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J Psychosom Res. 2021 Dec;151:110664. doi: 10.1016/j.jpsychores.2021.110664. Epub 2021 Nov 3.
Noise sensitivity (NS) following mild traumatic brain injury (mTBI) is common impacts functioning and outcomes. Recent research suggests psychological factors may have a significant role in the development of NS after mTBI. Psychological interventions have been advocated for to reduce this experience. To be effective, these interventions must aim to target the psychological processes that contribute to this relationship. Fear avoidance holds promise in this regard. The current study aimed to explore the role of fear avoidance in NS and examine its role in mediating the relationship between psychological distress and NS.
Adults (n = 234) diagnosed with mTBI were recruited from outpatient mTBI clinics throughout New Zealand. Participants completed self-report measures of pre-injury mental health status, as well as current post-concussion symptoms, psychological distress (anxiety, stress, depression, fear avoidance and post-traumatic stress symptoms) and functional status upon entry to an mTBI outpatient clinic (M = 8.9, SD = 9.2, post injury).
A pre-injury mental health diagnosis was associated with NS after mTBI, as were symptoms of anxiety, stress, depression, and post-traumatic stress. Regression analyses revealed that fear avoidance (β = 0.45, p = .01), as well as stress (β = 0.07, p = .01) and PTSD symptoms (β = 0.02, p = .01), made a significant and unique contribution to NS. A series of mediation analyses found that fear avoidance had a significant indirect effect on the relationships between psychological distress and NS.
Fear avoidance is related to NS following mTBI. Targeting fear avoidance behaviours and beliefs may represent a treatment target for reducing NS after mTBI.
轻度创伤性脑损伤 (mTBI) 后出现的噪声敏感 (NS) 很常见，会影响功能和预后。最近的研究表明，心理因素在 mTBI 后 NS 的发展中可能起着重要作用。提倡采用心理干预来减少这种体验。为了有效，这些干预措施必须旨在针对导致这种关系的心理过程。恐惧回避在这方面具有潜力。本研究旨在探讨恐惧回避在 NS 中的作用，并检验其在介导心理困扰与 NS 之间关系中的作用。
从新西兰各地的门诊 mTBI 诊所招募了被诊断为 mTBI 的成年人 (n=234)。参与者完成了自我报告的损伤前心理健康状况，以及当前的脑震荡后症状、心理困扰（焦虑、压力、抑郁、恐惧回避和创伤后应激症状）以及进入 mTBI 门诊诊所时的功能状态（M=8.9，SD=9.2，受伤后）。
损伤前的心理健康诊断与 mTBI 后的 NS 相关，以及焦虑、压力、抑郁和创伤后应激症状相关。回归分析显示，恐惧回避 (β=0.45，p=0.01) 以及压力 (β=0.07，p=0.01) 和 PTSD 症状 (β=0.02，p=0.01) 对 NS 有显著和独特的贡献。一系列中介分析发现，恐惧回避对心理困扰与 NS 之间的关系具有显著的间接影响。
恐惧回避与 mTBI 后的 NS 有关。针对恐惧回避行为和信念可能是减少 mTBI 后 NS 的治疗目标。
