Compensatory Cognitive Training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans With Mild Traumatic Brain Injury

Storzbach, Daniel; Twamley, Elizabeth W.; Roost, Mai S.; Golshan, Shahrokh; Williams, Rhonda M.; O’Neil, Maya; Jak, Amy J.; Turner, Aaron P.; Kowalski, Halina M.; Pagulayan, Kathleen F.; Huckans, Marilyn

doi:10.1097/htr.0000000000000228

Cited by 68 publications

(60 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The hybrid treatment led to medium effect sizes for improvements in attention and learning; at a practical level, this translates to the ability to retain approximately 30% more information following treatment. Although the full CogSMART protocol was not delivered in SMART-CPT, cognitive outcomes of this group are consistent with other studies of compensatory cognitive training approaches 37. Previous research suggests that standard PTSD treatments may also improve neuropsychological functioning,38 and our results suggest that these improvements might be more robust when treatment incorporates compensatory cognitive strategies.…”

Section: Discussionsupporting

confidence: 88%

SMART-CPT for veterans with comorbid post-traumatic stress disorder and history of traumatic brain injury: a randomised controlled trial

Jak

Jurick

Crocker

et al. 2018

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

ObjectiveTo better concurrently address emotional and neuropsychological symptoms common in veterans with comorbid post-traumatic stress disorder (PTSD) and history of traumatic brain injury (TBI), we integrated components of compensatory cognitive training from the Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) programme into cognitive processing therapy (CPT) for PTSD to create a hybrid treatment, SMART-CPT (CogSMART+CPT). This study compared the efficacy of standard CPT with SMART-CPT for treatment of veterans with comorbid PTSD and history of TBI reporting cognitive symptoms.MethodsOne hundred veterans with PTSD, a history of mild to moderate TBI and current cognitive complaints were randomised and received individually delivered CPT or SMART-CPT for 12 weeks. Participants underwent psychological, neurobehavioural and neuropsychological assessments at baseline, on completion of treatment and 3 months after treatment.ResultsBoth CPT and SMART-CPT resulted in clinically significant reductions in PTSD and postconcussive symptomatology and improvements in quality of life. SMART-CPT resulted in additional improvements in the neuropsychological domains of attention/working memory, verbal learning/memory and novel problem solving.ConclusionSMART-CPT, a mental health intervention for PTSD, combined with compensatory cognitive training strategies, reduces PTSD and neurobehavioural symptoms and also provides added value by improving cognitive functioning.

show abstract

Section: Discussionsupporting

confidence: 88%

SMART-CPT for veterans with comorbid post-traumatic stress disorder and history of traumatic brain injury: a randomised controlled trial

Jak

Jurick

Crocker

et al. 2018

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

show abstract

“…For example, it may be useful to educate patients about the importance of slowing down to carefully evaluate the short-term and long-term costs and benefits of various choices when they are faced with challenging or complex life decisions, particularly when they are experiencing active HCV symptoms or cognitive difficulties. Our group is investigating the efficacy of Compensatory Cognitive Training (CCT), a brief, manualized cognitive rehabilitation intervention for adults with mild cognitive impairments due to a variety of conditions such as combat-related traumatic brain injury, ageing, depression, and addictions (Storzbach, Twamley et al 2017). CCT teaches participants skills to help them manage everyday problems in the areas of attention, memory, and executive functions.…”

Section: Discussionmentioning

confidence: 99%

Functional MRI and delay discounting in patients infected with hepatitis C

McCready

Kohno

Kolessar³

et al. 2018

J. Neurovirol.

Self Cite

View full text Add to dashboard Cite

Background: Hepatitis C virus infected (HCV+) adults evidence increased rates of psychiatric and cognitive difficulties. This is the first study to use functional magnetic resonance imaging (fMRI) to examine brain activation in untreated HCV+ adults. Objective: To determine whether, relative to non-infected controls (CTLs), HCV+ adults exhibit differences in brain activation during a delay discounting task (DDT), a measure of one’s tendency to choose smaller immediate rewards over larger delayed rewards - one aspect of impulsivity. Methods: 20 adults with HCV and 26 CTLs completed an fMRI protocol during the DDT. Results: Mixed effects regression analyses of Hard versus Easy trials of the DDT showed that, compared with CTLs, the HCV+ group exhibited less activation in the left lateral occipital gyrus, precuneus and superior frontal gyrus. There were also significant interactive effects for Hard – Easy contrasts in the bilateral medial frontal gyrus, left insula, left precuneus, left inferior parietal lobule, and right temporal occipital gyrus; the CTL group evidenced a positive relationship between impulsivity and activation, while the HCV+ group exhibited a negative relationship. Within the HCV+ group, those with high viral load chose immediate rewards more often than those with low viral load, regardless of choice difficulty; those with low viral load chose immediate rewards more often on hard choices relative to easy choices. Conclusions: Results show that HCV+ patients exhibit greater impulsive behavior when presented with difficult choices, and impulsivity is negatively related to activation in regions important for cognitive control. Thus, interventions that decrease impulsive choice may be warranted with some HCV+ patients.

