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A Pilot Study Examining the Effect of Mindfulness-Based Stress Reduction on Symptoms of Chronic Mild Traumatic Brain Injury/Postconcussive Syndrome

Azulay, Joanne PhD; Smart, Colette M. PhD; Mott, Tasha PhD; Cicerone, Keith D. PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

Journal of Head Trauma Rehabilitation: July/August 2013 - Volume 28 - Issue 4 - p 323–331
doi: 10.1097/HTR.0b013e318250ebda
Interventions for Mild TBI

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.

JFK Johnson Rehabilitation Institute (Drs Azulay, Smart, Mott, and Cicerone), and New Jersey Neuroscience Institute (Drs Azulay, Smart, and Mott), Edison, New Jersey; and Department of Psychology, University of Victoria, Victoria, British Columbia, Canada (Dr Smart).

Corresponding Author: Joanne Azulay, PhD, 2048 Oak Tree Rd, Edison NJ 08820.

The authors declare no conflicts of interest.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins