Trajectories of fear avoidance behavior and recovery after mild traumatic brain injury: Findings from the Toronto Concussion Study.

IF 1.7 4区医学 Q3 PSYCHOLOGY, CLINICAL

Rehabilitation Psychology Pub Date : 2025-07-03 DOI:10.1037/rep0000619

Billy Lam, Ana Mikolić, Mark Bayley, Tharshini Chandra, Paul Comper, Evan Foster, Tavina Sathish, Noah D Silverberg

{"title":"Trajectories of fear avoidance behavior and recovery after mild traumatic brain injury: Findings from the Toronto Concussion Study.","authors":"Billy Lam, Ana Mikolić, Mark Bayley, Tharshini Chandra, Paul Comper, Evan Foster, Tavina Sathish, Noah D Silverberg","doi":"10.1037/rep0000619","DOIUrl":null,"url":null,"abstract":"Objective: Fear avoidance behavior is associated with more severe postconcussion symptoms after mild traumatic brain injury (mTBI). However, it remains unclear when after injury fear avoidance behavior becomes a barrier to recovery. This study investigated changes in early fear avoidance behavior after mTBI and its associations with postconcussion symptoms.Method: Adults with concussion (N = 308) were prospectively recruited from an outpatient concussion clinic in Ontario, Canada. They completed measures assessing fear avoidance behavior (Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire) and postconcussion symptoms (Sport Concussion Assessment Tool-5) at Weeks 2 and 8 postinjury (N = 216).Results: Based on normative reference values, the two most common postconcussion trajectories of fear avoidance behavior were those with persistently low and those with initially elevated but decreasing fear avoidance behavior. Using linear regression, we found an interaction effect between fear avoidance behavior at Weeks 2 and 8, indicating that participants with persistently elevated fear avoidance behavior (at Weeks 2 and 8) had more severe postconcussion symptoms at Week 8, whereas participants with initially elevated but decreasing fear avoidance behavior tended to recover well.Conclusion: Early fear avoidance behavior often decreases, but when it does not, it is associated with worse recovery from mTBI. These findings may inform the timing and design of interventions targeting fear avoidance behavior in patients with mTBI. (PsycInfo Database Record (c) 2025 APA, all rights reserved).","PeriodicalId":47974,"journal":{"name":"Rehabilitation Psychology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rehabilitation Psychology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1037/rep0000619","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Fear avoidance behavior is associated with more severe postconcussion symptoms after mild traumatic brain injury (mTBI). However, it remains unclear when after injury fear avoidance behavior becomes a barrier to recovery. This study investigated changes in early fear avoidance behavior after mTBI and its associations with postconcussion symptoms.

Method: Adults with concussion (N = 308) were prospectively recruited from an outpatient concussion clinic in Ontario, Canada. They completed measures assessing fear avoidance behavior (Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire) and postconcussion symptoms (Sport Concussion Assessment Tool-5) at Weeks 2 and 8 postinjury (N = 216).

Results: Based on normative reference values, the two most common postconcussion trajectories of fear avoidance behavior were those with persistently low and those with initially elevated but decreasing fear avoidance behavior. Using linear regression, we found an interaction effect between fear avoidance behavior at Weeks 2 and 8, indicating that participants with persistently elevated fear avoidance behavior (at Weeks 2 and 8) had more severe postconcussion symptoms at Week 8, whereas participants with initially elevated but decreasing fear avoidance behavior tended to recover well.

Conclusion: Early fear avoidance behavior often decreases, but when it does not, it is associated with worse recovery from mTBI. These findings may inform the timing and design of interventions targeting fear avoidance behavior in patients with mTBI. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

查看原文本刊更多论文

轻度创伤性脑损伤后恐惧回避行为和恢复的轨迹：来自多伦多脑震荡研究的发现。

目的：恐惧回避行为与轻度创伤性脑损伤（mTBI）后更严重的脑震荡后症状相关。然而，受伤后恐惧回避行为何时成为康复的障碍尚不清楚。本研究调查了mTBI后早期恐惧回避行为的变化及其与脑震荡后症状的关系。方法：从加拿大安大略省一家脑震荡门诊前瞻性招募成人脑震荡患者（N = 308）。他们在受伤后第2周和第8周完成了恐惧回避行为（创伤性脑损伤后恐惧回避行为问卷）和脑震荡后症状（运动脑震荡评估工具-5）的评估（N = 216）。结果：在标准参考值的基础上，两种最常见的脑震荡后恐惧回避行为轨迹是持续低水平和最初升高但逐渐降低的恐惧回避行为轨迹。使用线性回归，我们发现恐惧回避行为在第2周和第8周之间存在交互作用，表明恐惧回避行为持续升高的参与者（在第2周和第8周）在第8周有更严重的脑震荡后症状，而最初升高但减少恐惧回避行为的参与者往往恢复得很好。结论：早期恐惧回避行为经常减少，但如果没有减少，则与mTBI的恢复较差有关。这些发现可能为针对mTBI患者恐惧回避行为的干预时机和设计提供信息。（PsycInfo Database Record (c) 2025 APA，版权所有）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Rehabilitation Psychology Multiple-

CiteScore

4.80

自引率

7.40%

发文量

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.