An Open-Label Feasibility Trial Examining the Effectiveness of a Cognitive Training Program, Goal Management Training, in Individuals With Posttraumatic Stress Disorder.

Q1 Psychology Chronic Stress Pub Date : 2019-04-18 eCollection Date: 2019-01-01 DOI:10.1177/2470547019841599

Jenna E Boyd, Charlene O'Connor, Alina Protopopescu, Rakesh Jetly, Shawn G Rhind, Ruth A Lanius, Margaret C McKinnon

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Abstract

Background: Posttraumatic stress disorder (PTSD) is associated with dysfunction across multiple cognitive domains including executive functioning, attention, and verbal memory. This dysfunction is associated with negative impacts on functional outcomes (e.g., work or social functioning) and reduced response to psychotherapy for PTSD. Despite this knowledge, little work has investigated the efficacy of cognitive remediation strategies in improving cognition and functional outcomes among individuals with PTSD.

Objective: The current study investigated the efficacy of an established cognitive remediation program, Goal Management Training (GMT), in improving cognitive functioning in a pilot sample of individuals with PTSD symptoms in an inpatient treatment setting.

Method: Thirty-four inpatients with PTSD symptoms participated in either GMT in addition to treatment as usual (TAU; consisting of psychiatric management, group and individual psychotherapy) (TAU+GMT; n = 18) or TAU alone (n = 16). The TAU+GMT group received neuropsychological assessment at baseline and posttreatment, while both the TAU+GMT and TAU groups received assessment with clinical self-report measures at baseline and posttreatment.

Results: Paired-sample t-tests revealed significant improvements on measures of executive functioning (e.g., response inhibition, cognitive flexibility), processing speed, sustained attention, and verbal memory in the TAU+GMT group. Mixed-design analyses of variance (ANOVAs) revealed a trend toward an interaction effect indicating potentially greater improvements on a measure of the ability to engage in goal-directed behaviors while highly emotional in the TAU+GMT group as compared to the TAU group.

Discussion: The results of this small feasibility investigation of GMT in PTSD point toward the potential efficacy of GMT in ameliorating cognitive difficulties in individuals with PTSD.

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一项开放标签可行性试验，检查认知训练计划，目标管理训练对创伤后应激障碍个体的有效性。

背景:创伤后应激障碍(PTSD)与多个认知领域的功能障碍有关，包括执行功能、注意力和言语记忆。这种功能障碍与对功能结果(如工作或社会功能)的负面影响以及对PTSD心理治疗的反应降低有关。尽管有这些知识，很少有研究调查认知补救策略在改善PTSD患者认知和功能结果方面的功效。目的:目前的研究调查了一项既定的认知修复计划，目标管理训练(GMT)，在改善住院治疗环境中PTSD症状个体的认知功能方面的疗效。方法:34例有创伤后应激障碍症状的住院患者在常规治疗的基础上进行GMT治疗(TAU;包括精神管理、团体和个人心理治疗)(TAU+GMT;n = 18)或单独使用TAU (n = 16)。TAU+GMT组在基线和治疗后接受神经心理评估，TAU+GMT组和TAU组在基线和治疗后均接受临床自我报告评估。结果:配对样本t检验显示，TAU+GMT组在执行功能(如反应抑制、认知灵活性)、处理速度、持续注意力和言语记忆方面有显著改善。混合设计方差分析(anova)揭示了一种相互作用的趋势，表明与TAU组相比，TAU+GMT组在高度情绪化的情况下，在参与目标导向行为的能力方面可能有更大的改善。讨论:GMT治疗创伤后应激障碍的小型可行性调查结果表明，GMT治疗在改善创伤后应激障碍患者认知困难方面具有潜在功效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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