Psychometric properties of two instruments assessing catastrophizing and fear-avoidance behavior in mild traumatic brain injury

Skye King, Sven Z. Stapert, Melloney L.M. Wijenberg, Ieke Winkens, Jeanine A Verbunt, Marleen M. Rijkeboer, Joukje van der Naalt, Caroline M. van Heugten

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Abstract

Objective: Psychometrically sound measures of catastrophizing about symptoms and fear avoidance behavior are needed to further applications of the fear–avoidance model in mild traumatic brain injury (mTBI) for research and clinical purposes. To this end, two questionnaires were adapted (minor), the Postconcussion Symptom Catastrophizing Scale (PCS-CS) and the Fear of Mental Activity Scale (FMA). This study aimed to investigate the factor structure, internal consistency, test–retest reliability, and concurrent and construct validity of two adapted questionnaires in a sample of participants with mTBI compared to participants with orthopedic injury and healthy adults. Method: One hundred eighty-five mTBI participants (40% female), 180 participants with orthopedic injury (55% female), and 116 healthy adults (55% female) participated in the study. All participants were assessed at two time points (2 weeks postinjury and 3 months) using self-reported questionnaires. Data were collected using online questionnaires. Results: Findings indicated a three-factor model (magnification, rumination, helplessness) with a higher order factor (catastrophizing) for the PCS-CS and a two-factor model (activity avoidance and somatic focus) for the FMA. The results showed strong internal consistency, good test–retest reliability, and good concurrent and convergent validity for the PCS-CS and FMA across all samples. Conclusions: This study has shown that the PCS-CS and FMA are psychometrically sound instruments and can be considered for valid and reliable assessment of catastrophizing about postconcussion like symptoms and fear–avoidance beliefs about mental activities. These instruments can be used in research and clinical practice applications of the fear–avoidance model and add to explanations of prolonged recovery after mTBI.

Original languageEnglish
Pages (from-to)403-415
Number of pages13
JournalNeuropsychology
Volume38
Issue number5
Early online date23 May 2024
DOIs
Publication statusPublished - 23 May 2024

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