Assessing Accident Phobia in Mild Traumatic Brain Injury: The Accident Fear Questionnaire

• Published in: Rehabilitation psychology 2016-08, Vol.61 (3), p.317-327
• Main Authors: Sutherland, Jessica, Middleton, Jason, Ornstein, Tisha J., Lawson, Kerry, Vickers, Kristin
• Format: Article
• Language: English
• Subjects: Accidents, Traffic - psychology; Adult; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Brain Concussion - diagnosis; Brain Concussion - psychology; Chronic Pain - diagnosis; Chronic Pain - psychology; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Fear; Female; Glasgow Coma Scale; Human; Humans; Male; Middle Aged; Motor Traffic Accidents; Phobias; Phobic Disorders - diagnosis; Phobic Disorders - psychology; Psychometrics; Psychometrics - statistics & numerical data; Questionnaires; Reproducibility of Results; Retrospective Studies; Statistics as Topic; Surveys and Questionnaires; Survivors - psychology; Test Reliability; Test Validity; Traumatic Brain Injury
• ISSN: 0090-5550; 1939-1544
• DOI: 10.1037/rep0000090

Purpose: Despite a documented prevalence of accident phobia in almost 40% of motor vehicle accident (MVA) survivors, the onset of accident phobia after traumatic brain injury (TBI) remains poorly understood. There is currently a body of knowledge about posttraumatic stress disorder (PTSD) in patients with TBI, but less is known about accident phobia following TBI, particularly in cases of mild TBI (mTBI). Accident phobia can impede safe return to driving or motor vehicle travel, inhibiting return to daily functioning. In addition, pain complaints have been found to correlate positively with postinjury anxiety disorders. Method: The present study sought to determine the reliability and validity of the Accident Fear Questionnaire (AFQ), a measure used to assess accident phobia, in 72 patients with mTBI using secondary data analysis and the subsequent development of accident phobia postinjury. Furthermore, we sought to examine the impact of pain, anxiety, and depression complaints on the AFQ. Results: Results reveal convergent validity and reliability in mTBI populations. Additionally, pain, anxiety, and depression measures were significantly correlated with scores on the AFQ. Conclusions: Psychometrically, the phobia avoidance subscale of the AFQ is a reliable measure for use with mTBI populations, although some limitations were found. In particular, the accident profile (AP) subscale was not found to be reliable or valid and could be eliminated from the AFQ. Collectively, the present study contributes to the small body of published literature evaluating accident phobia in patients with mTBI and the impact of pain on the development of postinjury anxiety disorders. Impact and Implications This paper on the psychometric properties of the Accident Fear Questionnaire (AFQ) adds the following to the rehabilitation psychology literature: Accident phobia is a particular concern for people who have experienced traumatic brain injuries (TBIs) as a result of motor vehicle accidents (MVAs). Difficulty returning to previous functioning can hinder recovery, including fear of driving or being involved in future accidents. The Accident Fear Questionnaire (AFQ) has been tested in non-TBI populations, but this study extends previous research on its utility by exploring the psychometric properties of the AFQ in a mild TBI (mTBI) population. Consisting of 2 subscales, this study found that the phobic avoidance subscale of the AFQ to be reliable and valid in a population with