Citation

Wijenberg MLM, Stapert SZ, Verbunt JA, Ponsford JL, van Heugten CM. Brain Inj. 2017; 31(12): 1597-1604.

Affiliation

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience , Maastricht University , Maastricht , The Netherlands.

Copyright

(Copyright © 2017, Informa - Taylor and Francis Group)

DOI

10.1080/02699052.2017.1366551

PMID

28980825

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.

Language: en

Keywords

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