Evaluation of a hybrid treatment for Veterans with comorbid traumatic brain injury and posttraumatic stress disorder: Study protocol for a randomized controlled trial.
Comorbidity of posttraumatic stress disorder (PTSD) and history of traumatic brain injury (TBI) is high among Veterans of Operation Iraqi Freedom/Enduring Freedom/New Dawn (OIF/OEF/OND). Cognitive processing therapy (CPT) is empirically supported for the treatment of PTSD, but it is not specifically designed to accommodate the memory, attention, or problem solving deficits that are experienced by many Veterans with comorbid PTSD and TBI. Compensatory cognitive rehabilitation, including cognitive symptom management and rehabilitation therapy (CogSMART), is effective for cognitive deficits stemming from a variety of etiologies, including TBI. We have integrated components of CogSMART into CPT in order to address the unique challenges faced by Veterans with ongoing cognitive complaints related to PTSD and a history of mild TBI. Here we describe an ongoing randomized controlled trial investigating the efficacy of our novel hybrid treatment, SMART-CPT, as compared to standard CPT, for OIF/OEF/OND Veterans with PTSD and a history of mild to moderate TBI. We describe the development of this hybrid treatment as well as implementation of the randomized controlled trial.
Psychology Service, VA San Diego Healthcare System, United States; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States. Electronic address: ajak@ucsd.edu.
Amy J
AJ
Jak
Laureate Institute for Brain Research, University of Tulsa, United States. Electronic address: raupperle@laureateinstitute.org.
Robin
R
Aupperle
Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States. Electronic address: carie.rodgers@va.gov.
Carie S
CS
Rodgers
Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States. Electronic address: ajlang@ucsd.edu.
Ariel J
AJ
Lang
Research Service, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, United States. Electronic address: dschiehser@ucsd.edu.
Dawn M
DM
Schiehser
Psychology Service, VA San Diego Healthcare System, United States; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States; National Center for PTSD, White River Junction, VT, United States. Electronic address: snorman@ucsd.edu.
Sonya B
SB
Norman
Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, United States; Department of Psychiatry, University of California, San Diego, United States. Electronic address: etwamley@ucsd.edu.
Elizabeth W
EW
Twamley
D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000150:complications / Q000628:therapy*; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D006801:Humans; D054542:Iraq War, 2003-2011; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D012107:Research Design; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D014728:Veterans / Q000523:psychology*
Cognitive processing therapy; Cognitive rehabilitation; PTSD; TBI; Treatment; Veterans