ArticleRehabilitation psychology2021
Psychological mediators of avoidance and endurance behavior after concussion.
Article in Rehabilitation psychology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 27 citations in OpenAlex.
- Feasibility Randomized Controlled Trial of the Toolkit for Optimal Recovery After Concussion: A Live Video Program to Prevent Persistent Concussion Symptoms in Young Adults With Anxiety.Archives of physical medicine and rehabilitation · 2025Trial
- Cognitive and affective psychoeducation for Long COVID: a randomized controlled trial.Brain communications · 2025Trial
- Concussion in the Wild: Clinical Utility of Ambulatory Assessment of Symptoms and Everyday Exposures in Adolescents and Adults with Concussion.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2026Article
- [Importance of avoidance and endurance in post-COVID syndrome : Can dysfunctional patterns be changed?]Schmerz (Berlin, Germany) · 2025Article
- Catastrophizing Thoughts and Fear-Avoidance Behavior Are Related to Persistent Post-Concussion Symptoms after Mild Traumatic Brain Injury.Neurotrauma reports · 2025Article
- Preliminary Feasibility of a Novel Mind-Body Program to Prevent Persistent Concussion Symptoms Among Young Adults With Anxiety: Nonrandomized Open Pilot Study.JMIR formative research · 2024Article
- "I completely shut down": A mixed methods evaluation of the fear-avoidance model for young adults with a recent concussion and anxiety.Rehabilitation psychology · 2024Article
- "Alone in the dark": A qualitative study of treatment experiences among young adults with a recent concussion and anxiety.Neuropsychological rehabilitation · 2024Article
- Metacognitive Therapy for People Experiencing Persistent Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Preliminary Multiple Case-Series Study.Neurotrauma reports · 2024Article
- Avoidance and Endurance Responses to Pain Before and with Advanced Chronification: Preliminary Results from a Questionnaire Survey in Adult Patients with Non-Cancer Pain Conditions.Journal of pain research · 2024Article
- Management of Psychological Complications Following Mild Traumatic Brain Injury.Current neurology and neuroscience reports · 2023Review
- The Impact of a Recent Concussion on College-Aged Individuals with Co-Occurring Anxiety: A Qualitative Investigation.International journal of environmental research and public health · 2023Article
- "Hidden gains"? Measuring the impact of mindfulness-based interventions for people with mild traumatic brain injury: a scoping review.Brain injury · 2022Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectiveThe avoidance-endurance model (AEM) proposes multiple pathways from acute to chronic pain, with distinct cognitive and behavioral components in each pathway. The AEM may also be applicable to persistent symptoms after concussion. In this study, we tested the AEM as an explanatory framework for concussion outcomes, by using mediation analyses through the proposed psychological mechanisms. Based on the AEM, we hypothesized that postconcussion symptoms would significantly predict avoidance behavior through catastrophizing, and endurance behavior through thought suppression and self-distraction. PARTICIPANTS AND
methodsWe recruited 84 adults seeking treatment at 2 outpatient concussion clinics (
resultsWe found a significant indirect effect of postconcussion symptoms on avoidance behavior through catastrophizing (ab = .113 (.036), 95% CI [.053, .195]). The indirect effects of postconcussion symptoms on endurance behavior through thought suppression (ab = .011 (.012), 90% CI [.002, .035]) and "self-distraction" (ab = .003 (.009), 90% CI [.008, .022]) were not statistically significant.
conclusionsResults supported the catastrophizing-avoidance pathway in concussion, but not the thought-suppression-endurance or self-distraction-endurance pathways. Therefore, catastrophic thinking about concussion symptoms may be an appropriate treatment target for individuals who exhibit fear-avoidance behavior. Further research is needed to establish whether thought suppression and self-distraction are relevant for interventions aimed at reducing excessive endurance behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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