Psychological distress is common in persons with traumatic brain injury (TBI) but treatments remain underdeveloped. This randomized controlled trial of Acceptance and Commitment Therapy (ACT) was designed to address this gap. Ninety-three persons with medically-documented complicated mild to severe TBI, normal-to-mildly impaired memory, and clinically significant psychological distress in the chronic phase of recovery were randomized to receive eight weeks of ACT (manualized with adaptations to address TBI-related cognitive impairments) or a single session of needs assessment, brief counseling/education, and referral. The ACT group showed significantly greater reduction of psychological distress (Brief Symptom Inventory 18) and demonstrated improvements in psychological flexibility and commitment to action (Acceptance and Action Questionnaire-II (AAQ-II) scores). The number of treatment responders (post-treatment BSI 18 GSI T scores <63) was larger in the ACT group than in the control group. Entry of AAQ-II scores into the model of between-group differences in BSI 18 GSI T scores indicated that core ACT processes explained the variance in treatment group outcomes. Provision of ACT reduces psychological distress in persons with TBI in the chronic phase of recovery when adaptations are made to accommodate TBI-related cognitive impairments. Additional clinical trials with a structurally equivalent control group are needed.

中文翻译：

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创伤性脑损伤患者心理困扰接受承诺疗法的随机对照试验

心理困扰在创伤性脑损伤 (TBI) 患者中很常见，但治疗方法仍然不完善。这项接受和承诺疗法 (ACT) 的随机对照试验旨在解决这一差距。93 名患有医学证明的复杂的轻度至重度 TBI、正常至轻度受损的记忆以及在慢性恢复阶段有临床意义的心理困扰的人被随机分配接受八周的 ACT（手动调整以解决与 TBI 相关的问题）认知障碍）或单次需求评估、简短咨询/教育和转介。ACT 组的心理困扰显着减少（简要症状清单 18），并表现出心理灵活性和行动承诺的改善（接受和行动问卷-II (AAQ-II) 分数）。ACT 组的治疗反应者数量（治疗后 BSI 18 GSI T 评分 <63）比对照组多。将 AAQ-II 分数输入 BSI 18 GSI T 分数的组间差异模型表明核心 ACT 过程解释了治疗组结果的差异。当进行适应以适应 TBI 相关的认知障碍时，提供 ACT 可减少处于慢性恢复阶段的 TBI 患者的心理困扰。需要使用结构等效的对照组进行额外的临床试验。ACT 组的治疗反应者数量（治疗后 BSI 18 GSI T 评分 <63）比对照组多。将 AAQ-II 分数输入 BSI 18 GSI T 分数的组间差异模型表明核心 ACT 过程解释了治疗组结果的差异。当进行适应以适应 TBI 相关的认知障碍时，提供 ACT 可减少处于慢性恢复阶段的 TBI 患者的心理困扰。需要使用结构等效的对照组进行额外的临床试验。ACT 组的治疗反应者数量（治疗后 BSI 18 GSI T 评分 <63）比对照组多。将 AAQ-II 分数输入 BSI 18 GSI T 分数的组间差异模型表明核心 ACT 过程解释了治疗组结果的差异。当进行适应以适应 TBI 相关的认知障碍时，提供 ACT 可减少处于慢性恢复阶段的 TBI 患者的心理困扰。需要使用结构等效的对照组进行额外的临床试验。当进行适应以适应 TBI 相关的认知障碍时，提供 ACT 可减少处于慢性恢复阶段的 TBI 患者的心理困扰。需要使用结构等效的对照组进行额外的临床试验。当进行适应以适应 TBI 相关的认知障碍时，提供 ACT 可减少处于慢性恢复阶段的 TBI 患者的心理困扰。需要使用结构等效的对照组进行额外的临床试验。