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Link to original content: https://doi.org/10.1007/s11682-015-9440-2
Treatment of persistent post-concussive symptoms after mild traumatic brain injury: a systematic review of cognitive rehabilitation and behavioral health interventions in military service members and veterans | Brain Imaging and Behavior Skip to main content

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Treatment of persistent post-concussive symptoms after mild traumatic brain injury: a systematic review of cognitive rehabilitation and behavioral health interventions in military service members and veterans

  • Military\\/Veteran TBI
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Abstract

Increased prevalence of traumatic brain injury (TBI) has been associated with service members and veterans who completed combat deployments in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Management of persistent post-concussive symptoms (PCS) has been a challenge to healthcare providers throughout the Military and Veterans Healthcare Systems, as well as civilian healthcare providers, due in part to the chronic nature of symptoms, co-occurrence of behavioral health disorders such as depression, Posttraumatic Stress Disorder (PTSD), and substance use disorders, and fear of a potential stigma associated with psychiatric diagnoses and behavioral health treatment(s). This systematic review examined non-pharmacologic behavioral health interventions and cognitive rehabilitation interventions for PCS in military service members and veterans with a history of mild TBI (mTBI). Six electronic databases were searched with specific term limitations, identifying 121 citations. Ultimately, 19 articles met criteria for inclusion in this systematic review. Studies were broadly categorized into four subtypes: psychoeducational interventions, cognitive rehabilitation, psychotherapeutic approaches, and integrated behavioral health interventions for PCS and PTSD. The review provides an update of the empirical evidence for these four types of interventions for PCS in active duty service members and veterans. Recommendations for future research are discussed, including the need to expand and improve the limited evidence basis on how to manage persistent post-concussive symptoms in this population.

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References

  • Al Sayegh, A., Sandford, D., & Carson, A. J. (2010). Psychological approaches to treatment of postconcussion syndrome: a systematic review. Journal of Neurology, Neurosurgery and Psychiatry, 81(10), 1128–1134. doi:10.1136/jnnp.2008.170092.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (1994). Task force on DSM-IV: diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). Washington (DC): American Psychiatric Association.

    Google Scholar 

  • Azulay, J., Smart, C. M., Mott, T., & Cicerone, K. D. (2013). A pilot study examining the effect of mindfulness-based stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome. The Journal of Head Trauma Rehabilitation, 28(4), 323–331. doi:10.1097/HTR.0b013e318250ebda.

    Article  PubMed  Google Scholar 

  • Barnes, V. A., Rigg, J. L., & Williams, J. J. (2013). Clinical case series: treatment of PTSD with transcendental meditation in active duty military personnel. Military Medicine, 178(7), e836–e840. doi:10.7205/MILMED-D-12-00426.

    Article  PubMed  Google Scholar 

  • Belanger, H. G., Kretzmer, T., Vanderploeg, R. D., & French, L. M. (2010). Symptom complaints following combat-related traumatic brain injury: relationship to traumatic brain injury severity and posttraumatic stress disorder. Journal of International Neuropsychological Society, 16(1), 194–199. doi:10.1017/S1355617709990841.

    Article  Google Scholar 

  • Binder, L. M. (1986). Persisting symptoms after mild head injury: a review of the postconcussive syndrome. Journal of Clinical and Experimental Neuropsychology, 8(4), 323–346. doi:10.1080/01688638608401325.

    Article  CAS  PubMed  Google Scholar 

  • Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy, 34(8), 669–673.

    Article  CAS  PubMed  Google Scholar 

  • Bolzenius, J. D., Roskos, P. T., Salminen, L. E., Paul, R. H., & Bucholz, R. D. (2015). Cognitive and self-reported psychological outcomes of blast-induced mild traumatic brain injury in veterans: a preliminary study. Applied Neuropsychology Adult, 22(2), 79–87. doi:10.1080/23279095.2013.845823.

    Article  PubMed  Google Scholar 

  • Brenner, L. A., Vanderploeg, R. D., & Terrio, H. (2009). Assessment and diagnosis of mild traumatic brain injury, posttraumatic stress disorder, and other polytrauma conditions: burden of adversity hypothesis. Rehabilitation Psychology, 54(3), 239–246. doi:10.1037/a0016908.

    Article  PubMed  Google Scholar 

  • Brunger, H., Ogden, J., Malia, K., Eldred, C., Terblanche, R., & Mistlin, A. (2014). Adjusting to persistent post-concussive symptoms following mild traumatic brain injury and subsequent psycho-educational intervention: a qualitative analysis in military personnel. Brain Injury, 28(1), 71–80. doi:10.3109/02699052.2013.857788.

