Pagulayan KF, O'Neil M, Williams RM, Turner AP, Golshan S, Roost MS, Laman-Maharg B, Huckans M, Storzbach D, Twamley EW. Arch. Phys. Med. Rehabil. 2017; 98(9): 1893-1896.e2.
Affiliation
Department of Psychiatry, University of California, San Diego; Center of Excellence for Stress and Mental Health and Research Service, VA San Diego Healthcare System.
OBJECTIVE: To examine the potential moderating effects of mental health symptoms on the efficacy of Compensatory Cognitive Training (CCT) for Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) Veterans with a history of mild traumatic brain injury (mTBI).
DESIGN: Secondary analysis of a randomized controlled trial of CCT. Posttraumatic stress disorder (PTSD), 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: 119 Veterans with history of mTBI; 50 participated in CCT and 69 received usual care (UC). INTERVENTION: CCT is a 10-week group based (90 min/session) manualized cognitive rehabilitation intervention. MAIN OUTCOME MEASURES: Objective (neuropsychological functioning) and subjective (self-report) cognitive functioning as well as 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 to 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 to 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.