Key words: fear-avoidance model; biopsychosocial approach; brain injury; chronic phase; persistent symptoms; chronic disability

"Exploring the fear-avoidance model after brain injury"

After brain injury people often suffer from various symptoms that impact daily functioning. Specifically for mild traumatic brain injury, these symptoms are known as persistent post-concussion symptoms (PCS). It is still unknown why the extent, duration and impact of these symptoms vary highly across individuals. We showed that a combination of biological (e.g. injury severity), personal (e.g., age), and psychosocial (e.g., anxiety) variables, also known as a biopsychosocial approach, improves our understanding of prolonged recovery after brain injury. Moreover, we showed for the first time that the PCS-related fear-avoidance model, which emphasizes the role of anxiety and thoughts about symptoms, further improves our understanding of PCS-related disability. This model states we should not avoid the mental challenges PCS pose, but confront these challenges by thinking beyond diagnosis: ask about thoughts about symptoms and take these into account when helping patients with brain injury struggling with life’s curveballs.

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