    Article  PubMed  Google Scholar 

  • Bryant, R. A., Moulds, M., Guthrie, R., & Nixon, R. (2003). Treating acute stress disorder following mild traumatic brain injury. The American Journal of Psychiatry, 160(3), 585–587.

    Article  PubMed  Google Scholar 

  • Bryant, R. A., O’Donnell, M. L., Creamer, M., McFarlane, A. C., Clark, C. R., & Silove, D. (2010). The psychiatric sequelae of traumatic injury. The American Journal of Psychiatry, 167(3), 312–320. doi:10.1176/appi.ajp.2009.09050617.

    Article  PubMed  Google Scholar 

  • Cantor, J., Ashman, T., Dams-O’Connor, K., Dijkers, M. P., Gordon, W., Spielman, L., et al. (2014). Evaluation of the short-term executive plus intervention for executive dysfunction after traumatic brain injury: a randomized controlled trial with minimization. Archives of Physical Medicine and Rehabilitation, 95(1), 1–9 e3. doi:10.1016/j.apmr.2013.08.005.

    Article  PubMed  Google Scholar 

  • Caplan, L., Ivins, B., Poole, J., Vanderploeg, R., Jaffee, M., & Schwab, K. (2010). The structure of postconcussive symptoms in 3 US military samples. The Journal of Head Trauma Rehabilitation, 25(6), 447–458. doi:10.1097/HTR.0b013e3181d5bdbd.

    Article  Google Scholar 

  • Carroll, L.J., Cassidy, J.D., Peloso, P.M., Borg, J., von Holst, H., Holm, L., et al. (2004). Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, (43 Suppl), 84–105.

  • Centers for Disease Control and Prevention. (2014). Report to congress on traumatic brain injury in the United States: epidemiology and rehabilitation. Atlanta: National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention.

    Google Scholar 

  • Chard, K. M., Schumm, J. A., McIlvain, S. M., Bailey, G. W., & Parkinson, R. B. (2011). Exploring the efficacy of a residential treatment program incorporating cognitive processing therapy-cognitive for veterans with PTSD and traumatic brain injury. Journal of Traumatic Stress, 24(3), 347–351. doi:10.1002/jts.20644.

    Article  PubMed  Google Scholar 

  • Chen, A. J., Novakovic-Agopian, T., Nycum, T. J., Song, S., Turner, G. R., Hills, N. K., et al. (2011). Training of goal-directed attention regulation enhances control over neural processing for individuals with brain injury. Brain, 134(Pt 5), 1541–1554. doi:10.1093/brain/awr067.

    Article  PubMed  Google Scholar 

  • Cicerone, K. D. (2002). Remediation of “working attention” in mild traumatic brain injury. Brain Injury, 16(3), 185–195. doi:10.1080/02699050110103959.

    Article  PubMed  Google Scholar 

  • Cicerone, K. D., & Kalmar, K. (1995). Persistent postconcussion syndrome: the structure of subjective complaints after mild traumatic brain injury. The Journal of Head Trauma Rehabilitation, 10(3), 1–17.

    Article  Google Scholar 

  • Comper, P., Bisschop, S. M., Carnide, N., & Tricco, A. (2005). A systematic review of treatments for mild traumatic brain injury. Brain Injury, 19(11), 863–880.

    Article  CAS  PubMed  Google Scholar 

  • Cooper, D. B., Kennedy, J. E., Cullen, M. A., Critchfield, E., Amador, R. R., & Bowles, A. O. (2011). Association between combat stress and post-concussive symptom reporting in OEF/OIF service members with mild traumatic brain injuries. Brain Injury, 25(1), 1–7.

    Article  PubMed  Google Scholar 

  • Davis, J. J., Walter, K. H., Chard, K. M., Parkinson, R. B., & Houston, W. S. (2013). Treatment adherence in cognitive processing therapy for combat-related PTSD with history of mild TBI. Rehabilitation Psychology, 58(1), 36–42. doi:10.1037/a0031525.

    Article  PubMed  Google Scholar 

  • Defense and Veterans Brain Injury Center (2015). DoD Numbers for Traumatic Brain Injury Worldwide: 2000-2014. http://www.dvbic.org/dod-worldwide-numbers-tbi. Accessed 11 Jun 2015.

