Posttraumatic Stress Disorder, Traumatic Brain Injury
Conditions
Brief summary
Traumatic brain injury (TBI) is highly prevalent and frequently comorbid among Veterans and Service Members. Many of these individuals sustain more than one TBI over the course of their military careers, often with little recovery time between exposures placing them at increased risk for persistent cognitive, psychological, and psychosocial difficulties that impact daily functioning and life satisfaction. The short-term objective of this study is to examine the efficacy of the manualized, 10-week, telephone delivery of Tele-CABA for improving cognitive and adaptive functioning. The long-term objective of this study is to develop an accessible and acceptable intervention that can be broadly disseminated to address the complex rehabilitation needs of Veterans and Service Members. The overall goal of the Tele-CABA intervention is to reduce negative cognitive and psychiatric health outcomes for Veterans and Service Members with a history of TBI, promote personal resilience, and to design an intervention that is accessible and acceptable to patients struggling to recover from TBI.
Interventions
BEHAVIORALTele-CABA
Tele-CABA uses Behavioral Activation (BA) to identify meaningful goals and activities while learning cognitive skills to aid in working toward those goals. Early sessions of Tele-CABA focus on learning about TBI and lifestyle skills that can improve thinking abilities and mood. Cognitive skills taught each week include internal and external skills to help manage problems with memory, attention, and regulation of thinking processes. Investigators and patients will spend a part of each session applying the cognitive skills to managing real life situations and getting patients active in the service of personal goals. The Tele-CABA intervention will be delivered over 10 weekly, 60-minute telephone sessions.
BEHAVIORALUsual Care
Participants in the UC group will continue to receive their regular medical, psychiatric, and psychotherapeutic care.
Sponsors
Oregon Health and Science University
Portland VA Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Veterans * Active Duty Service Members * History of TBI (confirmed by TBI interview) * Self-reported cognitive complaints (as indicated on the NSI) * Able to communicate by telephone
Exclusion criteria
* Active suicidal intent * History of bipolar disorder * History of psychotic disorder * Decisionally impaired * Non-English speaking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in the Wechsler Adult Intelligence Scale-4th Edition, Digit Span subtest | Baseline; 12 weeks; and 6 months after baseline | Measure of attention and working memory; scaled score range = 0-20 (mean = 10; SS below 2 SD below the mean considered impaired) |
| Change in the Neurobehavioral Symptom Inventory (NSI) | Baseline; 12 weeks; and 6 months after baseline | Measure of postconcussion symptom severity; total score range = 0-88 (higher total score = worse symptoms) |
| Change in the Satisfaction with Life Scale (SWLS) | Baseline; 12 weeks; and 6 months after baseline | Measure of life satisfaction; total score range = 0-35 (higher total score = more satisfied) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in the PTSD Checklist-5 (PCL 5) | Baseline; after 12 weeks; and 6 months after baseline | Measure of PTSD symptoms; total score range = 0-80 (higher total score = worse PTSD) |
| Change in the Memory Compensation Questionnaire (MCQ) | Baseline; after 12 weeks; and 6 months after baseline | Measure of the use of strategies to improve memory relevant to daily living; total score range = 0-176 (lower total score = worse functioning) |
Countries
United States
Outcome results
None listed