Problem-Solving Therapy for Gulf War Illness

描述（由申请人提供）：

DESCRIPTION (provided by applicant): The purpose of this CDA is to help Dr. Lisa McAndrew become a national leader in developing and improving patientcenteredself-managementinterventionsforVeteranswithcomplexpost-deployment health concerns. Dr.McAndrewhassignificanttrainingintheoreticalmodelsforunderstandingpatientself-managementand evidence based behavioral treatments. This CDA will allow her to obtain additional skills in (1) health services research, particularly clinical trials and implementation methods (2) qualitative and quantitative methods (3) clinical neuroscience, and (4) grant writing. To support her training goals, Dr. McAndrew will adapt, develop and test a promising cognitive rehabilitation treatment, Problem-Solving Therapy for Gulf War Illness (GWI). Problem-solving is considered one of the most complex of cognitive abilities and is related to complicated behaviors such as setting goals, sequencing and multi-tasking. Impairment in problem-solving ability affects over 70% of Gulf War Veterans (GWV) with GWI and is prospectively related to 1.5 times greater risk of disability. Despite published reports documenting these deficits there are no treatments that target the problem- solving deficits associated with GWI in order to reduce disability. Problem-Solving Therapy teaches patients skills to compensate for problem-solving deficits in order to improve disability, defined as deficits in daily activities and social participation. It has been found to be effective among civilians with mild traumatic brain injury. To modify this intervention, Dr. McAndrew will use qualitative methods to better understand GWVs with GWI as well as VA providers' views on GWI and the proposed problem-solving intervention. She will then use this information to modify Problem-Solving Therapy for use with GWVs with GWI. Finally, she will examine the efficacy of this modified Problem-Solving Therapy for reducing the disability associated with GWI in a pilot randomized controlled trial. Dr.