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Self-efficacy predicts response to cognitive rehabilitation in military service members with post-concussive symptoms
Neuropsychological Rehabilitation (2020)
  • Heather G. Belanger, University of South Florida
  • Rodney D. Vanderploeg, University of South Florida
  • Glenn Curtiss, University of South Florida
  • Patrick Armistead-Jehle, Concussion Clinic, Munson Army Health Center, Fort Leavenworth, KS, USA
  • Jan E. Kennedy, Department of Rehabilitation Medicine, Brooke Army Medical Center (BAMC)
  • David F. Tate, University of Utah
  • Blessen C. Eapen, University of Texas at Austin
  • Amy O. Bowles, Uniformed Services University of the Health Sciences
  • Douglas B. Cooper, University of Texas Health Science Center at San Antonio
Abstract
This study examined whether self-efficacy differentiated treatment responders from non-responders in a trial of cognitive rehabilitation (CR) for postconcussive symptoms. 126 service members with mild TBI seen on average 9.5 months since injury completed one of four cognitive rehabilitation treatments for 6 weeks. The four treatment arms were: (1) Psychoeducation control, (2) Self-administered computerized CR, (3) Interdisciplinary CR, and (4) Interdisciplinary CR integrated with CBT. Outcome was assessed across time (baseline, and 6, 12, and 18 weeks post-treatment) for three domains: psychological (Symptom Checklist–90-Revised; SCL-90-R), cognitive (Paced Auditory Serial Addition Test; PASAT), and functional/behavioural (Key Behaviors Change Inventory; KBCI). Mixed model ANOVAs tested for self-efficacy differences across time in treatment responders versus non-responders, as defined by reliable change indices. A significant interaction was found on the SCL-90 such that responders had increasing self-efficacy with respect to psychological symptoms across four time points, whereas non-responders’ self-efficacy did not change. Perceived self-efficacy at the beginning of treatment was associated with treatment engagement within the psychological domain for responders only, suggesting a mediating role in treatment outcome. Overall, results suggest that increasing patients’ level of self-efficacy may be important for successful treatment of psychological distress in those with remote concussion.
Keywords
  • Concussion,
  • Rehabilitation,
  • Self-efficacy,
  • Traumatic brain injury
Publication Date
July 2, 2020
DOI
10.1080/09602011.2019.1575245
Citation Information
Heather G. Belanger, Rodney D. Vanderploeg, Glenn Curtiss, Patrick Armistead-Jehle, et al.. "Self-efficacy predicts response to cognitive rehabilitation in military service members with post-concussive symptoms" Neuropsychological Rehabilitation Vol. 30 Iss. 6 (2020) p. 1190 - 1203
Available at: http://works.bepress.com/tate-david/75/