Previous studies convincingly suggest that the biopsychosocial fear-avoidance model (FAM) may be of added value in understanding chronic disability after traumatic brain injury (TBI). In this model, persistent symptoms occur as a result of catastrophizing and fear-avoidance regarding initial symptoms, leading to depression, reduced mental activity, and greater disability in daily functioning. This study examined the FAM in a large English-speaking TBI sample. A cross-sectional study was conducted in 117 individuals with complicated mild, moderate, or severe TBI at 1–5 years post-injury. Participants completed questionnaires assessing personal, injury-related, and psychological characteristics. Reliability, correlational, and regression analyses were performed. Main outcome measures of chronic disability were depression, disuse (e.g., fewer mental activities), and functional disability. The results revealed that all correlations suggested by the FAM were significant. Catastrophizing thoughts were positively associated with TBI-related symptoms and fear-avoidance thoughts. Main outcome measures were positively associated with fear-avoidance thoughts and TBI-related symptoms. Further, variables in the FAM were of additive value to personal, injury-related, and psychological variables in understanding chronic disability after TBI. The separate regression analyses for depression, fewer mental activities, and disability revealed “fear-avoidance thoughts” as the only consistent variable. In conclusion, this study shows the association of the FAM with chronic disability after TBI, which has implications for assessment and future management of the FAM in TBI in English-speaking countries. Longitudinal studies are warranted to further investigate and refine the model.

中文翻译：

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创伤性脑损伤后慢性残疾的恐惧回避模型的相关性。

先前的研究令人信服地表明，生物心理社会恐惧回避模型 (FAM) 可能对理解创伤性脑损伤 (TBI) 后的慢性残疾具有附加价值。在这个模型中，持续的症状是由于对初始症状的灾难化和恐惧回避而发生的，导致抑郁、精神活动减少和日常功能更严重的残疾。这项研究检查了一个大型英语 TBI 样本中的 FAM。对 117 名在受伤后 1-5 年患有复杂轻度、中度或重度 TBI 的个体进行了横断面研究。参与者完成了评估个人、伤害相关和心理特征的问卷。进行了可靠性、相关性和回归分析。慢性残疾的主要结局指标是抑郁、废用（例如，较少的心理活动）和功能障碍。结果表明，FAM 提出的所有相关性都是显着的。灾难性想法与 TBI 相关症状和恐惧回避想法呈正相关。主要结局指标与恐惧回避想法和 TBI 相关症状呈正相关。此外，FAM 中的变量对于理解 TBI 后慢性残疾的个人、伤害相关和心理变量具有附加价值。对抑郁症、较少的精神活动和残疾的单独回归分析显示“恐惧回避想法”是唯一一致的变量。总之，这项研究表明 FAM 与 TBI 后慢性残疾的关联，这对英语国家 TBI 中 FAM 的评估和未来管理具有影响。有必要进行纵向研究以进一步调查和完善模型。