Fear avoidance behavior in youth with poor recovery from concussion: measurement properties and correlates of a new scale.

The objective of the current study was to develop a measure of fear avoidance behavior after concussion for youth and parent respondents and examine its basic psychometric properties and correlates. Children (N = 51) who were seen in a hospital concussion clinic after sustaining a concussion (M = 7.6 months, SD = 7.01) and their primary caregiver (N = 51)completed self- and informant-report measures of fear avoidance (Pediatric Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire; PFAB-TBI), post-concussion symptoms (Health Behavior Inventory), emotional distress (Strengths and Difficulties Questionnaire), and quality of life (Pediatric Quality of Life Inventory Version 4.0). The self- and informant-report PFAB-TBI scores were moderately correlated (r = 0.51, p < 0.001). Neither measure demonstrated floor or ceiling effects. Both had strong internal consistency (Cronbach's α = 0.87 and 0.89, respectively). The PFAB-TBI self-report was positively correlated with somatic symptoms (r = 0.37), emotional distress (r = 0.39), and negatively associated with quality of life (r = -0.57). The PFAB-TBI informant-report was positively associated with informant reported somatic symptoms (r = 0.52) and emotional distress (r = .50) Overall, the PFAB-TBI has desirable basic measurement properties and expected correlations with clinical outcomes. This measure can potentially help clinicians and researchers better understand the impacts of fear avoidance behavior after pediatric concussion.