Improving Cognitive Rehabilitation Outcomes for Veterans With mTBI+PTSD
VA Office of Research and Development
Summary
Posttraumatic stress disorder (PTSD) and mild TBI (mTBI) frequently co-occur in post-9/11 Veterans, and together are associated with worse cognitive performance, mental health, everyday functioning, community integration, quality of life, and treatment response than either condition alone. Additional comorbidities, such as depression and sleep disturbance, are common and further exacerbate these problems. The investigators will investigate Compensatory Cognitive Training (CCT) and Morning Bright Light Therapy (MBLT) vs Negative Ion Generator (ION), to directly target cognition, depression, and sleep disturbance and to improve CCT-associated rehabilitation outcomes. The investigator's randomized controlled trial in 144 Veterans with mTBI+PTSD across two VA sites will compare cognition, functioning, and other secondary outcomes following CCT+MBLT vs. CCT+ION. This study addresses the significant gap in services and evidence-based treatments for Veterans with mTBI+PTSD.
Description
The investigators aim to compare CCT+MBLT with CCT+ION for improving cognition, functioning, and secondary outcomes in Veterans with mTBI+PTSD. Objective cognitive performance and everyday functioning are co-primary outcomes. Depression and sleep disturbance are target mechanisms and secondary outcomes include PTSD symptom severity, post-concussive symptom severity, cognitive symptom severity, and quality of life. Improvements in mood and sleep will be investigated as mediators. To explore for whom these interventions are most effective, the investigators will evaluate whether individual dif…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Post 9/11 Veterans enrolled at VA San Diego or VA Portland * Ability to provide informed consent * Living independently * History of mTBI confirmed by OSU-TBI * Current diagnosis of PTSD confirmed by CAPS-5 * Current cognitive concerns ("Do you have concerns about your cognition, thinking, attention, or memory?") * Current concern regarding depression and/or sleep disturbance; defined by a score of 5 on the PHQ-9 and/or 8 on the ISI, respectively (score of 2 or higher on ISI item 1, 2, or 3, reflecting at least "moderate" difficulty with falling asleep, staying asleep, o…
Interventions
- DeviceCCT+MBLT
Compensatory Cognitive Training + Morning Bright Light Therapy (Aurora LightPad)
- DeviceCCT+ION
Compensatory Cognitive Training + Negative Ion Generator (SphereOne)
Locations (2)
- VA San Diego Healthcare System, San Diego, CASan Diego, California
- VA Portland Health Care System, Portland, ORPortland, Oregon