show abstract

“…The aim of their study was to assess the effect of the CogSMART intervention in combination with SE on improving postconcussive symptoms, neuropsychological performance, quality of life, functional capacity, emotional symptoms, and work participation [ 21 ]. Compensatory Cognitive Training (CCT) is a further development of CogSMART [ 23 ]. It is a group-based, manualized intervention that includes ten weekly sessions, and it is theoretically based on elements derived from prior cognitive training programs for people with TBI and severe mental illness [ 21 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…Compensatory Cognitive Training (CCT) is a further development of CogSMART [ 23 ]. It is a group-based, manualized intervention that includes ten weekly sessions, and it is theoretically based on elements derived from prior cognitive training programs for people with TBI and severe mental illness [ 21 , 23 , 24 ]. The intervention is focused on psychoeducation and compensatory strategy training, and it targets postconcussive symptom management and cognitive symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…The compensatory cognitive strategies target prospective memory, attention and concentration, learning and memory, and executive function [ 21 , 25 ]. Pilot studies of patients with mild to moderate TBI have demonstrated the efficacy of CogSMART and CCT in improving emotional problems, functional capacity, quality of life, and performance on neurocognitive measures [ 21 – 23 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial

Howe

Langlo

Terjesen

et al. 2017

Trials

Self Cite

View full text Add to dashboard Cite

BackgroundA considerable proportion of patients with mild to moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological, and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW are scarce. Furthermore, there has traditionally been weak collaboration among health-related rehabilitation services, the labor and welfare sector, and workplaces.Methods/designThis study protocol describes an innovative randomized controlled trial in which we will explore the effect of combining manualized cognitive rehabilitation (Compensatory Cognitive Training [CCT]) and supported employment (SE) on RTW and related outcomes for patients with mild to moderate TBI in real-life competitive work settings. The study will be carried out in the southeastern region of Norway and thereby be performed within the Norwegian welfare system. Patients aged 18–60 years with mild to moderate TBI who are employed in a minimum 50% position at the time of injury and sick-listed 50% or more for postconcussive symptoms 2 months postinjury will be included in the study. A comprehensive assessment of neurocognitive function, self-reported symptoms, emotional distress, coping style, and quality of life will be performed at baseline, immediately after CCT (3 months after inclusion), following the end of SE (6 months after inclusion), and 12 months following study inclusion. The primary outcome measures are the proportion of participants who have returned to work at 12-month follow-up and length of time until RTW, in addition to work stability as well as work productivity over the first year following the intervention. Secondary outcomes include changes in self-reported symptoms, emotional and cognitive function, and quality of life. Additionally, a qualitative RTW process evaluation focused on organizational challenges at the workplace will be performed.DiscussionThe proposed study will combine cognitive and vocational rehabilitation and explore the efficacy of increased cross-sectoral collaboration between specialized health care services and the labor and welfare system. If the intervention proves effective, the project will describe the cost-effectiveness and utility of the program and thereby provide important information for policy makers. In addition, knowledge about the RTW process for persons with TBI and their workplaces will be provided.Trial registrationClinicalTrials.gov, NCT03092713. Registered on 10 March 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2218-7) contains supplementary material, which is available to authorized users.

show abstract

Compensatory Cognitive Training for Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn Veterans With Mild Traumatic Brain Injury

Abstract: Findings indicate that training in compensatory cognitive strategies facilitates behavioral change (ie, use of cognitive strategies) as well as both subjective and objective improvements in targeted cognitive domains.

Cited by 68 publications

References 42 publications

SMART-CPT for veterans with comorbid post-traumatic stress disorder and history of traumatic brain injury: a randomised controlled trial

SMART-CPT for veterans with comorbid post-traumatic stress disorder and history of traumatic brain injury: a randomised controlled trial

Functional MRI and delay discounting in patients infected with hepatitis C

Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial

Contact Info

Product

Resources

About