  • Department of Defense, & Department of Veterans Affairs. (2009). VA/DoD clinical practice guideline for management of concussion/mild traumatic brain injury. Washington: Department of Defense, & Department of Veterans Affairs.

    Google Scholar 

  • Fork, M., Bartels, C., Ebert, A. D., Grubich, C., Synowitz, H., & Wallesch, C. W. (2005). Neuropsychological sequelae of diffuse traumatic brain injury. Brain Injury, 19(2), 101–108.

    Article  PubMed  Google Scholar 

  • Ghaffar, O., McCullagh, S., Ouchterlony, D., & Feinstein, A. (2006). Randomized treatment trial in mild traumatic brain injury. Journal of Psychosomatic Research, 61(2), 153–160. doi:10.1016/j.jpsychores.2005.07.018.

    Article  PubMed  Google Scholar 

  • Helmick, K., & Members of Consensus, C. (2010). Cognitive rehabilitation for military personnel with mild traumatic brain injury and chronic post-concussional disorder: results of April 2009 consensus conference. NeuroRehabilitation, 26(3), 239–255. doi:10.3233/NRE-2010-0560.

    PubMed  Google Scholar 

  • Helmick, K. M., Spells, C. A., Malik, S. Z., Davies, C. A., Marion, D. W., & Hinds, S. R. (2015). Traumatic brain injury in the US military: epidemiology and key clinical and research programs. Brain Imaging and Behavior. doi:10.1007/s11682-015-9399-z.

    PubMed  Google Scholar 

  • Huckans, M., Pavawalla, S., Demadura, T., Kolessar, M., Seelye, A., Roost, N., et al. (2010). A pilot study examining effects of group-based Cognitive Strategy Training treatment on self-reported cognitive problems, psychiatric symptoms, functioning, and compensatory strategy use in OIF/OEF combat veterans with persistent mild cognitive disorder and history of traumatic brain injury. Journal of Rehabilitation Research and Development, 47(1), 43–60.

    Article  PubMed  Google Scholar 

  • King, E. G., Kretzmer, T. S., Vanderploeg, R. D., Asmussen, S. B., Clement, V. L., & Belanger, H. G. (2013). Pilot of a novel intervention for postconcussive symptoms in active duty, veterans, and civilians. Rehabilitation Psychology, 58(3), 272–279. doi:10.1037/a0033116.

    Article  PubMed  Google Scholar 

  • Lange, R. T., Brickell, T. A., Kennedy, J. E., Bailie, J. M., Sills, C., Asmussen, S., et al. (2014). Factors influencing postconcussion and posttraumatic stress symptom reporting following military-related concurrent polytrauma and traumatic brain injury. Archives of Clinical Neuropsychology, 29(4), 329–347. doi:10.1093/arclin/acu013.

    Article  PubMed  Google Scholar 

  • Levine, B., Robertson, I. H., Clare, L., Carter, G., Hong, J., Wilson, B. A., et al. (2000). Rehabilitation of executive functioning: an experimental-clinical validation of goal management training. Journal of International Neuropsychological Society, 6(3), 299–312.

    Article  CAS  Google Scholar 

  • Levine, B., Stuss, D. T., Winocur, G., Binns, M. A., Fahy, L., Mandic, M., et al. (2007). Cognitive rehabilitation in the elderly: effects on strategic behavior in relation to goal management. Journal of International Neuropsychological Society, 13(1), 143–152. doi:10.1017/S1355617707070178.

    Article  Google Scholar 

  • Mathias, J. L., & Wheaton, P. (2007). Changes in attention and information-processing speed following severe traumatic brain injury: a meta-analytic review. Neuropsychology, 21(2), 212–223. doi:10.1037/0894-4105.21.2.212.

    Article  PubMed  Google Scholar 

  • McMillan, T., Robertson, I. H., Brock, D., & Chorlton, L. (2002). Brief mindfulness training for attentional problems after traumatic brain injury: A randomised control treatment trial. Neuropsychological Rehabilitation, 12(2), 117–125.

  • Mittenberg, W., Tremont, G., Zielinski, R. E., Fichera, S., & Rayls, K. R. (1996). Cognitive-behavioral prevention of postconcussion syndrome. Archives of Clinical Neuropsychology, 11(2), 139–145.

    Article  CAS  PubMed  Google Scholar 

  • Mooney, G., & Speed, J. (2001). The association between mild traumatic brain injury and psychiatric conditions. Brain Injury, 15(10), 865–877. doi:10.1080/02699050110065286.

