H - 31 Stress and Cognitive Symptoms among Community-Based Survivors of Mild to Moderate Traumatic Brain Injury: Findings from a Group Cognitive Rehabilitation Program.

Abstract

The current study evaluates a 12-week cognitive rehabilitation program for community-dwelling survivors of traumatic brain injury (TBI). The objective was to assess the feasibility and effects of a scalable, cost-effective group intervention. The present study was a quasi-experimental, within-subjects design that assessed survivors at baseline, week five, week nine, and week 12. Participants were survivors of brain injury of various etiologies, but only survivors of mild to moderate TBI who completed the full program (n = 12) were analyzed. Neuropsychiatric self-reported data were collected to evaluate the relationship between affective and cognitive symptoms in response to directed psychoeducation delivered within a group psychotherapeutic framework. A relationship in the rates of change between affective and cognitive post-concussion symptoms was hypothesized. Moreover, improvements in neuropsychological scores (RBANS) were hypothesized in all five domains. A panel regression revealed that slopes of stress symptoms, and not depression or anxiety symptoms, predicted the rate of change in post-concussive cognitive symptoms. Non-parametric analyses of ordinal trends revealed a significant decoupling of the association between stress symptoms and cognitive symptoms over the intervention period. Only improvements in memory performances were revealed. Qualitative focus groups were analyzed for themes to potentially explain the mechanism of change. Findings provide support for this program as a feasible cost-effective group modality for psychosocial cognitive training following mild to moderate TBI.