Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T20:45:16.976Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy of motivational interviewing and cognitive behavioral therapy for anxiety and depression symptoms following traumatic brain injury

Published online by Cambridge University Press:  28 December 2015

J. Ponsford ,
N. K. Lee ,
D. Wong ,
A. McKay ,
K. Haines ,
Y. Alway ,
M. Downing ,
C. Furtado  and
M. L. O'Donnell
J. Ponsford*
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
N. K. Lee
Affiliation:
National Centre for Education and Training on Addiction, Flinders University, SA, Australia National Drug Research Institute, Curtin University, WA, Australia
D. Wong
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
A. McKay
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
K. Haines
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
Y. Alway
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
M. Downing
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
C. Furtado
Affiliation:
Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
M. L. O'Donnell
Affiliation:
Phoenix Australia, University of Melbourne, Victoria, Australia
*
*Address for correspondence: Professor J. Ponsford, Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Monash University, Clayton, Victoria 3800, Australia. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Anxiety and depression are common following traumatic brain injury (TBI), often co-occurring. This study evaluated the efficacy of a 9-week cognitive behavioral therapy (CBT) program in reducing anxiety and depression and whether a three-session motivational interviewing (MI) preparatory intervention increased treatment response.

Method

A randomized parallel three-group design was employed. Following diagnosis of anxiety and/or depression using the Structured Clinical Interview for DSM-IV, 75 participants with mild-severe TBI (mean age 42.2 years, mean post-traumatic amnesia 22 days) were randomly assigned to an Adapted CBT group: (1) MI + CBT (n = 26), or (2) non-directive counseling (NDC) + CBT (n = 26); or a (3) waitlist control (WC, n = 23) group. Groups did not differ in baseline demographics, injury severity, anxiety or depression. MI and CBT interventions were guided by manuals adapted for individuals with TBI. Three CBT booster sessions were provided at week 21 to intervention groups.

Results

Using intention-to-treat analyses, random-effects regressions controlling for baseline scores revealed that Adapted CBT groups (MI + CBT and NDC + CBT) showed significantly greater reduction in anxiety on the Hospital Anxiety and Depression Scale [95% confidence interval (CI) −2.07 to −0.06] and depression on the Depression Anxiety and Stress Scale (95% CI −5.61 to −0.12) (primary outcomes), and greater gains in psychosocial functioning on Sydney Psychosocial Reintegration Scale (95% CI 0.04–3.69) (secondary outcome) over 30 weeks post-baseline relative to WC. The group receiving MI + CBT did not show greater gains than the group receiving NDC + CBT.

Conclusions

Findings suggest that modified CBT with booster sessions over extended periods may alleviate anxiety and depression following TBI.

