Exploring the fear-avoidance model after brain injury

Melloney Leonarda Maria Wijenberg

Research output: ThesisDoctoral ThesisInternal

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After brain injury people often suffer from various symptoms that impact daily functioning. Specifically for mild traumatic brain injury, these symptoms are known as persistent post-concussion symptoms (PCS). It is still unknown why the extent, duration and impact of these symptoms vary highly across individuals. We showed that a combination of biological (e.g. injury severity), personal (e.g., age), and psychosocial (e.g., anxiety) variables, also known as a biopsychosocial approach, improves our understanding of prolonged recovery after brain injury. Moreover, we showed for the first time that the PCS-related fear-avoidance model, which emphasizes the role of anxiety and thoughts about symptoms, further improves our understanding of PCS-related disability. This model states we should not avoid the mental challenges PCS pose, but confront these challenges by thinking beyond diagnosis: ask about thoughts about symptoms and take these into account when helping patients with brain injury struggling with life’s curveballs.
Original languageEnglish
Awarding Institution
  • Maastricht University
  • van Heugten, Caroline, Supervisor
  • Verbunt, Jeanine, Supervisor
  • Stapert, S.Z., Co-Supervisor
Award date5 Jul 2021
Place of PublicationMaastricht
Print ISBNs9789464233162
Publication statusPublished - 2021


  • fear-avoidance model
  • biopsychosocial approach
  • brain injury
  • chronic phase
  • persistent symptoms
  • chronic disability


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