A-183 Fear-Avoidance Correlated with Prolonged Symptomology Following mTBI

Abstract

Abstract Objective: Mild traumatic brain injury (mTBI) represents a significant public health concern, with approximately 1.7 million injuries annually in the U.S. While most mTBIs resolve within the first month post-injury, approximately 10-15% of patients suffer persistent, chronic symptoms. We evaluate how individual coping strategy affects severity of symptom burden in patients with prolonged recovery from mTBI. Method: We included 50 individuals (age 39.6 ± 19.0, 68% female) who sustained a mTBI at least one month prior to study assessment. Participants completed the Brain Injury Dispositions (BIRDS) scale to assess fear avoidance (FA) and endurance (END) behaviors during mTBI recovery, along with the SCAT5 symptom severity questionnaires. Pearson correlations measured the association of FA and END behaviors with number and severity of persisting concussive symptoms. Results: FA subscores showed a strong, positive correlation with total number of symptoms (r = .71, p < .001) and symptom severity (r = .66, p < .001). END subscores also showed significant, positive correlation with total number of symptoms (r = .46, p < .001) and symptom severity (r = .36, p < .001); however, this correlation was weaker than FA. Conclusions: Individuals employing extreme FA or END coping behaviors were found to report a greater number and severity of concussive symptoms after one-month since sustaining mTBI. Findings suggest that being either too avoidant or too aggressive in return to activity during recovery may result in worse symptomology and prolonged recovery following mTBI. Early detection of END or FA behaviors allows for more personalized treatment plans to improve patient recovery.