Research Reports - Examining the effect of mindfulness-based stress reduction on symptoms of chronic mild traumatic brain injury/postconcussive syndrome

J Head Trauma Rehabil. 2012 Jun 8

Azulay J, Smart CM, Mott T, Cicerone KD

OBJECTIVE:: To evaluate the effectiveness of the mindfulness-based stress
reduction (MBSR) program tailored to individuals with mild traumatic brain injury
(mTBI). DESIGN:: A convenience sample recruited from clinical referrals over a
2-year period completed outcome measures pre- and posttreatment intervention.
SETTING:: Post-acute brain injury rehabilitation center within a suburban medical
facility. PARTICIPANTS:: Twenty-two individuals with mTBI and a time postinjury
more than 7 months. Eleven participants were men and 11 were women, ranging in
age from 18 to 62 years. INTERVENTION:: A 10-week group (with weekly 2-hour
sessions) modeled after the MBSR program of Kabat-Zinn, but with modifications
designed to facilitate implementation in a population of individuals with brain
injury. (The treatment involved enhancement of attentional skills, in addition to
increased awareness of internal and external experiences associated with the
perspective change of acceptance and nonjudgmental attitude regarding those
experiences). MAIN OUTCOME MEASURES:: Perceived Quality of Life Scale, Perceived
Self-Efficacy Scale, and the Neurobehavioral Symptom Inventory. Secondary
measures included neuropsychological tests, a self-report problem-solving
inventory, and a self-report measure of mindfulness. RESULTS:: Clinically
meaningful improvements were noted on measures of quality of life (Cohen d =
0.43) and perceived self-efficacy (Cohen d = 0.50) with smaller but still
significant effects on measures of central executive aspects of working memory
and regulation of attention. CONCLUSION:: The MBSR program can be adapted for
participants with mTBI. Improved performance on measures associated with improved
quality of life and self-efficacy may be related to treatment directed at
improving awareness and acceptance, thereby minimizing the catastrophic
assessment of symptoms associated with mTBI and chronic disability. Additional
research on the comparative effectiveness of the MBSR program for people with
mTBI is warranted.

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