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