Keywords

Anxietycognitive behavioral therapydepressionmotivational interviewingtraumatic brain injury
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 5 , April 2016 , pp. 1079 - 1090
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arkowitz, H, Westra, HA, Miller, WR, Rollnick, S (Eds) (2008). Motivational Interviewing in the Treatment of Psychological Problems. Guilford Press: New York.Google Scholar
Ashman, T, Cantor, JB, Tasaosides, T, Spielman, L, Gordon, W (2014). Comparison of cognitive behavior therapy and supportive psychotherapy for treatment of depression following traumtic brain injury: a randomized controlled trial. Journal of Head Trauma Rehabilitation 29, 467–478.CrossRefGoogle Scholar
Baker, A, Lee, NK, Claire, M, Lewin, TJ, Grant, T, Pohlman, S, Saunders, JB, Kay-Lambkin, F, Constable, P, Carr, VJ (2005). Brief cognitive behavioural interventions for regular amphetamine users: a step in the right direction. Addiction 100, 367–378.CrossRefGoogle ScholarPubMed
Beck, AT, Rush, AJ, Shaw, BF, Emery, G (1979). Cognitive Therapy of Depression. Guilford: New York.Google Scholar
Beck, JG (1995). Cognitive Therapy: Basics and Beyond. Guilford Press: New York, USA.Google Scholar
Bedard, M, Felteau, M, Marshall, S, Cullen, N, Gibbons, C, Dubois, S, Maxwell, H, Mazmanian, D, Weaver, B, Rees, L, Gainer, R, Klein, R, Moustgaard, A (2014). Mindfulness-based cognitive therapy reduces symptoms of depression in people with a traumatic brain injury: results from a randomized controlled trial. Journal of Head Trauma Rehabilitation 29, E13–E22.CrossRefGoogle ScholarPubMed
Bombardier, CH, Fann, JR, Temkin, NR, Esselman, PC, Barber, J, Dikmen, SS (2010). Rates of major depressive disorder and clinical outcomes following traumatic brain injury. Journal of the American Medical Association 303, 1938–1945.CrossRefGoogle ScholarPubMed
Bryant, RA, Moulds, M, Guthrie, R, Nixon, RD (2003). Treating acute stress disorder following mild traumatic brain injury. American Journal of Psychiatry 160, 585–587.CrossRefGoogle ScholarPubMed
Butler, AC, Chapman, JE, Forman, EM, Beck, AT (2006). The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clinical Psychology Review 26, 17–31.CrossRefGoogle ScholarPubMed
Carroll, KM, Ball, SA, Nich, C, Martino, S, Frankforter, TL, Farentinos, C, Lynn, E, Mikulich-Gilbertson, SK, Morgenstern, J, Obert, JL, Polcin, D, Snead, N, Woody, GE, the National Institute on Drug Abuse Clinical Trials Network (2006). Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study. Drug and Alcohol Dependence 81, 301–312.CrossRefGoogle ScholarPubMed
Coughlin, A, Oddy, M, Crawford, J (2007). Memory and Information Processing Battery. Brain Injury Rehabilitation Trust: UK.Google Scholar
Cuijpers, P, van Straten, A, Andersson, G, van Oppen, P (2008). Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology 76, 909–922.CrossRefGoogle ScholarPubMed
Dahm, J, Wong, D, Ponsford, J (2013). Utility of the Depression Anxiety Stress Scales in assessing depression and anxiety following traumatic brain injury. Journal of Affective Disorders 151, 392–396.CrossRefGoogle Scholar
Dugas, MJ, Robichaud, M (2005). The Cognitive-Behavioral Treatment for Generalized Anxiety Disorder. Taylor & Francis Group: New York.Google ScholarPubMed
Fann, JR, Hart, T, Schome, KG (2009). Treatment for depression after traumatic brain injury: a systematic review. Journal of Neurotrauma 26, 2383–2402.CrossRefGoogle ScholarPubMed
Fann, JR, Bombardier, CH, Vannoy, S, Dyer, J, Ludman, E, Dikmen, S, Marshall, K, Barber, J, Temkin, N (2014). Telephone and in-person cognitive behavioral therapy for major depression after Traumatic brain injury: a randomized controlled trial. Journal of Neurotrauma 35, 45–57.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (2007). Structured Clinicial Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition (SCID-I/P). Biometrics Research Department, New York State Psychiatric Institute: New York.Google Scholar
