Psychological mediators of avoidance and endurance behavior after concussion.
Alex R Terpstra, Molly Cairncross, Keith O Yeates and 4 others
PMID 34410757WHAT IT FOUND
Catastrophizing mediated the link between post-concussion symptoms and avoidance behavior.
Thought suppression and self-distraction did not mediate endurance behavior. This supports targeting catastrophic beliefs to reduce avoidance, but does not support targeting these specific cognitive styles for endurance.
Key findings
01Post-concussion symptom severity predicted avoidance behavior through catastrophizing.
02The indirect effects of post-concussion symptoms on endurance behavior via thought suppression and self-distraction were not statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study is cross-sectional, so it cannot prove that catastrophizing causes avoidance; it only shows an association. The sample was predominantly Caucasian, female, and highly educated, limiting generalizability to broader concussion populations. The measure used for 'self-distraction' may not have accurately captured the intentional coping style described in the theoretical model. The sample size may have been too small to detect smaller mediation effects for endurance behavior.
The easy way to misread this
Do not assume that catastrophizing causes avoidance behavior. The study is cross-sectional and shows an association, not a causal link. Also, do not apply these findings to endurance behavior, as the proposed mediators for that behavior were not significant.