    Article  CAS  PubMed  Google Scholar 

  • Morissette, S. B., Woodward, M., Kimbrel, N. A., Meyer, E. C., Kruse, M. I., Dolan, S., et al. (2011). Deployment-related TBI, persistent postconcussive symptoms, PTSD, and depression in OEF/OIF veterans. Rehabilitation Psychology, 56(4), 340–350. doi:10.1037/a0025462.

    Article  PubMed  Google Scholar 

  • Nelson, L. A., Macdonald, M., Stall, C., & Pazdan, R. (2013). Effects of interactive metronome therapy on cognitive functioning after blast-related brain injury: a randomized controlled pilot trial. Neuropsychology, 27(6), 666–679. doi:10.1037/a0034117.

    Article  PubMed  Google Scholar 

  • Niemeier, J. P., Kreutzer, J. S., Marwitz, J. H., Gary, K. W., & Ketchum, J. M. (2011). Efficacy of a brief acute neurobehavioural intervention following traumatic brain injury: a preliminary investigation. Brain Injury, 25(7–8), 680–690. doi:10.3109/02699052.2011.573520.

    Article  PubMed  Google Scholar 

  • Novakovic-Agopian, T., Chen, A. J., Rome, S., Abrams, G., Castelli, H., Rossi, A., et al. (2011). Rehabilitation of executive functioning with training in attention regulation applied to individually defined goals: a pilot study bridging theory, assessment, and treatment. The Journal of Head Trauma Rehabilitation, 26(5), 325–338. doi:10.1097/HTR.0b013e3181f1ead2.

    Article  PubMed  Google Scholar 

  • Orman, J. A. L., Kraus, J. F., Zaloshnja, E., & Miller, T. (2011). Epidemiology. In J. Silver, T. McAllister, & S. Yudofsky (Eds.), Textbook of traumatic brain injury (2nd ed.). Arlington: American Psychiatric Publishing.

    Google Scholar 

  • Otis, J. D., McGlinchey, R., Vasterling, J. J., & Kerns, R. D. (2011). Complicating factors associated with mild traumatic brain injury: impact on pain and posttraumatic stress disorder treatment. Journal of Clinical Psychology in Medical Settings, 18(2), 145–154. doi:10.1007/s10880-011-9239-2.

    Article  PubMed  Google Scholar 

  • Perlick, D. A., Straits-Troster, K., Strauss, J. L., Norell, D., Tupler, L. A., Levine, B., et al. (2013). Implementation of multifamily group treatment for veterans with traumatic brain injury. Psychiatric Services, 64(6), 534–540. doi:10.1176/appi.ps.001622012.

    Article  PubMed  Google Scholar 

  • Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A. M., Nelms, R., et al. (2002). Impact of early intervention on outcome following mild head injury in adults. Journal of Neurology, Neurosurgery and Psychiatry, 73(3), 330–332.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Potter, S., & Brown, R. G. (2012). Cognitive behavioural therapy and persistent post-concussional symptoms: integrating conceptual issues and practical aspects in treatment. Neuropsychological Rehabilitation, 22(1), 1–25. doi:10.1080/09602011.2011.630883.

    Article  PubMed  Google Scholar 

  • PubMed, US National Library of Medicine. http://www.ncbi.nlm.nih.gov/pubmed/?term=%22cognitive+rehabilitation%22. Accessed June 10 2015.

  • Riegler, L. J., Neils-Strunjas, J., Boyce, S., Wade, S. L., & Scheifele, P. M. (2013). Cognitive intervention results in web-based videophone treatment adherence and improved cognitive scores. Medical Science Monitor, 19, 269–275. doi:10.12659/MSM.883885.

    Article  PubMed Central  PubMed  Google Scholar 

  • Robertson, I. H., Ward, T., Ridgeway, V., & Nimmo-Smith, I. (1996). The structure of normal human attention: the test of everyday attention. Journal of International Neuropsychological Society, 2(6), 525–534.

    Article  CAS  Google Scholar 

  • Rohling, M. L., Faust, M. E., Beverly, B., & Demakis, G. (2009). Effectiveness of cognitive rehabilitation following acquired brain injury: a meta-analytic re-examination of Cicerone et al.’s (2000, 2005) systematic reviews. Neuropsychology, 23(1), 20–39. doi:10.1037/a0013659.

