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

Melloney L. M. Wijenberg, Sven Z. Stapert, Jeanine A. Verbunt, Jennie L. Ponsford, Caroline M. Van Heugten

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)

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
DOIs
Publication statusPublished - 5 Oct 2017
Externally publishedYes

Keywords

  • Catastrophizing
  • chronic phase
  • fear avoidance behaviour
  • persistent symptoms
  • post concussional syndrome
  • Traumatic brain injury

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