Journal
BRAIN INJURY
Volume 31, Issue 12, Pages 1597-1604Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/02699052.2017.1366551
Keywords
Catastrophizing; chronic phase; fear avoidance behaviour; persistent symptoms; post concussional syndrome; Traumatic brain injury
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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 48.2months); 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.
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