Improving Cognitive Rehabilitation Outcomes for Veterans With mTBI+PTSD
Posttraumatic stress disorder (PTSD) and mild TBI (mTBI) frequently co-occur in post-9/11 Veterans, and together are associated with worse cognitive performance, mental health, everyday functioning, community integration, quality of life, and treatment response than either condition alone. Additional comorbidities, such as depression and sleep disturbance, are common and further exacerbate these problems. The investigators will investigate Compensatory Cognitive Training (CCT) and Morning Bright Light Therapy (MBLT) vs Negative Ion Generator (ION), to directly target cognition, depression, and sleep disturbance and to improve CCT-associated rehabilitation outcomes. The investigator's randomized controlled trial in 144 Veterans with mTBI+PTSD across two VA sites will compare cognition, functioning, and other secondary outcomes following CCT+MBLT vs. CCT+ION. This study addresses the significant gap in services and evidence-based treatments for Veterans with mTBI+PTSD.
• Post 9/11 Veterans enrolled at VA San Diego or VA Portland
• Ability to provide informed consent
• Living independently
• History of mTBI confirmed by OSU-TBI
• Current diagnosis of PTSD confirmed by CAPS-5
• Current cognitive concerns (Do you have concerns about your cognition, thinking, attention, or memory?)
• Current concern regarding depression and/or sleep disturbance; defined by a score of 5 on the PHQ-9 and/or 8 on the ISI, respectively (score of 2 or higher on ISI item 1, 2, or 3, reflecting at least moderate difficulty with falling asleep, staying asleep, or waking up too early in the morning)