Objective: Fear-avoidance and endurance behavior are well-established maladaptive coping styles in several chronic health conditions. There is also emerging evidence that both fear-avoidance and endurance coping are associated with poor outcome from mild traumatic brain injury (mTBI). The current study sought to characterize the early trajectories of avoidance and endurance behavior and confirm their association with disability outcomes. Method: Adults with mTBI (N = 88) completed measures of avoidance, endurance, and postconcussive symptoms at clinic intake (M = 40.2 days since injury). Avoidance and endurance measures were readministered 1 month later (N = 79), and a measure of perceived functional disability (World Health Organization Disability Assessment Schedule 2.0) was completed 3 months after clinic intake (N = 69). Results: Avoidance and endurance coping were weakly positively correlated with each other at intake (r = .28) and at 1 month postintake (r = .28). Change scores on these two measures over time were not significantly correlated (r = .04). Avoidance coping tended to decrease over time (95% CI [0.6, 2.5]; p = .002), whereas changes in endurance coping were variable. In generalized linear modeling, higher avoidance and endurance at clinic intake and increasing (or less rapidly decreasing) levels of these coping styles over 1 month was associated with greater perceived disability ratings at 3 months, even after controlling for postconcussion symptom severity at intake. Conclusion: These findings suggest that avoidance and endurance behavior are distinct coping styles with unique trajectories during the subacute recovery period. The results also support the need for psychologically informed early interventions that target specific profiles of maladaptive coping to mitigate risk for poor outcomes post-mTBI. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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轻度创伤性脑损伤后的回避和耐力应对与残疾结果相关。

目标：恐惧回避和耐力行为是几种慢性健康状况中公认的适应不良的应对方式。还有新的证据表明，恐惧回避和耐力应对都与轻度创伤性脑损伤 (mTBI) 的不良结果有关。目前的研究试图描述回避和耐力行为的早期轨迹，并确认它们与残疾结果的关联。方法：患有 mTBI 的成人（N = 88）在就诊时（M = 受伤后 40.2 天）完成了回避、耐力和脑震荡后症状的测量。1 个月后重新进行回避和耐力测量（N = 79），并在门诊就诊后 3 个月（N = 69）完成感知功能障碍的测量（世界卫生组织残疾评估表 2.0）。结果：在摄入 (r = .28) 和摄入后 1 个月 (r = .28) 时，回避和耐力应对彼此呈弱正相关。随着时间的推移，这两项测量的变化分数没有显着相关性 (r = .04)。回避应对倾向于随着时间的推移而降低（95% CI [0.6, 2.5]；p = .002），而耐力应对的变化是可变的。在广义线性模型中，即使在控制了摄入时脑震荡后症状的严重程度之后，在 1 个月内，临床摄入量较高的回避和耐力以及这些应对方式的增加（或降低速度较慢）水平与 3 个月时更高的感知残疾等级相关。结论：这些发现表明，在亚急性恢复期，回避和耐力行为是不同的应对方式，具有独特的轨迹。结果还支持需要针对适应不良应对的特定情况进行心理知情的早期干预，以减轻 mTBI 后不良结果的风险。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。