United States Department of Veterans Affairs

Volume 47 Number 1, 2010
Pages 43 — 60

Abstract — A pilot study examining effects of group-based Cognitive Strategy Training treatment on self-reported cognitive problems, psychiatric symptoms, functioning, and compensatory strategy use in OIF/OEF combat veterans with persistent mild cognitive disorder and history of traumatic brain injury

Marilyn Huckans, PhD;1-3* Shital Pavawalla, PhD;4-5 Theresa Demadura, MA;2 Michael Kolessar, MS;1,6 Adriana Seelye, MS;4 Noah Roost, PhD;2 Elizabeth W. Twamley, PhD;7-8 Daniel Storzbach, PhD1-2

1Research Division and 2Behavioral Health and Clinical Neurosciences Division, Portland Department of Veterans Affairs (VA) Medical Center, Portland, OR; 3Department of Psychiatry, Oregon Health and Science University, Portland, OR; 4Department of Psychology, Washington State University, Pullman, WA; 5Psychology Services, VA Palo Alto Health Care System, Palo Alto, CA; 6School of Professional Psychology, Pacific University, Portland, OR; 7VA San Diego Healthcare System, San Diego, CA; 8Department of Psychiatry, University of California, San Diego, La Jolla, CA

Abstract — We aimed to determine whether group-based Cognitive Strategy Training (CST) for combat veterans with mild cognitive disorder and a history of traumatic brain injury (TBI) has significant posttreatment effects on self-reported compensatory strategy usage, functioning, and psychiatric symptoms. Participants included 21 veterans returning from conflicts in Iraq or Afghanistan with a diagnosis of Cognitive Disorder, Not Otherwise Specified and a history of combat-related TBI. Participants attended 6- to 8-week structured CST groups designed to provide them training in and practice with a variety of compensatory cognitive strategies, including day planner usage. Of the participants, 16 completed pre- and posttreatment assessment measures. Following CST, participants reported significantly increased use of compensatory cognitive strategies and day planners; an increased perception that these strategies were useful to them; increased life satisfaction; and decreased depressive, memory, and cognitive symptom severity. Group-based CST is a promising intervention for veterans with mild cognitive disorder, and randomized controlled trials are required to further evaluate its efficacy.

Key words: blast injury, cognitive aids, cognitive rehabilitation, combat veterans, compensatory strategies, Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), postconcussive syndrome, posttraumatic stress disorder, traumatic brain injury.

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