Innovative multimodal and attention training to improve emotion communication in Veterans with TBI and PTSD

创新的多模式和注意力训练可改善患有 TBI 和 PTSD 退伍军人的情感沟通

• 批准号: 10590170
• 负责人: Julia Kay Waid-Ebbs
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10590170
• 关键词: Address; Affect; Affective; Aftercare; Attention; Brain; Clinical; Cognitive; Communication; Complex; Control Groups; Deterioration; Development; Emotional; Emotions; Employment; Exhibits; Expressed Emotion; Face; Facial Expression; Florida; Functional disorder; Future; Hour; Image; Impairment; Interpersonal Relations; Intervention; Life; Linear Regressions; Loudness; Measures; Methods; Modality; Multiple Sclerosis; Neuropsychology; Outcome; Parkinson Disease; Participant; Performance; Persons; Post-Traumatic Stress Disorders; Problem behavior; Process; Productivity; Protocols documentation; Quality of Care; Quality of life; Randomized; Randomized, Controlled Trials; Rehabilitation therapy; Research Design; Resolution; Role; Sampling; Social Interaction; Social isolation; Stimulus; Stroke; Suicide; Task Performances; Testing; Time; Training; Translating; Traumatic Brain Injury; Veterans; Work; clinical care; cohort; community reintegration; effectiveness evaluation; efficacy study; experience; feasibility testing; improved; indexing; innovation; mild traumatic brain injury; multimodality; neurological rehabilitation; novel; response; selective attention; service member; showing emotion; social; social communication; sustained attention; treatment effect; treatment group; treatment response; trend; verbal

Background. Deficits in emotion recognition are common in traumatic brain injury (TBI) and in post-traumatic stress disorder (PTSD) but these deficits have not been well studied in Veterans with both mild TBI (mTBI) and PTSD. Poor emotion recognition has been associated with poor quality of interpersonal relationships, loss of employment, behavioral problems, reduced social reintegration, social isolation and even suicide. Currently there are no interventions for emotion recognition deficits in Veterans with mTBI and PTSD, and interventions conducted in civilians with severe TBI have lacked training of both facial and vocal emotion recognition. In a preliminary study of an innovative combination of facial and vocal modalities, a multimodal affect recognition training (MMART) showed promise with significant improvement on the Florida Affect Battery (FAB) but lacked attention training that is an essential component in recognizing rapidly changing emotions in our everyday lives. Attention training using Brain HQ™ targets the required attention factors underlying emotion recognition. Given the need to improve relationships and productivity in Veterans with mTBI and PTSD, a randomized controlled trial is needed to determine the effectiveness of an innovative MMART combined with attention training to improve emotion recognition and everyday function. Objective & Hypotheses. The objective of this randomized controlled trial is to determine the treatment effect of a MultiModal Affect Recognition Training (MMART) combined with attention training in Veterans with TBI/PTSD. Hypothesis 1. MMART combined with attention training will significantly improve performance on tests of emotion recognition. Hypothesis 2: Treatment gains will translate to functional activities. Primary measures. Florida Affect Battery (FAB) and the Community Reintegration in Service members (CRIS). Secondary measures. Emotion Recognition Task (ERT), attention index of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Continuous Performance Task and the TBI Quality of Life (TBI-QOL) Ability to Participate in Social Roles and Activities. Methods. 20 Veterans with mTBI and PTSD will be randomized to either the combined training or an inactive control group. Both groups will attend 16, one-hour in-person sessions over 8 weeks. Outcomes will be assessed at pre-, post-, 3 month-post-treatment. A linear regression will be used to determine significant improvement of the treatment group over the control group, with t-tests to demonstrate within group improvement. Effect size calculations will be used to determine the power needed for a future Merit proposal. Significance. This study uses a novel combination of an innovative treatment, MMART+ Attention Training to restore the emotion recognition and attentional processes required for effective emotion communication in Veterans with mTBI/PTSD. This work meets a key VA RR&D priority of providing quality care to Veterans. Positive study results will guide the development of a future Merit to improve the quality of life for Veterans with emotion recognition deficits.

背景：情绪识别缺陷在创伤性脑损伤 (TBI) 和创伤后中很常见。 应激障碍 (PTSD)，但这些缺陷尚未在患有轻度 TBI (mTBI) 和轻度 TBI 的退伍军人中得到充分研究。 创伤后应激障碍（PTSD）情绪识别能力差与人际关系质量差、丧失能力有关。 目前，就业、行为问题、重返社会减少、社会孤立甚至自杀。 对于患有 mTBI 和 PTSD 的退伍军人的情绪识别缺陷没有干预措施，并且干预措施 对患有严重 TBI 的平民进行的研究缺乏面部和声音情感识别的训练。 面部和声音模式创新组合的初步研究，多模式情感识别 训练（MMART）显示出对佛罗里达情感电池（FAB）显着改善的希望，但缺乏 注意力训练是识别日常生活中快速变化的情绪的重要组成部分 使用 Brain HQ™ 进行注意力训练的目标是情绪识别所需的注意力因素。 鉴于需要改善患有 mTBI 和 PTSD 的退伍军人的关系和生产力，随机 需要对照试验来确定创新 MMART 与注意力相结合的有效性 旨在提高情绪识别和日常功能的培训。 目的和假设 该随机对照试验的目的是确定治疗效果。 多模式情感识别训练 (MMART) 与退伍军人注意力训练相结合 创伤性脑损伤/创伤后应激障碍。 假设 1. MMART 与注意力训练相结合将显着提高测试成绩 情感识别。 假设 2：治疗效果将转化为功能活动。 主要措施：佛罗里达州影响电池组 (FAB) 和服役人员社区重返社会 (CRIS)。 次要措施：情绪识别任务（ERT）、可重复电池的注意力指数。 神经心理状态评估 (RBANS)、连续执行任务和 TBI 质量 生活 (TBI-QOL) 参与社会角色和活动的能力。 方法 20 名患有 mTBI 和 PTSD 的退伍军人将被随机分配到联合训练组或非活动训练组。 对照组将在 8 周内参加 16 场为期一小时的面对面会议。 在治疗前、治疗后、治疗后 3 个月进行评估，将使用线性回归来确定显着性。 治疗组相对于对照组的改善，通过组内 t 检验进行证明 效果大小计算将用于确定未来优点提案所需的功率。 意义 本研究采用创新疗法 MMART+ 注意力训练的新颖组合来 恢复有效情绪沟通所需的情绪识别和注意力过程 患有 mTBI/PTSD 的退伍军人 这项工作满足了 VA RR&D 为退伍军人提供优质护理的关键优先事项。 积极的研究结果将指导未来优点的发展，以改善退伍军人的生活质量 情绪识别缺陷。