    Article  PubMed  Google Scholar 

  • Roy, M. J., Francis, J., Friedlander, J., Banks-Williams, L., Lande, R. G., Taylor, P., et al. (2010). Improvement in cerebral function with treatment of posttraumatic stress disorder. Annals of the New York Academy of Sciences, 1208, 142–149. doi:10.1111/j.1749-6632.2010.05689.x.

    Article  PubMed  Google Scholar 

  • Ruff, R. L., Riechers, R. G., 2nd, Wang, X. F., Piero, T., & Ruff, S. S. (2012). For veterans with mild traumatic brain injury, improved posttraumatic stress disorder severity and sleep correlated with symptomatic improvement. Journal of Rehabilitation Research and Development, 49(9), 1305–1320.

    Article  PubMed  Google Scholar 

  • Rutherford, W. H. (1989). Postconcussion symptoms: relationship to acute neurological indices, individual differences, and circumstances of injury. In H. Levin, H. Eisenberg, & A. Benton (Eds.), Mild head injury (pp. 217–228). New York: Oxford University Press.

    Google Scholar 

  • Schneiderman, A. I., Braver, E. R., & Kang, H. K. (2008). Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: persistent postconcussive symptoms and posttraumatic stress disorder. American Journal of Epidemiology, 167(12), 1446–1452. doi:10.1093/aje/kwn068.

    Article  PubMed  Google Scholar 

  • Silverberg, N. D., Hallam, B. J., Rose, A., Underwood, H., Whitfield, K., Thornton, A. E., et al. (2013). Cognitive-behavioral prevention of postconcussion syndrome in at-risk patients: a pilot randomized controlled trial. The Journal of Head Trauma Rehabilitation, 28(4), 313–322. doi:10.1097/HTR.0b013e3182915cb5.

    Article  PubMed  Google Scholar 

  • Smith, B., Harms, W. D., Burres, S., Korda, H., Rosen, H., & Davis, J. (2012). Enhancing behavioral health treatment and crisis management through mobile ecological momentary assessment and SMS messaging. Health Informatics Journal, 18(4), 294–308. doi:10.1177/1460458212445349.

    Article  PubMed  Google Scholar 

  • Snell, D. L., Surgenor, L. J., Hay-Smith, E. J., & Siegert, R. J. (2009). A systematic review of psychological treatments for mild traumatic brain injury: an update on the evidence. Journal of Clinical and Experimental Neuropsychology, 31(1), 20–38. doi:10.1080/13803390801978849.

    Article  PubMed  Google Scholar 

  • Snell, D. L., Siegert, R. J., Hay-Smith, E. J., & Surgenor, L. J. (2011). Associations between illness perceptions, coping styles and outcome after mild traumatic brain injury: preliminary results from a cohort study. Brain Injury, 25(11), 1126–1138. doi:10.3109/02699052.2011.607786.

    Article  PubMed  Google Scholar 

  • Sripada, R. K., Rauch, S. A., Tuerk, P. W., Smith, E., Defever, A. M., Mayer, R. A., et al. (2013). Mild traumatic brain injury and treatment response in prolonged exposure for PTSD. Journal of Traumatic Stress, 26(3), 369–375. doi:10.1002/jts.21813.

    Article  PubMed  Google Scholar 

  • Straits-Troster, K., Gierisch, J. M., Strauss, J. L., Dyck, D. G., Dixon, L. B., Norell, D., et al. (2013). Multifamily group treatment for veterans with traumatic brain injury: what is the value to participants? Psychiatric Services, 64(6), 541–546. doi:10.1176/appi.ps.001632012.

    Article  PubMed  Google Scholar 

  • Sullivan, K. W., Quinn, J. E., Pramuka, M., Sharkey, L. A., & French, L. M. (2012). Outcomes from a pilot study using computer-based rehabilitative tools in a military population. Studies in Health Technology and Informatics, 181, 71–77.

    PubMed  Google Scholar 

  • Terrio, H., Brenner, L. A., Ivins, B. J., Cho, J. M., Helmick, K., Schwab, K., et al. (2009). Traumatic brain injury screening: preliminary findings in a US Army Brigade Combat Team. The Journal of Head Trauma Rehabilitation, 24(1), 14–23. doi:10.1097/HTR.0b013e31819581d8.

    Article  PubMed  Google Scholar 

  • Tiersky, L. A., Anselmi, V., Johnston, M. V., Kurtyka, J., Roosen, E., Schwartz, T., et al. (2005). A trial of neuropsychologic rehabilitation in mild-spectrum traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 86(8), 1565–1574. doi:10.1016/j.apmr.2005.03.013.

