Citation

Bombardier CH, Fann JR, Ludman EJ, Vannoy SD, Dyer JR, Barber JK, Temkin NR. J. Head Trauma Rehabil. 2017; 32(5): 343-353.

Affiliation

Department of Rehabilitation Medicine, University of Washington, Seattle (Drs Bombardier and Dyer); Departments of Psychiatry and Behavioral Sciences, Rehabilitation Medicine and Epidemiology, University of Washington, Seattle (Dr Fann); Group Health Research Institute, Seattle, Washington (Dr Ludman); Counseling and School Psychology, University of Massachusetts, Boston (Dr Vannoy); Department of Neurological Surgery, University of Washington, Seattle (Mr Barber); and Department of Neurological Surgery and Biostatistics, University of Washington, Seattle (Dr Temkin).

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000288

PMID

28195952

Abstract

OBJECTIVE: To explore the relations of cognitive, behavioral, and physical activity variables to depression severity among people with traumatic brain injury (TBI) undergoing a depression treatment trial. SETTING: Community. PARTICIPANTS: Adults (N = 88) who sustained complicated mild to severe TBI within the past 10 years, met criteria for major depressive disorder, and completed study measures.

DESIGN: Randomized controlled trial.

METHODS: Participants were randomized to cognitive-behavioral therapy (n = 58) or usual care (n = 42). Outcomes were measured at baseline and 16 weeks. We combined the groups and used regressions to explore the relations among theoretical variables and depression outcomes. MAIN MEASURES: Depression severity was measured with the Hamilton Depression Rating Scale and Symptom Checklist-20. Theory-based measures were the Dysfunctional Attitudes Scale (DAS), Automatic Thoughts Questionnaire (ATQ), Environmental Rewards Observation Scale (EROS), and the International Physical Activity Questionnaire (IPAQ).

RESULTS: Compared with non-TBI norms, baseline DAS and ATQ scores were high and EROS and IPAQ scores were low. All outcomes improved from baseline to 16 weeks except the DAS. The ATQ was an independent predictor of baseline depression. An increase in EROS scores was correlated with decreased depression.

CONCLUSIONS: Increasing participation in meaningful roles and pleasant activities may be a promising approach to treating depression after TBI.

Language: en