Research Reports - The relations of cognitive, behavioral, and physical activity variables to depression severity in traumatic brain injury

J Head Trauma Rehabil. 2017 Feb 10. doi: 10.1097/HTR.0000000000000288. [Epub
ahead of print]

Bombardier CH(1), Fann JR, Ludman EJ, Vannoy SD, Dyer JR, Barber JK, Temkin NR.

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.

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