TY - JOUR
T1 - Relevance of the Fear-Avoidance Model for Chronic Disability after Traumatic Brain Injury
AU - Wijenberg, Melloney L.M.
AU - Hicks, Amelia J.
AU - Downing, Marina G.
AU - Van Heugten, Caroline M.
AU - Stapert, Sven Z.
AU - Ponsford, Jennie L.
PY - 2020/12/15
Y1 - 2020/12/15
N2 - Previous studies convincingly suggest that the biopsychosocial fear-Avoidance model (FAM) may be of added value in understanding chronic disability after traumatic brain injury (TBI). In this model, persistent symptoms occur as a result of catastrophizing and fear-Avoidance regarding initial symptoms, leading to depression, reduced mental activity, and greater disability in daily functioning. This study examined the FAM in a large English-speaking TBI sample. A cross-sectional study was conducted in 117 individuals with complicated mild, moderate, or severe TBI at 1-5 years post-injury. Participants completed questionnaires assessing personal, injury-related, and psychological characteristics. Reliability, correlational, and regression analyses were performed. Main outcome measures of chronic disability were depression, disuse (e.g., fewer mental activities), and functional disability. The results revealed that all correlations suggested by the FAM were significant. Catastrophizing thoughts were positively associated with TBI-related symptoms and fear-Avoidance thoughts. Main outcome measures were positively associated with fear-Avoidance thoughts and TBI-related symptoms. Further, variables in the FAM were of additive value to personal, injury-related, and psychological variables in understanding chronic disability after TBI. The separate regression analyses for depression, fewer mental activities, and disability revealed "fear-Avoidance thoughts"as the only consistent variable. In conclusion, this study shows the association of the FAM with chronic disability after TBI, which has implications for assessment and future management of the FAM in TBI in English-speaking countries. Longitudinal studies are warranted to further investigate and refine the model.
AB - Previous studies convincingly suggest that the biopsychosocial fear-Avoidance model (FAM) may be of added value in understanding chronic disability after traumatic brain injury (TBI). In this model, persistent symptoms occur as a result of catastrophizing and fear-Avoidance regarding initial symptoms, leading to depression, reduced mental activity, and greater disability in daily functioning. This study examined the FAM in a large English-speaking TBI sample. A cross-sectional study was conducted in 117 individuals with complicated mild, moderate, or severe TBI at 1-5 years post-injury. Participants completed questionnaires assessing personal, injury-related, and psychological characteristics. Reliability, correlational, and regression analyses were performed. Main outcome measures of chronic disability were depression, disuse (e.g., fewer mental activities), and functional disability. The results revealed that all correlations suggested by the FAM were significant. Catastrophizing thoughts were positively associated with TBI-related symptoms and fear-Avoidance thoughts. Main outcome measures were positively associated with fear-Avoidance thoughts and TBI-related symptoms. Further, variables in the FAM were of additive value to personal, injury-related, and psychological variables in understanding chronic disability after TBI. The separate regression analyses for depression, fewer mental activities, and disability revealed "fear-Avoidance thoughts"as the only consistent variable. In conclusion, this study shows the association of the FAM with chronic disability after TBI, which has implications for assessment and future management of the FAM in TBI in English-speaking countries. Longitudinal studies are warranted to further investigate and refine the model.
KW - chronic disability
KW - chronic phase
KW - fear-Avoidance model
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85098085490&partnerID=8YFLogxK
U2 - 10.1089/neu.2020.7135
DO - 10.1089/neu.2020.7135
M3 - Article
C2 - 32842860
AN - SCOPUS:85098085490
VL - 37
SP - 2639
EP - 2646
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
SN - 0897-7151
IS - 24
ER -