"I completely shut down": A mixed methods evaluation of the fear-avoidance model for young adults with a recent concussion and anxiety.

IF 1.9 4区 医学 Q3 PSYCHOLOGY, CLINICAL
Rehabilitation Psychology Pub Date : 2024-08-01 Epub Date: 2024-02-15 DOI:10.1037/rep0000549
Brenda C Lovette, Ellie A Briskin, Victoria A Grunberg, Ana-Maria Vranceanu, Jonathan Greenberg
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引用次数: 0

Abstract

Purpose/objectives: The fear-avoidance model is a well-established framework for understanding the transition from acute to chronic pain. However, its applicability to concussions is not yet well understood. Here, we conduct the first mixed methods analysis of the fear-avoidance model in young adults with a recent concussion and co-occurring anxiety and assess the model's alignment with their lived experience.

Research method/design: We conducted a mixed methods analysis using a cross-sectional parallel design. Seventeen participants completed questionnaires corresponding with the elements in the fear-avoidance model (e.g., pain catastrophizing, avoidance, disability, anxiety, depression, etc.) and participated in semistructured interviews probing their experiences following their concussion between March 2021 and February 2022. We calculated bivariate correlations for quantitative data and analyzed the qualitative data using hybrid inductive-deductive thematic analysis.

Results: Quantitative results demonstrated strong and medium-sized correlations among theorized relationships within the fear-avoidance model (rs = .40-.85) with the majority being statistically significant. Qualitative results provided substantial convergent and complementary support (e.g., bi-directionality of some relationships, associations between nonadjacent model components, centrality of anxiety in symptom persistence) for the application of the fear-avoidance model to concussions. Findings highlighted additional factors (social factors and post-injury endurance patterns) relevant to this population.

Conclusion/implications: The fear-avoidance model is a useful lens for understanding the lived experience of young adults with a recent concussion and co-occurring anxiety. Psychosocial treatment for this population would benefit from focusing on the interplay of concussion symptoms, anxiety, depression, disability, and pain-related fear, offering adaptive confrontation strategies, and addressing the interpersonal impact of concussion. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

"我完全崩溃了采用混合方法评估针对近期有脑震荡和焦虑症的年轻人的恐惧-回避模式。
目的/目标:恐惧-回避模型是一个行之有效的框架,可用于理解从急性疼痛到慢性疼痛的转变。然而,该模型对脑震荡的适用性尚未得到很好的理解。在此,我们首次采用混合方法对近期患有脑震荡并同时伴有焦虑症的年轻人的恐惧-回避模型进行了分析,并评估了该模型与他们生活经验的一致性:我们采用横断面平行设计进行了混合方法分析。17 名参与者填写了与恐惧-回避模型中的要素(如疼痛灾难化、回避、残疾、焦虑、抑郁等)相对应的问卷,并在 2021 年 3 月至 2022 年 2 月期间参加了半结构式访谈,探究他们脑震荡后的经历。我们计算了定量数据的二元相关性,并采用归纳-演绎混合主题分析法分析了定性数据:定量结果表明,在恐惧-规避模型中,各理论关系之间存在较强和中等程度的相关性(rs = .40-.85),其中大部分具有统计学意义。定性结果为恐惧-回避模型在脑震荡中的应用提供了大量的趋同性和互补性支持(例如,某些关系的双向性、非相邻模型成分之间的关联、焦虑在症状持续中的中心地位)。研究结果强调了与该人群相关的其他因素(社会因素和伤后耐力模式):恐惧-回避模型是了解近期患有脑震荡并同时伴有焦虑症的年轻人生活经历的一个有用视角。针对这一人群的社会心理治疗应关注脑震荡症状、焦虑、抑郁、残疾和与疼痛相关的恐惧之间的相互作用,提供适应性对抗策略,并解决脑震荡对人际关系的影响。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
7.40%
发文量
65
期刊介绍: Rehabilitation Psychology is a quarterly peer-reviewed journal that publishes articles in furtherance of the mission of Division 22 (Rehabilitation Psychology) of the American Psychological Association and to advance the science and practice of rehabilitation psychology. Rehabilitation psychologists consider the entire network of biological, psychological, social, environmental, and political factors that affect the functioning of persons with disabilities or chronic illness. Given the breadth of rehabilitation psychology, the journal"s scope is broadly defined.
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