The role of fear-avoidance and helplessness in explaining functional disability in chronic pain: a prospective study.
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SourceInternational Journal of Behavioral Medicine, 14, 4, (2007), pp. 237-241
Article / Letter to editor
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International Journal of Behavioral Medicine
SubjectDCN 1: Perception and Action; EBP 1: Determinants of Health and Disease; EBP 3: Effective Primary Care and Public Health; N4i 4: Auto-immunity, transplantation and immunotherapy; NCEBP 2: Evaluation of complex medical interventions; NCEBP 8: Psychological determinants of chronic illness; EBP 1: Determinants of Health and Disease
OBJECTIVE: Based on the fear-avoidance and helplessness models, the relative contribution of fear of pain, avoidance behavior, worrying, and helplessness were examined in relation to fluctuations in functional disability in chronic-pain patients. METHODS: A cohort of 181 chronic-pain patients first completed various questionnaires and kept a 7-day pain journal during a standard 3-month waiting-list period prior to their scheduled treatment at an Interdisciplinary Pain Centre and did so again immediately preceding the intervention. RESULTS: At baseline, fear of pain, avoidance behavior, and helplessness all predicted functional disability after 3 months. Stepwise regression analyses showed avoidance behavior to be the strongest predictor of change in functional disability followed by helplessness, thus both ahead of fear of pain. CONCLUSION: The current findings support the roles of both fear-avoidance factors and helplessness in the functional disability in chronic-pain patients awaiting treatment but revealed a central role for avoidance behavior.
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