Does the fear avoidance model explain persistent symptoms after traumatic brain injury?

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking.

OBJECTIVE: To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI.

DESIGN: Cross-sectional study.

PARTICIPANTS: 48 patients with TBI, of which 31 patients with mTBI, had persistent symptoms (mean time since injury 48.2 months); 92% of the entire sample fulfilled the criteria for post-concussion syndrome.

OUTCOME VARIABLES: catastrophizing, fear-avoidance, depression and post-concussion symptoms.

RESULTS: High levels of catastrophizing were found in 10% and high levels of fear avoidance behaviour were found in 35%. Catastrophizing, fear avoidance behaviour, depressive symptoms and post-concussion symptoms correlated significantly with each other (p < 0.05).

CONCLUSION: The fear-avoidance model proposes a possible explanation for persistent symptoms. Validation and normative data are needed for suitable measures of catastrophizing and fear avoidance of post-concussion symptoms after TBI. Longitudinal prospective cohort studies are needed to establish its causal and explanatory nature.

Original languageEnglish
Pages (from-to)1597–1604
Number of pages8
JournalBrain Injury
Volume31
Issue number12
Early online date5 Oct 2017
DOIs
Publication statusPublished - Oct 2017

Keywords

  • Journal Article
  • HEAD-INJURY
  • MUSCULOSKELETAL PAIN
  • Traumatic brain injury
  • DEPRESSION SCALE
  • CONCUSSION SYMPTOMS
  • Catastrophizing
  • chronic phase
  • HOSPITAL ANXIETY
  • POSTCONCUSSIVE SYMPTOMS
  • CHRONIC TINNITUS
  • MULTIPLE-SCLEROSIS
  • PAIN CATASTROPHIZING SCALE
  • CROSS-VALIDATION
  • fear avoidance behaviour
  • post concussional syndrome
  • persistent symptoms

Cite this

@article{14c9d15e8f4245d7856797876c58f404,
title = "Does the fear avoidance model explain persistent symptoms after traumatic brain injury?",
abstract = "BACKGROUND: A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking.OBJECTIVE: To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI.DESIGN: Cross-sectional study.PARTICIPANTS: 48 patients with TBI, of which 31 patients with mTBI, had persistent symptoms (mean time since injury 48.2 months); 92{\%} of the entire sample fulfilled the criteria for post-concussion syndrome.OUTCOME VARIABLES: catastrophizing, fear-avoidance, depression and post-concussion symptoms.RESULTS: High levels of catastrophizing were found in 10{\%} and high levels of fear avoidance behaviour were found in 35{\%}. Catastrophizing, fear avoidance behaviour, depressive symptoms and post-concussion symptoms correlated significantly with each other (p < 0.05).CONCLUSION: The fear-avoidance model proposes a possible explanation for persistent symptoms. Validation and normative data are needed for suitable measures of catastrophizing and fear avoidance of post-concussion symptoms after TBI. Longitudinal prospective cohort studies are needed to establish its causal and explanatory nature.",
keywords = "Journal Article, HEAD-INJURY, MUSCULOSKELETAL PAIN, Traumatic brain injury, DEPRESSION SCALE, CONCUSSION SYMPTOMS, Catastrophizing, chronic phase, HOSPITAL ANXIETY, POSTCONCUSSIVE SYMPTOMS, CHRONIC TINNITUS, MULTIPLE-SCLEROSIS, PAIN CATASTROPHIZING SCALE, CROSS-VALIDATION, fear avoidance behaviour, post concussional syndrome, persistent symptoms",
author = "Wijenberg, {Melloney L M} and Stapert, {Sven Z} and Verbunt, {Jeanine A} and Ponsford, {Jennie L} and {Van Heugten}, {Caroline M}",
year = "2017",
month = "10",
doi = "10.1080/02699052.2017.1366551",
language = "English",
volume = "31",
pages = "1597–1604",
journal = "Brain Injury",
issn = "0269-9052",
publisher = "TAYLOR & FRANCIS LTD",
number = "12",

}

Does the fear avoidance model explain persistent symptoms after traumatic brain injury? / Wijenberg, Melloney L M; Stapert, Sven Z; Verbunt, Jeanine A; Ponsford, Jennie L; Van Heugten, Caroline M.

