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J Head Trauma Rehabil. 2017 Jan/Feb;32(1):16-24. doi: 10.1097/HTR.0000000000000228.

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

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VA Portland Healthcare System, Portland, Oregon (Drs Storzbach, Roost, O'Neil, and Huckans and Ms Kowalski); Departments of Psychiatry (Drs Storzbach, O'Neil, and Huckans) and Neurology (Dr Storzbach), Oregon Health & Science University, Portland, Oregon; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California (Drs Twamley and Jak); Department of Psychiatry, University of California, San Diego, La Jolla (Drs Twamley, Golshan, and Jak); VA Puget Sound Health Care System, Seattle, Washington (Drs Williams, Turner, and Pagulayan); Departments of Rehabilitation Medicine (Drs Williams and Turner) and Psychiatry and Behavioral Sciences (Dr Pagulayan), University of Washington School of Medicine, Seattle.



The purpose of the study was to evaluate the efficacy of group-based 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.


One hundred nineteen OEF/OIF/OND Veterans with history of mild traumatic brain injury participated at 3 sites, and 50 of the Veterans were randomized to CCT group, while 69 Veterans were randomized to the usual care control group. The CCT group participated in 10 weeks of CCT. Both CCT and usual care groups were assessed at baseline, 5 weeks (midway through CCT), 10 weeks (immediately following CCT), and 15 weeks (5-week follow-up) on measures of subjective cognitive complaints, use of cognitive strategies, psychological functioning, and objective cognitive performance.


Veterans who participated in CCT reported significantly fewer cognitive and memory difficulties and greater use of cognitive strategies. They also demonstrated significant improvements on neurocognitive tests of attention, learning, and executive functioning, which were 3 of the cognitive domains targeted in CCT.


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.

[Indexed for MEDLINE]

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