B – 64 Effects of an Intensive Treatment Program Including Individual Cognitive Training on Cognitive Symptoms and Skill Use in Service Members and Veterans with a History of Mild Traumatic Brain Injury and Posttraumatic Stress Disorder

Abstract Objective To evaluate the effects of an intensive treatment program (ITP) on cognitive post-concussion symptoms (PCS) and compensatory skill utilization in service members and veterans (SMVs) with self-reported history of mild traumatic brain injury (mTBI) and/or Posttraumatic Stress Disorder (PTSD) who received primary treatments of individual cognitive training (CT) and cognitive processing therapy (CPT). Method Between 1/2016 and 3/2024, 427 SMVs participated in Operation Mend’s ITP (median age 42, 66% white, 83% male), with daily, individual CT and CPT as primary treatments. Participants completed a battery including the Neurobehavioral Symptom Inventory (NSI) cognitive subscale and a Cognitive Skills Questionnaire at baseline, completion, and three/six/twelve-month follow-up (FU). The drop-out rate was 3%. FU data is available for about 50% of program completers per timepoint. Neuropsychologist/Psychologist-led CT sessions followed a manualized protocol, personalized to the SMV’s needs and goals. Results The NSI cognitive subscale (possible range 0–16) decreased from a mean of 9.8 [95% CI 9.5, 10.2] at baseline to 6.0 [5.7, 6.4], and was 7.4 [6.9, 8.0] at twelve-month FU with similar results for three- and six-month FU (p<.001). The mean days of skills use increased from 3.4 days a week [3.3, 3.6] to 5.0 [4.8, 5.1] at program completion, and were 4.1 [3.9, 4.3] at twelve-month FU, again similar for the other timepoints (p<.001). Conclusion ITP participation was associated with significant and sustained reductions in cognitive PCS symptoms and increased skill use for up to one year. Future analyses will examine relationships between mental health symptoms, PCS, and compensatory skill utilization in SMVs.