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Brain Inj. 2019 Aug 19:1-9. doi: 10.1080/02699052.2019.1645357. [Epub ahead of print]

Long-term effects of executive function training among veterans with chronic TBI.

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Mental Health Service, San Francisco VA Health Care System , San Francisco , California , USA.
Department of Psychiatry, University of California , San Francisco , California , USA.
Neurology Service, Veteran's Administration Northern California Health Care System , Martinez , California , USA.
Neurology Service, San Francisco VA Health Care System , San Francisco , California , USA.
Department of Neurology, University of California , San Francisco , California , USA.
Helen Wills Neuroscience Institute, University of California , Berkeley , USA.


Objective: To investigate long-term effects of GOALS executive function training in Veterans with chronic TBI. In a recently completed study Veterans with chronic TBI showed improvement immediately post-GOALS but not control training on measures of executive function, functional task performance, and emotion regulation. We now examine the long-term maintenance of post-GOALS training changes in the same sample. Setting: San Francisco VA Health Care System (SFVAHCS), and VA Northern California Health-Care System (VANCHS) in Martinez. Participants and Design: 24 Veterans with chronic TBI were assessed at baseline, post-GOALS training, and long-term follow-up 6+ months following completion of training with a structured telephone interview, neuropsychological and complex functional performance measures, and self-report measures of daily and emotional functioning. Results: Participants reported an increased likelihood of involvement in competitive employment/volunteering at follow-up (61%) compared to baseline (26%; χ2 = 5.66, p < .01, ѱ = .35). Repeated measures MANOVAS indicated improvement on attention/executive function (F = 13.85, p < .01, partial η2 = .42), complex functional task performance (GPS Total: F = 9.12, p < .01, partial η2 = .38) and daily functioning (MPAI Total: F = 3.23, p < .05, partial η2 = .21), and reduction in overall mood disturbance (POMS Total: F = 3.42, p < .05, partial η2 = .22) at follow-up relative to baseline. Discussion: Training in attention regulation applied to participant-defined goals is associated with meaningful long-term improvement in cognitive skills, emotion regulation, and daily functioning in Veterans with chronic TBI.


Traumatic brain injury; Veterans; cognitive rehabilitation; long-term follow-up

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