Abstract
Cognitive control enables individuals to imagine future events and develop personal goals, which are critical for sense of purpose. For Veterans with chronic multi-symptom illness (CMI), augmenting cognitive control and other factors related to brain health may improve symptom management and quality of life (QoL). This pilot study utilizes neuroscience evidence to enhance psychological health, with a combination of remote meditation and aerobic exercise (mental and physical [MAP] training) to evaluate what type of distance-based instruction is optimal for Veterans engaged in these health behaviors. Twenty-five Veterans with CMI were randomized to either an eight-week directed MAP (dMAP; nā=ā12) group where specific instructions were provided via text messaging or an eight-week self-guided MAP (sgMAP; nā=ā13) group where they received the goals of the MAP intervention without weekly guidance. Participants also completed health coaching weekly. Self-report health measures were collected during baseline, post-treatment, and three-month follow-up, with the primary outcome assessed using the Behavior Rating Inventory of Executive Function - Adult Version (BRIEF-A). A significant group-by-time interaction was observed for the BRIEF-A subscales: inhibit and task monitor, both demonstrating differences in the direction of change between the groups. A significant overall time effect was observed for depression, sleep quality, and mental health-related QoL, each demonstrating improvement. MAP training significantly improved multiple symptoms in Veterans with CMI. This suggests that empowering Veterans with goals and support through health coaching may be a viable approach to improving health in those suffering from chronic illness.
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References
McAndrew, L., Helmer, D., Phillips, L., Chandler, H., Ray, K., Quigley, K.: Iraq and Afghanistan Veterans report symptoms consistent with chronic multisymptom illness one year after deployment. J. Rehabil. Res. Dev. 53(1), 59ā70 (2016)
Institute of Medicine: Chronic multisymptom Illness in Gulf War Veterans: Case Definitions Reexamined. The National Academies Press, Washington, D.C. (2014). https://doi.org/10.17226/18623
Porter, B., Long, K., Rull, R., Dursa, E.: Millennium cohort study team: prevalence of chronic multisymptom illness/gulf war illness over time among millennium cohort participants, 2001 to 2016. J. Occup. Environ. Med. 62(1), 4ā10 (2020)
Department of Veterans Affairs and Department of Defense: VA/DoD clinical practice guideline for the management of chronic multisymptom illness (2021). https://www.healthquality.va.gov/guidelines/MR/cmi/VADoDCMICPG508.pdf
Niendam, T., Laird, A., Ray, K., Dean, Y., Glahn, D., Carter, C.: Meta-analytic evidence for a superordinate cognitive control network subserving diverse executive functions. Cogn. Affect. Behav. Neurosci. 12(2), 241ā268 (2012)
Cole, M.W., Repovs, G., Anticevic, A.: The frontoparietal control system: a central role in mental health. Neuroscientist 20(6), 652ā664 (2014)
Allan, J.L., McMinn, D., Daly, M.A.: Bidirectional relationship between executive function and health behavior: evidence, implications, and future directions. Front. Neurosci. 10(386) (2016)
Shors, T., Chang, H., Millon, E.: MAP training my BrainTM: meditation plus aerobic exercise lessens trauma of sexual violence more than either activity alone. Front. Neurosci. 12, 211 (2018)
Alderman, B., Olson, R., Brush, C., Shors, T.: MAP training: combining meditation and aerobic exercise reduces depression and rumination while enhancing synchronized brain activity. Transl. Psychiatry 6, e726 (2016)
Lavadera, P., Millon, E., Shors, T.: MAP train my brain: meditation combined with aerobic exercise reduces stress and rumination while enhancing quality of life in medical students. J. Altern. Complement. Med. 26(5) (2020)
Millon, E.M., Shors, T.: Taking neurogenesis out of the lab and into the world with MAP train my BrainTM. Behav. Brain Res. 376, Epub (2019)
Shors, T., Olson, R., Bates, M., Selby, E., Alderman, B.: Mental and physical (MAP) training: a neurogenesis-inspired intervention that enhances health in humans. Neurobiol. Learn. Mem. 115, 3ā9 (2014)
Fukuda, K., Nisenbaum, R., Stewart, G., et al.: Chronic multisymptom illness affecting air force veterans of the gulf war. JAMA 280(11), 981ā988 (1998)
U.S. Department of Veteran Affairs: Annie App for Veterans. https://mobile.va.gov/app/annie-app-veterans
U.S. Department of Veteran Affairs: Whole Health, 26 July 2021. https://www.va.gov/WHOLEHEALTH/veteran-resources/whole-health-basics.asp. Accessed 14 Jan 2022
Roth, R., Isquith, P., Gioia, G.: Behavioral Rating Inventory of Executive FunctionāAdult Version. Psychological Assessment Resources, Inc., Lutz (2005)
Derogatis, L., Spencer, P.: Brief Symptom Inventory: BSI. Pearson, Upple Saddle River (1993)
