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).
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。
J Neurol Neurosurg Psychiatry. 2018-12-15
NPJ Digit Med. 2024-12-18
Life (Basel). 2024-7-18
Psychiatr Res Clin Pract. 2022-12-21
JAMA. 2013-12-11
Behav Res Ther. 2013-6-22
Zotero 插件