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Title: Does the fear avoidance model explain persistent symptoms after traumatic brain injury?
Epworth Authors: Ponsford, Jennie
Other Authors: Wijenberg, Melloney
Stapert, Sven
Verbunt, Jeanine
Van Heugten, Caroline
Keywords: Catastrophizing Thoughts
Mild Traumatic Brain Injury
Chronic Phase
Fear Avoidance Behaviour
Fear Avoidance Model
Post Concussion Syndrome
Depressive Symptoms
Tramatic Brain Injury
Recovery Delay
Post Concussional Syndrome
Persistent Symptoms
Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
Issue Date: Oct-2017
Publisher: Taylor & Francis
Citation: Brain Inj. 2017;31(12):1597-1604
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.
DOI: 10.1080/02699052.2017.1366551
PubMed URL:
ISSN: 0269-9052
Journal Title: Brain Injury
Type: Journal Article
Affiliated Organisations: Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University , Maastricht , the Netherlands.
Limburg Brain Injury Centre, Limburg, The Netherlands
Department of Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands
Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
Type of Clinical Study or Trial: Cross-Sectional Study
Appears in Collections:Neurosciences

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