伍军人的 PTSD 症状显著减轻（P <.001）。
结论
这项初步研究表明，CALM 对降低 TBI 和 PTSD 退伍军人的情绪失调有效。
Zotero 插件