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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aims of this study were threefold. Firstly, to investigate the effect of increasing threat-expectancy on attentional biases towards pain-related words. Secondly, to determine the interaction between threat-expectancy and the effectiveness of two coping strategies on pain threshold and tolerance. Thirdly, to investigate the relationship between fear of pain and the experimental manipulations. One hundred undergraduate psychology students were randomly assigned to receive either threat-increasing or reassuring information about the cold pressor task. After reading the information, all participants completed the dot-probe task for four categories of pain-related words. Following the dot-probe task, participants were randomly allocated to one of two coping strategy conditions (focusing on affective vs sensory aspects of pain). Participants then completed the cold pressor task while engaging in the relevant coping strategy. There was a significant effect of threat on bias towards affective vs sensory pain words. Participants in the threat condition showed a stronger bias towards affective pain words. In contrast, the no-threat condition displayed a stronger bias towards sensory pain words. Significant interaction effects were observed between threat and coping strategy for threshold and tolerance. These results indicated that focusing on sensory pain sensations was helpful in the absence of threat, however, in the presence of threat was relatively unhelpful in comparison to focusing on the affective components of pain. The present results provide support for the fear-avoidance model of pain [Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85:317-332] and confirm the importance of threat-expectancy in hypervigilance towards pain and fear avoidance.
Pain 2005 Dec 15
PMID:The role of threat-expectancy in acute pain: effects on attentional bias, coping strategy effectiveness and response to pain. 1629 90

The cognitive-behavioral, fear-avoidance (FA) model of chronic pain (Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 1995a;62:363-72) has found broad empirical support, but its multivariate, predictive relationships have not been uniformly validated. Applicability of the model across age groups of chronic pain patients has also not been tested. Goals of this study were to validate the predictive relationships of the multivariate FA model using structural equation modeling and to evaluate the factor structure of the Tampa Scale of Kinesiophobia (TSK), levels of pain-related fear, and fit of the FA model across three age groups: young (< or =40), middle-aged (41-54), and older (> or =55) adults. A heterogeneous sample of 469 chronic pain patients provided ratings of catastrophizing, pain-related fear, depression, perceived disability, and pain severity. Using a confirmatory approach, a 2-factor, 13-item structure of the TSK provided the best fit and was invariant across age groups. Older participants were found to have lower TSK fear scores than middle-aged participants for both factors (FA, Harm). A modified version of the Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eek H (Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 1995a;62:363-72.) FA model provided a close fit to the data (chi(2)(29)=42.0, p>0.05, GFI=0.98, AGFI=0.97, CFI=0.99, RMSEA=0.031 (90% CI 0.000-0.050), p close fit=0.95). Multigroup analyses revealed significant differences in structural weights for older vs. middle-aged participants. For older chronic pain patients, a stronger mediating role for pain-related fear was supported. Results are consistent with a FA model of chronic pain, while indicating some important age group differences in this model and in levels of pain-related fear. Longitudinal testing of the multivariate model is recommended.
Pain 2006 Apr
PMID:The fear-avoidance model of chronic pain: validation and age analysis using structural equation modeling. 1651 74

