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Are fear-avoidance beliefs related to the inception of an episode of back pain?: a prospective study
Department of Occupational and Environmental Medicine, Örebro Medical Center, Örebro, Sweden.ORCID iD: 0000-0001-5359-0452
Department of Health Promotion for Personnel, Örebro Medical Center, Örebro, Sweden.
Department of Occupational and Environmental Medicine, Örebro Medical Center, Örebro, Sweden.
Department of Medical, Clinical and Experimental Psychology , Maastricht University and Institute for Rehabilitation Research, Hoensbroek, The Netherlands.
1999 (English)In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321, Vol. 14, no 6, 1051-1059 p.Article in journal (Refereed) Published
Abstract [en]

Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factors in che transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they are associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidance and catastrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5, but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early point in the development of pain and associated activity problems in people with back pain. Theoretically, our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.

Place, publisher, year, edition, pages
1999. Vol. 14, no 6, 1051-1059 p.
Keyword [en]
fear-avoidance, catastrophizing, low back pain, chronic pain, risk factors, prospective study
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychology
Research subject
Public health; Psychology
Identifiers
URN: urn:nbn:se:oru:diva-41726DOI: 10.1080/08870440008407366ISI: 000085717300006PubMedID: 22175261Scopus ID: 2-s2.0-0344160495OAI: oai:DiVA.org:oru-41726DiVA: diva2:781012
Available from: 2015-01-15 Created: 2015-01-15 Last updated: 2015-03-10Bibliographically approved

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