    Article  PubMed  Google Scholar 

  • Twamley, E. W., Jak, A. J., Delis, D. C., Bondi, M. W., & Lohr, J. B. (2014). Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for veterans with traumatic brain injury: pilot randomized controlled trial. Journal of Rehabilitation Research and Development, 51(1), 59–70. doi:10.1682/JRRD.2013.01.0020.

    Article  PubMed  Google Scholar 

  • Vanderploeg, R. D., Curtiss, G., & Belanger, H. G. (2005). Long-term neuropsychological outcomes following mild traumatic brain injury. Journal of International Neuropsychological Society, 11(3), 228–236. doi:10.1017/S1355617705050289.

    Article  Google Scholar 

  • Vanderploeg, R. D., Curtiss, G., Luis, C. A., & Salazar, A. M. (2007). Long-term morbidities following self-reported mild traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 29(6), 585–598. doi:10.1080/13803390600826587.

    Article  PubMed  Google Scholar 

  • Vanderploeg, R. D., Belanger, H. G., Horner, R. D., Spehar, A. M., Powell-Cope, G., Luther, S. L., et al. (2012). Health outcomes associated with military deployment: mild traumatic brain injury, blast, trauma, and combat associations in the Florida National Guard. Archives of Physical Medicine and Rehabilitation, 93(11), 1887–1895. doi:10.1016/j.apmr.2012.05.024.

    Article  PubMed  Google Scholar 

  • Vas, A., Chapman, S., Aslan, S., Spence, J., Keebler, M., Rodriguez-Larrain, G., et al. (2015). Reasoning training in veteran and civilian traumatic brain injury with persistent mild impairment. Neuropsychological Rehabilitation, 1-30. doi:10.1080/09602011.2015.1044013.

  • Walter, K. H., Barnes, S. M., & Chard, K. M. (2012a). The influence of comorbid MDD on outcome after residential treatment for veterans with PTSD and a history of TBI. Journal of Traumatic Stress, 25(4), 426–432. doi:10.1002/jts.21722.

    Article  PubMed  Google Scholar 

  • Walter, K. H., Kiefer, S. L., & Chard, K. M. (2012b). Relationship between posttraumatic stress disorder and postconcussive symptom improvement after completion of a posttraumatic stress disorder/traumatic brain injury residential treatment program. Rehabilitation Psychology, 57(1), 13–17. doi:10.1037/a0026254.

    Article  PubMed  Google Scholar 

  • Wolf, G. K., Strom, T. Q., Kehle, S. M., & Eftekhari, A. (2012). A preliminary examination of prolonged exposure therapy with Iraq and Afghanistan veterans with a diagnosis of posttraumatic stress disorder and mild to moderate traumatic brain injury. The Journal of Head Trauma Rehabilitation, 27(1), 26–32. doi:10.1097/HTR.0b013e31823cd01f.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors gratefully acknowledge Anne C. Ritter for editing contributions.

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All authors declare no conflicts of interest. This article does not contain any studies with human participants performed by any of the authors.

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Authors and Affiliations

  1. Defense and Veteran’s Brain Injury Center, San Antonio Military Medical Center MCHE MDU (DVBIC), 3551 Roger Brooke Drive, Fort Sam Houston, TX, 78234-6200, USA

    Douglas B. Cooper & Jan E. Kennedy

  2. Department of Neurology, San Antonio Military Medical Center, Fort Sam Houston, TX, USA

    Douglas B. Cooper & Jan E. Kennedy

  3. Defense and Veterans Brain Injury Center, Bethesda, MD, USA

    Anne E. Bunner

  4. Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    Valerie Balldin

  5. Missouri Institute of Mental Health, University of Missouri at St. Louis, St. Louis, MO, USA

    David F. Tate

  6. Polytrauma Rehabilitation Center, South Texas Veterans Health Care System, San Antonio, TX, USA

    Blessen C. Eapen & Carlos A. Jaramillo

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Cooper, D.B., Bunner, A.E., Kennedy, J.E. et al. Treatment of persistent post-concussive symptoms after mild traumatic brain injury: a systematic review of cognitive rehabilitation and behavioral health interventions in military service members and veterans. Brain Imaging and Behavior 9, 403–420 (2015). https://doi.org/10.1007/s11682-015-9440-2

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