Treatment-seeking veterans who come for diagnostics and/or treatment to University of
California, Los Angeles (UCLA) Operation Mend show a high level of memory concern. To
address this issue, the veterans receive training in evidence-informed compensatory
strategies. However, a high level of memory concern remains, and this study aims to
investigate the efficacy of adding memory drills to the treatment program.
There is mixed evidence in the literature about whether memory drills, which tend to show
improvement in computerized cognitive tasks, generalize to naturalistic forms of memory.
Specifically, the efficacy of computerized training for prospective memory (PM), perhaps
the most naturalistic form of memory, is understudied. The proposed study seeks to answer
the question whether adding a computerized "drilling" of retrospective and prospective
memory to Operation Mend's Cognitive Training enhances patients' PM performance & reduces
their memory concerns.
Study participants will be only be recruited from participants of the Operation Mend
Intensive Treatment Programs (ITPs). The BRAIN ITP is a two-week intensive brain health
program for patients who may have a history of mild traumatic brain injury and other
comorbidities who wish to focus on improving their day-to-day cognitive functioning,
maximizing their brain health as well as reducing the impact of other symptoms such as
physical pain. It involves cognitive training sessions and meetings with
neuropsychologists, neurologists, occupational therapists, dieticians, etc. The PTSD ITP
is a two-week intensive therapy and skills training program for patients who wish to
focus on evidence-based treatment for PTSD and other psychological and cognitive
comorbidities that involves mental health sessions and meetings with psychiatrists,
psychologists, neuropsychologists, etc.
This will be a randomized controlled trial with three groups. The experimental group with
BRAIN ITP participants will receive the normal standard of care and memory drilling while
the BRAIN ITP control group receives only the normal standard of care. The third control
group will come from the PTSD ITP who receive normal standard of care plus PTSD
treatment. This control group is included because of indications of a connection between
PTSD symptomology and PM deficits.
In the BRAIN ITP, the standard PM training for both the experimental and control group
takes place during the patient's individual sessions with a neuropsychologist. In total,
there are seven sessions. At each of these sessions the neuropsychologist will review a
new compensatory strategy for prospective memory and assign a naturalistic task for
completion as homework to practice the strategy. The experimental group will receive the
additional "memory drills" training. This training includes the completion of a list
learning memory task and then a prospective memory task conducted on the computer at each
session. The PTSD ITP group will receive the standard of care (cognitive processing
therapy and cognitive training).
Participants will be assessed at baseline (before entering the program), at exit
(immediately after the two-week program) and at 3 months post exit. The assessments
consist of surveys regarding their PM performance in their day-to-day lives, a
computerized and naturalistic objective measurement of PM. All assessments, except for
the exit assessment which does not include the naturalistic task, will be administered
via Zoom by study staff. Participants will fill out the exit assessment by themselves.
The total study time will be approximately 2 to 3.5 hours over the course of
approximately 15 to 17 weeks.