Mild Traumatic Brain Injury Clinical Trial
Official title:
Prevention of Persistent Post-concussion Syndrome With Cognitive-behavioural Therapy in At-risk Patients
This study investigates how well a new therapy program prevents persistent symptoms (e.g., headaches, fatigue, irritability, etc.) after concussion. The program involves examining beliefs about concussion and learning healthy coping strategies, and is completed with the first three months post-injury.
Although the majority of patients with mild traumatic brain injury (MTBI) experience complete
recovery within three months, a sizeable group continues to report frequent and severe
symptoms such as headaches, fatigue, difficulty concentrating, forgetfulness, and
irritability, in what is labeled persistent post-concussion syndrome (PCS). Persistent PCS is
associated with vocational, recreational, and social disability. Early education and
reassurance (treatment as usual) is effective in general, but appears insufficient for this
subgroup.
Recent research has identified risk factors for persistent PCS, including inaccurate illness
beliefs, maladaptive coping behaviour, and emotional distress. The present study will
evaluate the additive efficacy of a cognitive-behavioural therapy protocol designed to modify
these risk factors, over and above treatment as usual.
Participants with MTBI will be recruited within six weeks of injury. Those identified as
being at-risk for persistent PCS based on evidence-based criteria will receive treatment as
usual and then be randomly assigned to receive either no further intervention or
cognitive-behavioural therapy. We hypothesize that the group receiving cognitive-behavioural
therapy will have fewer PCS symptoms and be less disabled at follow-up. We also hypothesize
that compensation-seeking status will mitigate this improvement and that illness beliefs,
coping behaviour, and emotional distress will mediate this improvement. A blinded rater will
conduct the baseline and outcome assessments.
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