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Goal-Oriented Attentional Self-Regulation Training Improves Executive Function and Complex Attention in Veterans With
Rachel Santiago1, Maria Kryza-Lacombe2,3, Jillian Tessier1
1San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
Objective:
Mild traumatic brain injury (mTBI) is the most common brain injury. Some individuals experience ongoing cognitive, physical, and emotional complaints post-mTBI. Goal-Oriented Attentional Self-Regulation (GOALS) is a cognitive rehabilitation training that incorporates applied mindfulness-based attention regulation strategies into its protocol and targets executive control difficulties. This study expands previous work that demonstrated improved executive function, functional outcomes, and emotional functioning among veterans with acquired brain injury and examines GOALS training effects in veterans with a history of mTBI, specifically.
Method:
Veterans with a history of mTBI at least 6 months post-injury (N = 32) were randomly assigned to GOALS (n = 18) or an intensity-matched active control group (Brain Health Education [BHE] training; n = 14). Evaluator blinded assessments at baseline and post-intervention included neuropsychological and complex functional task performance, and self-report measures of emotional functioning/regulation.
Results:
GOALS, but not BHE, showed significant improvements on a composite measure of overall Attention/Executive Function composite, and on measures of Working Memory, Sustained Attention, Inhibition, and complex functional ability. There was also a significant decrease in post-traumatic stress disorder symptoms.
Conclusions:
GOALS training improved performance on neuropsychological and ecologically valid functional measures of complex attention and executive function, as well as emotional functioning in veterans with mTBI. Improving executive functions may also improve functioning in other domains such as emotional regulation and functional performance, making it particularly relevant for veterans with a history of mTBI and comorbid psychiatric symptoms.
