Details

Autor(en) / Beteiligte

• Lovette, Brenda C.
• Briskin, Ellie A.
• Grunberg, Victoria A.
• Vranceanu, Ana-Maria
• Greenberg, Jonathan
• Kratz, Anna
• Perrin, Paul B

Titel

"I Completely Shut Down": A Mixed Methods Evaluation of the Fear-Avoidance Model for Young Adults With a Recent Concussion and Anxiety

Ist Teil von

• Rehabilitation psychology, 2024-08, Vol.69 (3), p.206-216

Ort / Verlag

United States: American Psychological Association

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• 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. Impact and ImplicationsOur findings suggest that the fear-avoidance model is a useful lens for understanding the lived experiences of young adults with co-occurring anxiety-a population at risk for developing persistent concussion symptoms. Treatment should consider the interplay of concussion symptoms, anxiety, depression, disability, and pain-related fear by offering adaptive confrontation strategies and addressing the interpersonal impact of concussion. Results emphasize the value of psychosocial treatment during the early phase of recovery, a crucial time to impact outcomes. Future research should include more diverse populations, longitudinal designs, and deeper exploration of symptom confrontation strategies to support recovery.