Advances in Treatment: Examining the Effectiveness of a Behavioral Intervention.
| Status: | Recruiting |
|---|---|
| Healthy: | No |
| Age Range: | 9 - 17 |
| Updated: | 9/20/2017 |
| Start Date: | June 2015 |
| End Date: | June 2018 |
| Contact: | Cherylynn Marino, Ph.D. |
| Email: | cmarino@kesslerfoundation.org |
| Phone: | (973) 324-8431 |
The purpose of this research is to investigate the influence a mindfulness based cognitive
therapy (MBCT) intervention will have on internalizing and externalizing problems in children
and adolescents that have suffered a Traumatic Brain Injury (TBI). MBCT is a manualized
intervention developed to increase social-emotional resiliency through mindful attention.
Internalizing problems refer to a set of symptoms in which a person over-controls their
emotions and results in social withdrawal, feelings of worthlessness, depression, and anxiety
(Bloom et al., 2001). In contrast, externalizing problems refer to an under-control of
emotions which results in conduct problems, impulsive behavior, and aggression. Social and
emotional difficulties are prominent consequences of childhood TBI. Left untreated or
undertreated, these problems often persist into adulthood, producing a wide range of
challenges adapting in personal and vocational domains. At present, there are minimal
non-pharmacological therapeutic approaches that effectively treat psychosocial deficits
unique to TBI. Developing innovative, evidence based methods is essential in helping children
recover from the injury.
therapy (MBCT) intervention will have on internalizing and externalizing problems in children
and adolescents that have suffered a Traumatic Brain Injury (TBI). MBCT is a manualized
intervention developed to increase social-emotional resiliency through mindful attention.
Internalizing problems refer to a set of symptoms in which a person over-controls their
emotions and results in social withdrawal, feelings of worthlessness, depression, and anxiety
(Bloom et al., 2001). In contrast, externalizing problems refer to an under-control of
emotions which results in conduct problems, impulsive behavior, and aggression. Social and
emotional difficulties are prominent consequences of childhood TBI. Left untreated or
undertreated, these problems often persist into adulthood, producing a wide range of
challenges adapting in personal and vocational domains. At present, there are minimal
non-pharmacological therapeutic approaches that effectively treat psychosocial deficits
unique to TBI. Developing innovative, evidence based methods is essential in helping children
recover from the injury.
Traumatic Brain Injury (TBI) represents a significant, adverse life event. Among the
estimated 634,000 pediatric TBI cases occurring annually in the United States (Langlois,
Rutlan-Brown, & Thomas, 2006), some reports suggest that approximately 50% of these children
and adolescents will develop emotional and behavioral problems. For example, pediatric TBI is
associated with negative psychosocial health outcomes including symptoms of internalizing
such as depression, (Bloom et al., 2001; Fann, Hart, & Schomer, 2009), withdrawal, and
anxiety, and symptoms of externalizing such as impulsivity and aggression (Iversion, 2005;
Cole et al., 2008). These maladaptive symptoms are typically correlated with problems in
interpersonal relationships and overall social adjustment, contributing to further detriment
to social and emotional development (Ganesalingam et al., 2011).
Despite these statistics, our understanding of how to best treat problematic psychosocial
sequelae that follow pediatric TBI is largely uncertain and remains an understudied area in
the literature. Indeed, relatively few empirically rigorous studies have been conducted
examining effective treatment methods targeting internalizing and externalizing symptoms
among youth with a TBI; yet, this is an essential area of study that needs to be a priority
in research efforts (Semrud-Clikeman, 2010).
Given the beneficial outcomes found with other pediatric populations, it is expected that the
MBCT intervention would have a similar, positive impact on adjustment among children and
adolescents post TBI. Problems in impulsivity, emotional lability, and anxiety are
experienced by many children and adolescents with a TBI, suggesting that a MBCT intervention,
which focuses on improving attention, regulatory processes, and reducing stress, would be
particularly advantageous for this population.
Youth that meet the inclusion / exclusion criteria will be randomly assigned to either the
control group (arts and crafts activities group) or the MBCT experimental condition. The
treatments will be 75 minute, weekly sessions for 8 weeks.
estimated 634,000 pediatric TBI cases occurring annually in the United States (Langlois,
Rutlan-Brown, & Thomas, 2006), some reports suggest that approximately 50% of these children
and adolescents will develop emotional and behavioral problems. For example, pediatric TBI is
associated with negative psychosocial health outcomes including symptoms of internalizing
such as depression, (Bloom et al., 2001; Fann, Hart, & Schomer, 2009), withdrawal, and
anxiety, and symptoms of externalizing such as impulsivity and aggression (Iversion, 2005;
Cole et al., 2008). These maladaptive symptoms are typically correlated with problems in
interpersonal relationships and overall social adjustment, contributing to further detriment
to social and emotional development (Ganesalingam et al., 2011).
Despite these statistics, our understanding of how to best treat problematic psychosocial
sequelae that follow pediatric TBI is largely uncertain and remains an understudied area in
the literature. Indeed, relatively few empirically rigorous studies have been conducted
examining effective treatment methods targeting internalizing and externalizing symptoms
among youth with a TBI; yet, this is an essential area of study that needs to be a priority
in research efforts (Semrud-Clikeman, 2010).
Given the beneficial outcomes found with other pediatric populations, it is expected that the
MBCT intervention would have a similar, positive impact on adjustment among children and
adolescents post TBI. Problems in impulsivity, emotional lability, and anxiety are
experienced by many children and adolescents with a TBI, suggesting that a MBCT intervention,
which focuses on improving attention, regulatory processes, and reducing stress, would be
particularly advantageous for this population.
Youth that meet the inclusion / exclusion criteria will be randomly assigned to either the
control group (arts and crafts activities group) or the MBCT experimental condition. The
treatments will be 75 minute, weekly sessions for 8 weeks.
Inclusion Criteria:
- Moderate or severe Traumatic Brain Injury (TBI)
- TBI occurred at least 6 months prior
- Age at enrollment: 9 to 17 years.
- Elevated internalizing or externalizing symptoms
Exclusion Criteria:
- Substantial impairment in language ability
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