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CONTEXT:Current therapies for traumatic brain injury (TBI) include pharmacotherapy, psychotherapy, and cognitive rehabilitation. Unfortunately, psychological and emotional issues regularly go untreated in individuals with TBI even after they receive treatment for physical, behavioral, and cognitive issues. Mindfulness-based cognitive therapy (MBCT) may offer new rehabilitation opportunities for individuals with TBI.
OBJECTIVE:
To demonstrate the efficacy of MBCT in the treatment of clinically diagnosed depression in a TBI population.
DESIGN:
The research team measured depression, pain frequency and intensity, energy levels, health status, and function preintervention and postintervention.
SETTING:
The research team conducted the study at the Ottawa Hospital Rehabilitation Centre, Ontario, Canada.
PARTICIPANTS:
The research team recruited 23 participants from two sources: (1) the brain injury program at the hospital and (2) the local head-injury association. Twenty participants completed the study.
INTERVENTION:
The intervention was 8 weeks in length, with a 90-minute MBCT session once a week. The research team based the specific content of the study's intervention on a combination of Kabat-Zinn's manualized mindfulness-based stress reduction program and Segal and colleague's manual for MBCT.
OUTCOME MEASURES:
The research team determined statistical significance using paired t-tests for continuous outcomes and the McNemar chi-square test for dichotomous categorical outcomes. They also calculated effect sizes for all depression measures.
RESULTS:
Postintervention, the study found that MBCT significantly reduced (P < .050) depression symptoms on all scales compared to baseline. The study demonstrated medium to large effect sizes for each depression measure. Participants indicated reduced pain intensity (P = .033) and increased energy levels (P = .004). No significant changes occurred in anxiety symptoms, pain frequency, and level of functioning postintervention.
CONCLUSION:
MBCT was efficacious in reducing depression in the TBI population, providing ample rationale for further research with more robust designs. This study marks an important step toward the development and provision of MBCT on a wider scale to support the rehabilitation efforts of people who have depression symptoms following TBI.
CONTEXT:Current therapies for traumatic brain injury (TBI) include pharmacotherapy, psychotherapy, and cognitive rehabilitation. Unfortunately, psychological and emotional issues regularly go untreated in individuals with TBI even after they receive treatment for physical, behavioral, and cognitive issues. Mindfulness-based cognitive therapy (MBCT) may offer new rehabilitation opportunities for individuals with TBI.
OBJECTIVE:
To demonstrate the efficacy of MBCT in the treatment of clinically diagnosed depression in a TBI population.
DESIGN:
The research team measured depression, pain frequency and intensity, energy levels, health status, and function preintervention and postintervention.
SETTING:
The research team conducted the study at the Ottawa Hospital Rehabilitation Centre, Ontario, Canada.
PARTICIPANTS:
The research team recruited 23 participants from two sources: (1) the brain injury program at the hospital and (2) the local head-injury association. Twenty participants completed the study.
INTERVENTION:
The intervention was 8 weeks in length, with a 90-minute MBCT session once a week. The research team based the specific content of the study's intervention on a combination of Kabat-Zinn's manualized mindfulness-based stress reduction program and Segal and colleague's manual for MBCT.
OUTCOME MEASURES:
The research team determined statistical significance using paired t-tests for continuous outcomes and the McNemar chi-square test for dichotomous categorical outcomes. They also calculated effect sizes for all depression measures.
RESULTS:
Postintervention, the study found that MBCT significantly reduced (P < .050) depression symptoms on all scales compared to baseline. The study demonstrated medium to large effect sizes for each depression measure. Participants indicated reduced pain intensity (P = .033) and increased energy levels (P = .004). No significant changes occurred in anxiety symptoms, pain frequency, and level of functioning postintervention.
CONCLUSION:
MBCT was efficacious in reducing depression in the TBI population, providing ample rationale for further research with more robust designs. This study marks an important step toward the development and provision of MBCT on a wider scale to support the rehabilitation efforts of people who have depression symptoms following TBI.
OBJECTIVE:We sought to determine if we could reduce symptoms of depression in individuals with a traumatic brain injury using mindfulness-based cognitive therapy.
SETTING:
The study was conducted in a community setting.
PARTICIPANTS:
We enrolled adults with symptoms of depression after a traumatic brain injury.
DESIGN:
We conducted a randomized controlled trial; participants were randomized to the 10-week mindfulness-based cognitive therapy intervention arm or to the wait-list control arm.
MAIN MEASURES:
The primary outcome measure was symptoms of depression using the Beck Depression Inventory-II.
RESULTS:
The parallel group analysis revealed a greater reduction in Beck Depression Inventory-II scores for the intervention group (6.63, n = 38,) than the control group (2.13, n = 38, P = .029). A medium effect size was observed (Cohen d = 0.56). The improvement in Beck Depression Inventory-II scores was maintained at the 3-month follow-up.
CONCLUSION:
These results are consistent with those of other researchers that use mindfulness-based cognitive therapy to reduce symptoms of depression and suggest that further work to replicate these findings and improve upon the efficacy of the intervention is warranted.
OBJECTIVE:We sought to determine if we could reduce symptoms of depression in individuals with a traumatic brain injury using mindfulness-based cognitive therapy.
SETTING:
The study was conducted in a community setting.
PARTICIPANTS:
We enrolled adults with symptoms of depression after a traumatic brain injury.
DESIGN:
We conducted a randomized controlled trial; participants were randomized to the 10-week mindfulness-based cognitive therapy intervention arm or to the wait-list control arm.
MAIN MEASURES:
The primary outcome measure was symptoms of depression using the Beck Depression Inventory-II.
RESULTS:
The parallel group analysis revealed a greater reduction in Beck Depression Inventory-II scores for the intervention group (6.63, n = 38,) than the control group (2.13, n = 38, P = .029). A medium effect size was observed (Cohen d = 0.56). The improvement in Beck Depression Inventory-II scores was maintained at the 3-month follow-up.
CONCLUSION:
These results are consistent with those of other researchers that use mindfulness-based cognitive therapy to reduce symptoms of depression and suggest that further work to replicate these findings and improve upon the efficacy of the intervention is warranted.
Mindfulness-based interventions (MBIs) improve depression symptoms after traumatic brain injury (TBI), with medium to large effect sizes. The goal of this study was to determine the clinical significance of individual changes in depression symptoms by examining data from three studies. Three criteria were used to assess the clinical significance of pre- to post-treatment change in Beck Depression Inventory-II (BDI-II) scores: (1) reliable change to account for measurement error, (2) five-point change to detect minimally important clinical differences, and (3) severity change to measure the severity of depression symptoms. The number of participants who met all three of these criteria (i.e., the three-criterion standard) was calculated for (a) all MBI participants across the three studies (N = 90) and for (b) only participants who completed the randomized controlled trial (study 3). According to the three-criterion standard, 50 % of TBI participants had BDI-II scores that clinically improved (45/90) and none had scores that deteriorated. When this standard was applied to study 3, more participants in the treatment group (20/38) had improved scores compared to controls (13/38). The majority of all participants also showed clinically improved BDI-II scores according to each of the separate criteria: reliable change (64/90), five-point change (49/90), and severity change (51/90). We suggest that (a) the three-criterion standard be considered the gold standard for assessing treatment-related change in depression symptoms, and (b) reporting the clinical significance of individual change may be more informative to clinicians when assessing the impact of MBIs on clients with TBI compared to findings based exclusively on group averages.