McNeil and Rainwater's Fear of Pain Questionnaire III (FPQ-III, 1998) is an empirically derived self-report inventory that assesses fear of three broad categories of pain: Severe, Minor, and Medical Pain. Previous exploratory and confirmatory factor analyses suggest that the original 3-factor model of the FPQ-III has a poor fit [Osman A, Breitenstein JL, Barrios FX, Gutierrez PM, Kopper BA. The Fear of Pain Questionnaire-III: further reliability and validity with nonclinical samples. J Behav Med 2002;25:155-73; Albaret MC, Sastre MTM, Cottensin A, Mullet E. The Fear of Pain Questionnaire: factor structure in samples of young, middle-aged and elderly European people. Eur J Pain 2004;8:273-81; Roelofs J, Peters ML, Deutz J, Spijker C, Vlaeyen JWS. The Fear of Pain Questionnaire (FPQ): further psychometric examination in a non-clinical sample. Pain 2005;116:339-46.]. The goals of this study were to empirically evaluate the previously proposed 3-factor models of the FPQ-III, identify and remove items that contribute to the factor instability of the FPQ-III, and evaluate potential alternative models based on a reduced item pool. A sample of 589 participants from the University of Regina and the University of Manitoba communities was randomly divided into two subsamples of approximately equal size. FPQ-III data from these subsamples were subjected to confirmatory factor analysis and an iterative combination of exploratory and confirmatory factor analyses. The initial confirmatory factor analysis revealed that none of the previous models had acceptable fit to the data. Following iterative factor analyses and item reductions, a 4-factor model with good fit to the data and invariance across gender was identified. This model comprised 20-items distributed on factors representing Severe, Minor, Injection, and Dental Pain. The total scale and subscale scores based on the 4-factor model had good internal consistency, and preliminary support for construct validity was obtained. Use of this short version of the measure--the FPQ-Short Form--is discussed and directions for future research outlined.
Pain 2008 Jan
PMID:The Fear of Pain Questionnaire-Short Form (FPQ-SF): factorial validity and psychometric properties. 1748 61

The aim of this work was to study whether fear of movement, and pain catastrophizing predict pain related-disability and depression in sub-acute whiplash patients. Moreover, we wanted to test if fear of movement is a mediator in the relation between catastrophizing and pain-related disability/depression as has been suggested by the fear-avoidance model [Vlaeyen JWS, Kole-Snijders AMJ, Boeren RGB, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 1995;62:363-72]. The convenience sample used was of 147 sub-acute whiplash patients (pain duration less than 3 months). Two stepwise regression analyses were performed using fear of movement and catastrophizing as the independent variables, and disability and depression as the dependent variables. After controlling for descriptive variables and pain characteristics, catastrophizing and fear of movement were found to be predictors of disability and depression. Pain intensity was a predictor of disability but not of depression. The mediation effect of fear of movement in the relationships between catastrophizing and disability, and between catastrophizing and depression was also supported. The results of this study are in accordance with the fear-avoidance model, and support a biopsychosocial perspective for whiplash disorders.
Eur J Pain 2009 May
PMID:The fear-avoidance model in whiplash injuries. 1864 Aug 60

The primary purpose of this study was to analyze the sequential relationships proposed by the fear-avoidance model of pain [Vlaeyen JWS et al. The role of fear of movement/(re)injury in pain disability. J Occup Rehab 1995;5:235-52]. Specifically, this study evaluated whether early change in catastrophizing predicted late change in fear of movement, and whether these factors influenced post-treatment return-to-work. Secondary analyses tested relationships between (1) early change in catastrophizing, late change in depression, and disability; and (2) early change in catastrophizing, late change in pain severity, and disability. Analyses were conducted on a sample of 121 individuals (82 men and 32 women) with a work-related musculoskeletal injury, and high baseline catastrophizing and fear of movement scores. Participants were enrolled in a 10-week community-based disability management intervention, and they completed measures of catastrophizing, fear of movement, depression and pain severity at pre-, mid- and post-treatment. Return-to-work was assessed 4 weeks following termination of the intervention. Contrary to predictions, results from correlational analyses revealed non-significant relationships among indices of early change in catastrophizing and late changes in fear of movement, depression and pain severity. Multiple logistic regression analyses revealed that early change in catastrophizing, late changes in fear of movement and late change in pain severity were significant predictors of return-to-work, while late changes in depression were not. These findings highlight the importance of reductions in psychosocial risk factors in augmenting return-to-work outcomes. Implications for the fear-avoidance model and future research are discussed.
Pain 2009 Sep
PMID:A prospective sequential analysis of the fear-avoidance model of pain. 1977 14