Fear avoidance behavior is related to symptom persistence and disability in various health conditions, such as chronic pain. Fear avoidance behavior also may impact recovery from mild traumatic brain injury (mTBI), but no measure of this construct has been psychometrically validated for the mTBI population. Adults who sustained an mTBI (n = 159) were recruited from three outpatient mTBI clinics. Participants completed the new Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire (FAB-TBI). The FAB-TBI includes 16 items drawn from well-established fear avoidance scales, primarily in the chronic pain literature. An exploratory factor analysis and Rasch analysis were conducted to evaluate the factor structure, dimensionality, and differential item functioning of the FAB-TBI. The FAB-TBI scale was found to have strong internal consistency (Cronbach's α = 0.9). Exploratory factor analysis suggested at least two distinct factors (activity avoidance and cogniphobia). Initial fit to the Rasch model was adequate, with one misfitting item. The model was not improved after removing the misfitting item. Best fit to the unidimensional Rasch model was achieved after items were combined into three super items based on exploratory factor analysis and retaining the misfitting item χ²(6, n = 159) = 2.1, p = 0.06). The FAB-TBI appears to be a psychometrically sound measure of fear avoidance behavior after mTBI. Conversion tables are made available to convert scores into interval-level data for future research.

中文翻译：

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创伤性脑损伤问卷后恐惧回避行为的评估。

恐惧回避行为与各种健康状况下的症状持续和残疾有关，例如慢性疼痛。恐惧回避行为也可能影响轻度创伤性脑损伤 (mTBI) 的恢复，但尚未针对 mTBI 人群对这种结构的测量进行心理测量验证。患有 mTBI 的成年人 ( n = 159) 从三个门诊 mTBI 诊所招募。参与者完成了新的创伤性脑损伤后恐惧回避行为问卷 (FAB-TBI)。FAB-TBI 包括 16 个项目，这些项目来自完善的恐惧回避量表，主要是在慢性疼痛文献中。进行探索性因素分析和 Rasch 分析以评估 FAB-TBI 的因素结构、维度和差异项目功能。发现 FAB-TBI 量表具有很强的内部一致性（Cronbach's α = 0.9）。探索性因素分析表明至少有两个不同的因素（活动回避和认知恐惧症）。对 Rasch 模型的初始拟合是足够的，只有一个不合适的项目。去除不拟合项后，模型没有得到改进。² (6, n  = 159) = 2.1, p  = 0.06)。FAB-TBI 似乎是 mTBI 后恐惧回避行为的心理测量方法。转换表可用于将分数转换为区间级数据以供将来研究。