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。情绪识别的不足在创伤性脑损伤（TBI）和创伤后很常见 应激障碍（PTSD），但这些缺陷在轻度TBI（MTBI）和 PTSD。情绪低落与人际关系质量差有关，丧失 就业，行为问题，减少社会重返社会，社会隔离甚至自杀。现在 情绪识别没有干预措施在MTBI和PTSD的退伍军人中定义，干预措施 在患有严重TBI的平民中进行的表演缺乏对面部和声音情感认识的培训。在 面部和声音方式创新组合的初步研究，一种多模式识别 训练（MMART）显示出承诺，并在佛罗里达影响电池（Fab）方面有显着改善，但缺失 注意训练是识别我们日常情绪快速变化情绪的重要组成部分 居住。使用Brain HQ™的注意训练目标是情绪识别所需的注意因素。 鉴于需要通过MTBI和PTSD提高退伍军人的关系和生产力，这是一个随机的 需要对照试验来确定创新的MMART和注意力的有效性 训练以改善情绪识别和每天的功能。 客观和假设。这项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）与退伍军人的注意力训练相结合 TBI/PTSD。 假设1。MMART与注意训练的结合将显着提高 情绪识别。 假设2：治疗收益将转化为功能活动。 主要措施。佛罗里达州影响电池（FAB）和服务成员的社区重返社会（CRIS）。 次要措施。情感识别任务（ERT），可重复电池的注意指数 评估神经心理学地位（RBAN），连续的绩效任务和TBI质量 生活（TBI-QOL）参与社会角色和活动的能力。 方法。 20名具有MTBI和PTSD的退伍军人将被随机分配给组合训练或不活动 对照组。两组将在8周内参加16个小时的面对面课程。结果将是 在前，3个月后进行评估。线性回归将用于确定重要 对照组的治疗组改进了，t检验可在组内证明 改进。效应大小计算将用于确定未来优异提议所需的功率。 意义。这项研究使用了创新治疗，MMART+注意培训的新型组合 恢复有效情绪沟通所需的情绪识别和注意力过程 MTBI/PTSD的退伍军人。这项工作符合为退伍军人提供优质护理的关键VA RR＆D。 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。