Two instruments to assess catastrophizing and fear-avoidance behavior in mild traumatic brain injury

What is it about?

Fear and avoidance behaviors are normal responses to aversive stimuli. However after an injury (such as mild traumatic brain injury, referred to as mTBI), some individuals experience persistent complaints (for example postconcussion symptoms including headaches, fatigue, memory and attention concerns) that negatively interfere with their daily lives. These complaints make it difficult for the individual to return to work, participate in their social environment, and complete normal everyday tasks (such as household tasks). The mechanisms that underlie these complaints are unclear but it is thought that symptom catastrophizing and fear-avoidance behaviors may be associated factors. Symptom catastrophizing can be understood as interpreting symptoms in an overly negative way. While, fear-avoidance behaviors are behaviors or activities that an individual avoids due to fear of increasing symptoms or re-injury. These two factors can lead to depression and disability. It is important to have reliability and valid measures of these factors not only for research purposes but also for clinical purposes. This study investigated the psychometric properties of two adapted instruments to measure catastrophizing, the Postconcussion Symptoms Catastrophizing Scale (PCS-CS), and fear avoidance behavior, the Fear of Mental Activity Scale (FMA) in participants with MTBI. Results showed that both instruments had good reliability and good validity.

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Photo by ODISSEI on Unsplash

Photo by ODISSEI on Unsplash

Why is it important?

This study has shown that these two instruments, the PCS-CS and FMA, are psychometrically sound and can be considered valid and reliable for the assessment of catastrophizing about postconcussion like symptoms and fear-avoidance beliefs about mental activities. These instruments can be used in research and in clinical practice applications to add to the explanations and treatment of prolonged recovery after mTBI.