In: Brain Injury, Vol. 31, No. 12, 10.2017, p. 1597–1604.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Does the fear avoidance model explain persistent symptoms after traumatic brain injury?

AU - Wijenberg, Melloney L M

AU - Stapert, Sven Z

AU - Verbunt, Jeanine A

AU - Ponsford, Jennie L

AU - Van Heugten, Caroline M

PY - 2017/10

Y1 - 2017/10

N2 - BACKGROUND: A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking.OBJECTIVE: To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI.DESIGN: Cross-sectional study.PARTICIPANTS: 48 patients with TBI, of which 31 patients with mTBI, had persistent symptoms (mean time since injury 48.2 months); 92% of the entire sample fulfilled the criteria for post-concussion syndrome.OUTCOME VARIABLES: catastrophizing, fear-avoidance, depression and post-concussion symptoms.RESULTS: High levels of catastrophizing were found in 10% and high levels of fear avoidance behaviour were found in 35%. Catastrophizing, fear avoidance behaviour, depressive symptoms and post-concussion symptoms correlated significantly with each other (p < 0.05).CONCLUSION: The fear-avoidance model proposes a possible explanation for persistent symptoms. Validation and normative data are needed for suitable measures of catastrophizing and fear avoidance of post-concussion symptoms after TBI. Longitudinal prospective cohort studies are needed to establish its causal and explanatory nature.

AB - BACKGROUND: A minority of patients with mild traumatic brain injury (mTBI) experience a persistent symptom complex also known as post-concussion syndrome. Explanations for this syndrome are still lacking.OBJECTIVE: To investigate if the fear avoidance model, including catastrophizing thoughts and fear avoidance behaviour, poses a possible biopsychosocial explanation for lingering symptoms and delay in recovery after traumatic brain injury (TBI) with special focus on mTBI.DESIGN: Cross-sectional study.PARTICIPANTS: 48 patients with TBI, of which 31 patients with mTBI, had persistent symptoms (mean time since injury 48.2 months); 92% of the entire sample fulfilled the criteria for post-concussion syndrome.OUTCOME VARIABLES: catastrophizing, fear-avoidance, depression and post-concussion symptoms.RESULTS: High levels of catastrophizing were found in 10% and high levels of fear avoidance behaviour were found in 35%. Catastrophizing, fear avoidance behaviour, depressive symptoms and post-concussion symptoms correlated significantly with each other (p < 0.05).CONCLUSION: The fear-avoidance model proposes a possible explanation for persistent symptoms. Validation and normative data are needed for suitable measures of catastrophizing and fear avoidance of post-concussion symptoms after TBI. Longitudinal prospective cohort studies are needed to establish its causal and explanatory nature.

KW - Journal Article

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KW - Traumatic brain injury

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KW - CONCUSSION SYMPTOMS

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KW - chronic phase

KW - HOSPITAL ANXIETY

KW - POSTCONCUSSIVE SYMPTOMS

KW - CHRONIC TINNITUS

KW - MULTIPLE-SCLEROSIS

KW - PAIN CATASTROPHIZING SCALE

KW - CROSS-VALIDATION

KW - fear avoidance behaviour

KW - post concussional syndrome

KW - persistent symptoms

U2 - 10.1080/02699052.2017.1366551

DO - 10.1080/02699052.2017.1366551

M3 - Article

C2 - 28980825

VL - 31

SP - 1597

EP - 1604

JO - Brain Injury

JF - Brain Injury

SN - 0269-9052

IS - 12

ER -