Military and Veterans Affairs
The objective of this randomized control crossover study with a follow up evaluation 6+ months post completion of Goal-Oriented Attentional Self-Regulation (GOALS) executive function training was to examine longer term effectiveness of GOALS training in Veterans with comorbid PTSD and mild TBI (mTBI).
32 Veterans witha current diagnosis of PTSD and history of chronic mTBI completed follow-up evaluation 6+ months after completing GOALS training.
Immediately after GOALS, but not control training, participants significantly improved from baseline on:1) measures of attention/executive function; 2) complex functional task performance; and 3) on emotional regulation self-report measures: PTSD symptoms on PCL-M; and depression symptoms on BDI-II.
At follow-up evaluation 6+ months post GOALS training, majority of participants (96%) reported incorporating some trained strategies into their daily life. Participants maintained significant improvements relative to their baseline on: 1) measures of attention/executive function (overall neuropsychological attention/executive function domain score, and following subdomains: working memory, mental flexibility, sustained attention, inhibition and memory); 2) complex functional task performance (overall performance score and subdomains of: planning, self-monitoring, task execution, attentional maintenance and switching, and memory); and 3) emotional regulation self- report measures (PTSD symptoms on PCL-M; and depression symptoms on BDI-II).
Training in attention regulation applied to participant-defined goals may contribute to meaningful long-term improvement in cognitive skills, emotion regulation and daily functioning in Veterans with comorbid PTSD/mTBI. The characteristics of participants that appeared to benefit most, as well as intervention techniques considered important in the transfer of training to participant’s daily lives will be discussed.