Gould, KR, Ponsford, J, Johnston, L, Schönberger, M (2011 b). The relationship between psychiatric disorders and one-year psychosocial outcome. Journal of Head Trauma Rehabilitation 26, 79–89.CrossRefGoogle Scholar
Gould, KR, Ponsford, JL, Johnston, L, Schönberger, M (2011 a). The nature, frequency and course of psychiatric disorders in the first year after traumatic brain injury: a prospective study. Psychological Medicine 41, 2099–2109.CrossRefGoogle ScholarPubMed
Hibbard, MR, Uysal, S, Kelpler, K, Bogdany, J, Silver, J (1998). Axis I psychopathology in individuals with traumatic brain injury. Journal of Head Trauma Rehabilitation 13, 24–39.CrossRefGoogle ScholarPubMed
Hodgson, J, McDonald, S, Tate, R, Gertler, P (2005). A randomised controlled trial of a cognitive behavioural therapy program for managing social anxiety after acquired brain injury. Brain Impairment 6, 169–180.CrossRefGoogle Scholar
Hsieh, M, Ponsford, J, Wong, D, McKay, A (2012 a). Exploring variables associated with change in cognitive behaviour therapy (CBT) for anxiety following traumatic brain injury. Disability and Rehabilitation 34, 408–415.CrossRefGoogle ScholarPubMed
Hsieh, M, Ponsford, J, Wong, D, Schönberger, M, McKay, A, Haines, K (2012 b). A cognitive behaviour therapy (CBT) programme for anxiety folowing moderate to severe traumatic brain injury (TBI): two case studies. Brain Injury 26, 126–138.CrossRefGoogle Scholar
Hsieh, M, Ponsford, J, Wong, D, Schönberger, M, McKay, A, Haines, K (2012 c). Development of a motivational interviewing programme as a prelude to CBT for anxiety & depression following Traumatic brain injury. Neuropsychological Rehabilitation 22, 563–584.CrossRefGoogle Scholar
Hsieh, M, Ponsford, J, Wong, D, Schönberger, M, Taffe, J, McKay, A (2012 d). Motivational interviewing and cognitive behavior therapy for anxiety following traumatic brain injury: a pilot randomized controlled trial. Neuropsychological Rehabilitation 22, 585–608.CrossRefGoogle Scholar
Jorge, RE, Robinson, RG, Moser, D, Tateno, A, Crespo-Facorro, B, Arndt, S (2004). Major depression following traumatic brain injury. Archives of General Psychiatry 61, 42–50.CrossRefGoogle ScholarPubMed
Kim, E, Lauterbach, EC, Reeve, A, Arciniegas, DB, Coburn, KL, Mendez, MF, Rummans, TA, Coffey, EC, ANPA Committee on Research (2007). Neuropsychiatric complications of traumatic brain injury: a critical review of the literature. Journal of Neuropsychiatry and Clinical Neurosciences 19, 106–127.CrossRefGoogle ScholarPubMed
Langlois, JA, Rutland-Brown, W, Thomas, KE (2006). Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control: Atlanta, GA.Google Scholar
Medley, AR, Powell, T (2010). Motivational interviewing to promote self-awareness and engagement in rehabilitation following acquired brain injury: a conceptual review. Neuropsychological Rehabilitation 20, 481–508.CrossRefGoogle ScholarPubMed
Nelson, HE, Willison, J (1991). National Adult Reading Test (NART): Test Manual, 2nd edn. NFER Nelson: Windsor, UK.Google Scholar
O'Donnell, ML, Lau, W, Tipping, S, Holmes, ACN, Ellen, S, Judson, R, Varker, T, Elliot, P, Bryant, RA, Creamer, MC, Forbes, D (2012). Stepped early psychological intervention for posttraumatic stress disorder, other anxiety disorders, and depression following serious injury. Journal of Traumatic Stress 25, 125–133.CrossRefGoogle ScholarPubMed
Pagulayan, KF, Hoffman, JM, Temkin, NR, Machamer, JE, Dikmen, SS (2008). Functional limitations and depression after traumatic brain injury: examination of the temporal relationship. Archives of Physical Medicine & Rehabilitation 89, 1887–1892.CrossRefGoogle ScholarPubMed
