SMART-CPT for veterans with comorbid post-traumatic stress disorder and history of traumatic brain injury: a randomised controlled trial
- PMID: 30554135
- DOI: 10.1136/jnnp-2018-319315
SMART-CPT for veterans with comorbid post-traumatic stress disorder and history of traumatic brain injury: a randomised controlled trial
Abstract
Objective: To better concurrently address emotional and neuropsychological symptoms common in veterans with comorbid post-traumatic stress disorder (PTSD) and history of traumatic brain injury (TBI), we integrated components of compensatory cognitive training from the Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) programme into cognitive processing therapy (CPT) for PTSD to create a hybrid treatment, SMART-CPT (CogSMART+CPT). This study compared the efficacy of standard CPT with SMART-CPT for treatment of veterans with comorbid PTSD and history of TBI reporting cognitive symptoms.
Methods: One hundred veterans with PTSD, a history of mild to moderate TBI and current cognitive complaints were randomised and received individually delivered CPT or SMART-CPT for 12 weeks. Participants underwent psychological, neurobehavioural and neuropsychological assessments at baseline, on completion of treatment and 3 months after treatment.
Results: Both CPT and SMART-CPT resulted in clinically significant reductions in PTSD and postconcussive symptomatology and improvements in quality of life. SMART-CPT resulted in additional improvements in the neuropsychological domains of attention/working memory, verbal learning/memory and novel problem solving.
Conclusion: SMART-CPT, a mental health intervention for PTSD, combined with compensatory cognitive training strategies, reduces PTSD and neurobehavioural symptoms and also provides added value by improving cognitive functioning.
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: None declared.
Similar articles
-
Worse baseline executive functioning is associated with dropout and poorer response to trauma-focused treatment for veterans with PTSD and comorbid traumatic brain injury.Behav Res Ther. 2018 Sep;108:68-77. doi: 10.1016/j.brat.2018.07.004. Epub 2018 Jul 19. Behav Res Ther. 2018. PMID: 30031369 Clinical Trial.
-
Evaluation of a hybrid treatment for Veterans with comorbid traumatic brain injury and posttraumatic stress disorder: Study protocol for a randomized controlled trial.Contemp Clin Trials. 2015 Nov;45(Pt B):210-216. doi: 10.1016/j.cct.2015.10.009. Epub 2015 Oct 21. Contemp Clin Trials. 2015. PMID: 26500169 Clinical Trial.
-
Psychological Symptoms and Rates of Performance Validity Improve Following Trauma-Focused Treatment in Veterans with PTSD and History of Mild-to-Moderate TBI.J Int Neuropsychol Soc. 2020 Jan;26(1):108-118. doi: 10.1017/S1355617719000997. Epub 2019 Oct 29. J Int Neuropsychol Soc. 2020. PMID: 31658923
-
The Efficacy of Cognitive Processing Therapy for PTSD Related to Military Sexual Trauma in Veterans: A Review.J Evid Based Soc Work (2019). 2019 Nov-Dec;16(6):595-614. doi: 10.1080/26408066.2019.1666767. Epub 2019 Nov 24. J Evid Based Soc Work (2019). 2019. PMID: 32459157 Review.
-
Psychological therapies for post-traumatic stress disorder and comorbid substance use disorder.Cochrane Database Syst Rev. 2016 Apr 4;4(4):CD010204. doi: 10.1002/14651858.CD010204.pub2. Cochrane Database Syst Rev. 2016. PMID: 27040448 Free PMC article. Review.
Cited by 5 articles
-
A systematic review on integrated care for traumatic brain injury, mental health, and substance use.PLoS One. 2022 Mar 3;17(3):e0264116. doi: 10.1371/journal.pone.0264116. eCollection 2022. PLoS One. 2022. PMID: 35239715 Free PMC article.
-
The Impact of Neurocognitive Functioning on the Course of Posttraumatic Stress Symptoms following Civilian Traumatic Brain Injury.J Clin Med. 2021 Oct 30;10(21):5109. doi: 10.3390/jcm10215109. J Clin Med. 2021. PMID: 34768628 Free PMC article.
-
Research Letter: PTSD Symptom Severity and Multiple Traumatic Brain Injuries Are Associated With Elevated Memory Complaints in Veterans With Histories of Mild TBI.J Head Trauma Rehabil. 2021 Nov-Dec 01;36(6):418-423. doi: 10.1097/HTR.0000000000000659. J Head Trauma Rehabil. 2021. PMID: 33656481 Free PMC article.
-
An Update on the Complexity and Importance of Accurately Diagnosing Post-Traumatic Stress Disorder and Comorbid Traumatic Brain Injury.Neurosci Insights. 2020 Mar 2;15:2633105520907895. doi: 10.1177/2633105520907895. eCollection 2020. Neurosci Insights. 2020. PMID: 32391522 Free PMC article. Review.
-
Pig Brains Have Homologous Resting-State Networks with Human Brains.Brain Connect. 2019 Sep;9(7):566-579. doi: 10.1089/brain.2019.0673. Epub 2019 Jun 24. Brain Connect. 2019. PMID: 31115245 Free PMC article.
Publication types
MeSH terms
Grant support
LinkOut - more resources
Full Text Sources
Medical