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Utility of in-session assessments during cognitive behavioral therapy for depression after traumatic brain injury: Results from a randomized controlled trial.
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- Author(s): Erickson, Jennifer M.; Williams, Ryan; Bombardier, Charles H.; Fann, Jesse R.
- Source:
NeuroRehabilitation; 2024, Vol. 54 Issue 2, p245-257, 13p- Subject Terms:
PREDICTION models; SECONDARY analysis; GRAPHIC arts; DIAGNOSTIC imaging; RESEARCH funding; FATIGUE (Physiology); QUESTIONNAIRES; TREATMENT effectiveness; AFFECTIVE disorders; APPETITE; DESCRIPTIVE statistics; ANHEDONIA; TELEPHONES; RESEARCH methodology; SLEEP; CONVALESCENCE; BRAIN injuries; COGNITIVE therapy; MENTAL depression; PREDICTIVE validity; EVALUATION; DISEASE complications - Source:
- Additional Information
- Subject Terms:
- Abstract: BACKGROUND: The development of depression after moderate to severe traumatic brain injury (TBI) is common. Cognitive-behavioral therapy (CBT) can be used to treat post-TBI depression, but the symptoms response is poorly described. OBJECTIVE: This secondary analysis assessed: (1) the trajectory of depression symptoms up to 12 sessions of CBT, (2) which depressive symptom clusters were responsive to in-person and phone CBT, and (3) whether interim depression thresholds predict 16-week treatment response. METHOD: This secondary analysis of the IRB-approved Life Improvement Following Traumatic Brain Injury trial included 100 adults with major depressive disorder (MDD) within ten years of moderate to severe traumatic brain injury from throughout the US. We used a combination of descriptive, graphical, and diagnostic accuracy methods. RESULTS: Cardinal and cognitive-affective symptom clusters improved most from CBT over 16 weeks. At 8 and 16 weeks, the most responsive individual symptoms were anhedonia, depressed mood, and fatigue; the least responsive were sleep and appetite. PHQ-9 thresholds with a Negative Predictive Value greater than 0.7 for sessions 6, 7, and 8 were, respectively: >15, >10, and >9. CONCLUSION: In-person and phone CBT led to similar symptom responses during treatment. Additionally, using PHQ-9 thresholds for predicting intervention response within eight sessions may help identify the need for treatment adjustments. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of NeuroRehabilitation is the property of IOS Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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