Rao, V, Lyketsos, CG (2002). Psychiatric aspects of traumatic brain injury. Psychiatric Clinics of North America 25, 43–69. Retrieved from http://www.elsevier.com/journals/psychiatric-clinics-of-north-america/0193-953X CrossRefGoogle ScholarPubMed
Schönberger, M, Ponsford, J (2010). The factor structure of the Hospital Anxiety and Depression Scale in individuals with traumatic brain injury. Psychiatry Research 179, 342–349.CrossRefGoogle ScholarPubMed
Schönberger, M, Ponsford, JL, Gould, KR, Johnston, L (2011). The temporal relationship between depression, anxiety and functional status after traumatic brain injury: a cross-lagged analysis. Journal of the International Neuropsychological Society 17, 1–7.CrossRefGoogle ScholarPubMed
Schulz, KF, Altman, DG, Moher, D, for the CONSORT Group (2010). CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. British Medical Journal 340, c332.CrossRefGoogle ScholarPubMed
Soo, C, Tate, R (2007). Psychological treatment for anxiety in people with traumatic brain injury. Cochrane Database of Systematic Reviews 3, Art. No.: CD005239.Google Scholar
Tate, RL, Hodgkinson, A, Veerbangsa, A, Maggiotto, S (1999). Measuring psychosocial recovery after traumatic brain injury: psychometric properties of a new scale. Journal of Head Trauma Rehabilitation 14, 543–557.CrossRefGoogle ScholarPubMed
Tiersky, LA, Anselmi, V, Johnston, MV, Kurtyka, J, Roosen, E, Schwartz, T, Deluca, J (2005). A trial of neuropsychologic rehabilitation in mild-spectrum traumatic brain injury. Archives of Physical Medicine and Rehabilitation 86, 1565–1574.CrossRefGoogle ScholarPubMed
Van den Broek, MD (2005). Why does neuro-rehabilitation fail? Journal of Head Trauma Rehabilitation 20, 464–473.CrossRefGoogle Scholar
Waldron, B, Casserly, LM, O'Sullivan, C (2013). Cognitive behavioural therapy for depression and anxiety in adults with acquired brain injury: what works for whom? Neuropsychological Rehabilitation 23, 64–101.CrossRefGoogle Scholar
Warden, DL, Gordon, B, McAllister, TW, Silver, JM, Barth, JT, Bruns, J, Drake, A, Gentry, T, Jagoda, A, Katz, DI, Kraus, J, Labbate, LA, Ryan, LM, Sparling, MB, Walters, B, Whyte, J, Zapata, A, Zitnay, G (2006). Guidelines for the pharmacologic treatment of neurobehavioral sequelae of traumatic brain injury. Journal of Neurotrauma 23, 1468–1501.CrossRefGoogle ScholarPubMed
Watkins, CL, Auton, MF, Deans, CF, Dickinson, HA, Jack, CIA, Lightbody, E, Sutton, C, van den Broek, MD, Leathley, MJ (2007). Motivational interviewing early after acute stroke. Stroke 38, 1004–1009.CrossRefGoogle ScholarPubMed
Westra, HA, Dozois, DJ (2006). Preparing clients for cognitive behavioral therapy: a randomized pilot study of motivational interviewing for anxiety. Cognitive Therapy and Research 30, 481–498.CrossRefGoogle Scholar
Westra, HA, Dozois, DJA (2003). Motivational Interviewing Adapted for Anxiety. Treatment Manual. Department of Psychology, York University: York.Google Scholar
Westra, HA, Dozois, DJA, Marcus, M (2007). Expectancy, homework compliance, and initial change in cognitive behavioral therapy for anxiety. Journal of Consulting and Clinical Psychology 75, 363–373.CrossRefGoogle ScholarPubMed
Whelan-Goodinson, R, Ponsford, J, Johnston, L, Grant, F (2009). Psychiatric disorders following traumatic brain injury: their nature and frequency. Journal of Head Trauma Rehabilitation 24, 324–332.CrossRefGoogle ScholarPubMed
Whelan-Goodinson, R, Ponsford, J, Schönberger, M (2008). Association between psychiatric state and outcome following traumatic brain injury. Journal of Rehabilitation Medicine 40, 850–857.CrossRefGoogle ScholarPubMed
Wong, D, Dahm, J, Ponsford, J (2013). Factor structure of the depression anxiety stress scales in individuals with traumatic brain injury. Brain Injury 27, 1377–1382.CrossRefGoogle ScholarPubMed
Supplementary material: File

Ponsford supplementary material

Ponsford supplementary material 1

Download Ponsford supplementary material(File)
File 136.7 KB