Objective: Although there has been considerable speculation in recent years about the effect of multiple concussions on long term cognitive and behavioral functioning, little is known empirically about its effect on clinical symptomatology and response to treatment interventions. Method: Subjects included 126 Active Duty Service Members with a history of mTBI (3-24 months post-injury) and ongoing cognitive complaints who participated in a six-week randomized controlled trial (RCT) of cognitive rehabilitation (CR) interventions. Primary outcome measures included Paced Auditory Serial Addition Test (PASAT); Symptom Checklist – 90 Revised (SCL-90-R) Global Distress Scale; Key Behaviors Change Inventory (KBCI). Subjects were stratified based upon lifetime concussion frequency (single concussion n = 43; two to four concussions n = 51; five or more concussions n = 31) for the current study. Results: Repeated measures analyses of variance were conducted to compare the effect of number of concussions on each primary outcome measure. The interaction...

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