Fear avoidance and return to work after mild traumatic brain injury

Area of Science:

• Neuroscience
• Occupational Health
• Psychology

Background:

• Fear avoidance is a known factor in persistent symptoms following mild traumatic brain injury (mTBI).
• The relationship between fear avoidance and return to work (RTW) after mTBI requires further investigation.

Purpose of the Study:

• To examine the association between fear avoidance behaviors and RTW outcomes in individuals with mTBI.
• To determine if persistent or increasing fear avoidance impacts the likelihood of returning to work.

Main Methods:

• Analysis of two merged prospective mTBI cohorts (n=175) of adults engaged in work.
• Utilized the Fear Avoidance Behavior after Traumatic Brain Injury (FAB-TBI) questionnaire at enrollment and 6 months post-injury.
• Employed multivariate approaches to analyze associations between FAB-TBI scores and RTW at 6-9 months post-mTBI.

Main Results:

• 53% of participants achieved RTW by 6-9 months post-mTBI.
• Early fear avoidance showed a weak association with RTW.
• Persistent high fear avoidance or increasing avoidance over time were significantly associated with a greater likelihood of remaining off work.

Conclusions:

• Pervasive and increasing fear avoidance behaviors after mTBI are linked to lower rates of RTW.
• Further research is necessary to identify critical transition points in recovery where fear avoidance behaviors change.