Stress Inoculation Training For Impulsive Behaviors In Adults With Traumatic Brain Injury

A stress inoculation training program involving relaxation, self-instructional, and coping skills training was delivered to 5 persons with traumatic brain injury in an attempt to reduce the frequency of their impulsive behaviors. A multiple-baseline across subjects design was utilized to evaluate the effectiveness of the 10-week intervention. Dependent measures included frequency of impulsive behaviors as recorded by staff members at the residential facility where all 5 participants resided, ratings of role-play-probes, effectiveness ratings by the participants' rehabilitation counselors, and interview information obtained from the participants and their counselors. The data showed a small, but consistent reduction in impulsive behaviors across the 5 participants. Additionally, results indicated changes in role-play ratings did not correspond to changes in in-vivo behavioral frequency recordings for 4 of the 5 subjects. These findings suggest that individuals with moderate to severe impairments may require more salient behavioral contingencies and consistent cuing procedures to control their impulsive behavior.