DerouesnĆ©, C., Dealberto, M., Boyer, P., et al.: Empirical evaluation of the ācognitive difficulties scaleā for assessment of memory complaints in general practice: a study of 1628 cognitively normal subjects aged 45ā75 years. Int. J. Geriatr. Psychiatry 8(7), 599ā607 (1993)
Baer, R., Smith, G., Lykins, E., et al.: Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment 15(3), 329ā342 (2008)
Wilkins, K., Lang, A., Norman, S.: Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions. Depress. Anxiety 28(7), 596ā606 (2011)
Kroenke, K., Spitzer, R., Williams, J.: The PHQ-9: validity of a brief depression severity measure. J. Gen. Intern. Med. 16, 606ā613 (2001)
Buysse, D.J., Reynolds, C.F., Monk, T.H., Berman, S.R., Kupfer, D.J.: The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 28(2), 193ā213 (1989)
Cohen, S., Kamarck, T., Mermelstein, R.: A global measure of perceived stress. J. Health Soc. Behav. 24(4), 385ā396 (1983)
Ware, J., Sherbourne, C.: The MOS 36-item short-form health survey (SF-36): I. Coneptual framework and item selection. Med. Care 30(6), 473ā483 (1992)
Oliver, E.J., Markland, D., Hardy, J., Petherick, C.M.: The effects of autonomy-supportive versus controlling environments on self-talk. Motiv. Emot. 32(3), 200ā212 (2008)
Hagger, M.S., Hardcastle, S.J., Chater, A., Mallett, C., Pal, S., Chatzisarantis, N.L.: Autonomous and controlled motivational regulations for multiple health-related behaviors: between- and within-participants analyses. Health Psychol. Behav. Med. 2(1), 565ā601 (2014)
Gagne, M., Ryan, R.M., Bargmann, K.: Autonomy support and need satisfaction in the motivation and well-being of gymnasts. J. Appl. Sport Psychol. 15(4), 372ā390 (2003)
Grolnick, W.S., Ryan, R.M., Deci, E.L.: Inner resources for school achievement: motivational mediators of childrenās perceptions of their parents. J. Educ. Psychol. 83(4), 508ā517 (1991)
Vansteenkiste, M., Simons, J., Lens, W., Sheldon, K.M., Deci, E.L.: Motivating learning, performance, and persistence: the synergistic effects of intrinsic goal contents and autonomy-supportive contexts. J. Pers. Soc. Psychol. 87(2), 246ā260 (2004)
Vansteenkiste, M., Simons, J., Lens, W., Soenens, B., Matos, L.: Examining the motivational impact of intrinsic versus extrinsic goal framing and autonomy-supportive versus internally controlling communication style on early adolescentsā academic achievement. Child Dev. 76(2), 483ā501 (2005)
Hofmann, W., Schmeichel, B.J., Baddeley, A.D.: Executive functions and self-regulation. Trends Cogn. Sci. 16(3), 174ā180 (2012)
Kelley, N.J., Gallucci, A., Riva, P., Romero Lauro, L.J., Schmeichel, B.J.: Stimulating self-regulation: a review of non-invasive brain stimulation studies of goal-directed behavior. Front. Behav. Neurosci. 12(337) (2019)
Cook, D.B., Stegner, A.J., Ellingson, L.D.: Exercise alters pain sensitivity in Gulf War Veterans with chronic musculoskeletal pain. J. Pain 11(8), 764ā772 (2010)
Rayhan, R.U., Stevens, B.W., Raksit, M.P., et al.: Exercise challenge in Gulf War Illness reveals two subgroups with altered brain structure and function. PLoS ONE 8(6), e63903 (2013)
Li, M., Xu, C., Yao, W., et al.: Self-reported post-exertional fatigue in Gulf War veterans: roles of autonomic testing. Front. Neurosci. 7(269) (2014)
Matsangas, P., Mysliwiec, V.: The utility of the Pittsburgh sleep quality index in US military personnel. Mil. Psychol. 30(4), 360ā369 (2018)
Huang, Y., Zhu, M.: Increased global PSQI score is associated with depressive symptoms in an adult population from the United States. Nat. Sci. Sleep 12, 487ā495 (2020)
Polaski, A., Phelps, A.L., Smith, T.J., et al.: Integrated meditation and exercise therapy: a randomized controlled pilot of a combined nonpharmacological intervention focused on reducing disability and pain in patients with chronic low back pain. Pain Med. 23(2), 444ā458 (2021)
Funding
This pilot study was funded by the Georgetown-Howard Universities Center for Clinical and Translational Science: Pilot Translational and Clinical Studies Program.
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Authors report no conflicts of interest. The opinions presented in this article are those of the authors and do not reflect the views of any institution/agency of the U.S. government, Georgetown University, Uniformed Services University of the Health Sciences, or the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.
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Breneman, C.B. et al. (2022). Improved Psychological Health Through a Remote Behavioral Intervention: A Telehealth Pilot Study for Veterans with Chronic Multi-symptom Illness. In: Schmorrow, D.D., Fidopiastis, C.M. (eds) Augmented Cognition. HCII 2022. Lecture Notes in Computer Science(), vol 13310. Springer, Cham. https://doi.org/10.1007/978-3-031-05457-0_2
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