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Phongsaphakjarukorn N, Kanlayanaphotporn R, Jensen MP, Janwantanakul P. Responsiveness and clinically important differences of the PROMIS short form-depression 8a, anxiety 8a, and PASS-20 in individuals with chronic low back pain. Pain Rep 2024; 9:e1170. [PMID: 38910868 PMCID: PMC11191038 DOI: 10.1097/pr9.0000000000001170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Depression and anxiety are the most commonly reported mental health conditions. The Patient-Reported Outcomes Measurement Information System Short Form v1.0-Depression 8a (PROMIS-D-8a), Anxiety 8a (PROMIS-Anx8a), and Pain Anxiety Symptoms Scale-20 (PASS-20) measures were designed to assess depression, general anxiety, and pain-related anxiety, respectively. Objectives To examine the responsiveness and estimate the clinically important differences (CIDs) of the Thai version of these measures in individuals with chronic low back pain (CLBP). Methods The study sample comprised 144 participants with CLBP. Responsiveness was evaluated by calculating the change scores, effect sizes (ESs), standardized response means (SRMs), area under the curve (AUC), and correlations between the change scores and associated Global Perceived Effect (GPE). We also estimated CIDs by the difference in mean change score between improved and unchanged groups and standard error of measurement (SEM) for each measure. Results Statistically significant differences in the mean change scores, ESs, and SRMs supported the responsiveness of all measures. The AUCs achieved acceptable discriminatory ability (0.71-0.72) for moderate improvement but not for any improvement (0.65-0.68). The correlations between GPE and change scores on all measures were low (r ranging 0.28-0.33). The estimated CIDs for the PROMIS-D-8a, PROMIS-Anx8a, and PASS-20 were 3.64, 4.20, and 8.80, respectively. Conclusion The PROMIS-D-8a, PROMIS-Anx8a, and PASS-20 measures were sensitive for detecting clinical changes over time in individuals with CLBP. The CID values can be used as reference points for assessing meaningful improvements in the domains assessed by these scales in clinical and research practice.
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Affiliation(s)
| | - Rotsalai Kanlayanaphotporn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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2
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D’Souza RS, Gupta M, Abd-Elsayed A. Measuring outcomes. SPINAL FUSION TECHNIQUES 2024:71-75. [DOI: 10.1016/b978-0-323-88223-1.00017-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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3
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Quirk SE, Koivumaa-Honkanen H, Kavanagh BE, Honkanen RJ, Heikkinen J, Williams LJ. Exploring the comorbidity between personality and musculoskeletal disorders among adults: A scoping review. Front Psychiatry 2022; 13:1079106. [PMID: 36819943 PMCID: PMC9932280 DOI: 10.3389/fpsyt.2022.1079106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/20/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION There is growing awareness of the comorbidity between mental and musculoskeletal disorders (MSDs) and their associated burden. We aimed to explore what is known regarding the existing epidemiological clinical-and population- based literature on the comorbidity between personality disorders (PDs) and MSDs specifically. In addition, we aimed to investigate their associated burden by examining a range of outcomes including morbidity/mortality, patient- and clinical-reported outcomes, work-related outcomes, hospital admissions, and financial costs. Finally, we sought to identify gaps in the literature and provide recommendations for further research. METHODS Studies with participants 15 years of age were eligible. Categorical PDs/features (DSM-III/IV/5 or ICD 9/10), identified by a health care professional, medical records, diagnostic interviews, or self-administered questionnaires. The definitions/groupings of MSDs were guided by the ICD-10 including conditions of the back, joints, and soft tissue, and disorders of bone density and structure. Published peer-reviewed and gray literature were considered. Eligible study designs were cohort, case-control, and cross-sectional studies, and existing reviews of observational studies. Identification and selection of articles, data extraction and the presentation of the results was conducted according to the Joanna Briggs Institute methodological guidance and the PRISMA extension for scoping reviews. RESULTS In total, 57 articles were eligible including 10 reviews and 47 individual studies. Across clinical and population settings, we detected evidence of comorbidity between PDs and chronic back/neck/spine conditions, arthritis, and fibromyalgia, and emerging evidence of associations between PDs and reduced bone mineral density. In terms of knowledge gaps, the burden associated with PDs and MSDs is poorly understood, as is their underlying mechanisms. DISCUSSION This scoping review might prompt further research into PDs and MSDs as separate groups of disorders, along with their comorbidity and the mechanisms that may link them. SYSTEMATIC REVIEW REGISTRATION https://osf.io/mxbr2/registrations.
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Affiliation(s)
- Shae E Quirk
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia.,Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland.,Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Heli Koivumaa-Honkanen
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland.,Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Mental Health and Wellbeing Center, Kuopio University Hospital, Kuopio, Finland
| | - Bianca E Kavanagh
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Risto J Honkanen
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland.,Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jeremi Heikkinen
- Institute of Clinical Medicine, Psychiatry, University of Eastern Finland, Kuopio, Finland.,Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Lana J Williams
- School of Medicine, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Geelong, VIC, Australia.,Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
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Vranceanu AM, Bakhshaie J, Reichman M, Doorley J, Elwy AR, Jacobs C, Chen N, Esposito J, Laverty D, Matuszewski PE, Fatehi A, Bowers LC, Harris M, Ring D. A Live Video Program to Prevent Chronic Pain and Disability in At-Risk Adults With Acute Orthopedic Injuries (Toolkit for Optimal Recovery): Protocol for a Multisite Feasibility Study. JMIR Res Protoc 2021; 10:e28155. [PMID: 33908886 PMCID: PMC8116990 DOI: 10.2196/28155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/09/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Despite the pivotal role of psychosocial factors in pain and disability after orthopedic injury, there are no evidence-based preventive interventions targeting psychosocial factors in patients with acute orthopedic injuries. We developed the first mind-body intervention focused on optimizing recovery and improving pain and disability in patients with acute orthopedic injuries who exhibit high levels of catastrophic thinking about pain and/or pain anxiety (Toolkit for Optimal Recovery [TOR] after orthopedic injury). In a pilot single-site randomized controlled trial (RCT), the TOR met a priori set benchmarks for feasibility, acceptability, and satisfaction. The next step in developing TOR is to conduct a multisite feasibility RCT to set the stage for a scientifically rigorous hybrid efficacy-effectiveness trial. OBJECTIVE The objective of this study is to conduct a rigorous multisite feasibility RCT of TOR to determine whether the intervention and study methodology meet a priori set benchmarks necessary for the successful implementation of a future multisite hybrid efficacy-effectiveness trial. In this paper, we describe the study design, manualized treatments, and specific strategies used to conduct this multisite feasibility RCT investigation. METHODS This study will be conducted at 3 geographically diverse level 1 trauma centers, anonymized as sites A, B, and C. We will conduct a multisite feasibility RCT of TOR versus the minimally enhanced usual care (MEUC) control (60 patients per site; 30 per arm) targeting a priori set feasibility benchmarks. Adult patients with acute orthopedic injuries who endorse high pain catastrophizing or pain anxiety will be recruited approximately 1-2 months after injury or surgery (baseline). Participants randomized to the TOR will receive a 4-session mind-body treatment delivered via a secure live video by trained clinical psychologists. Participants randomized to the MEUC will receive an educational booklet. Primary outcomes include feasibility of recruitment, appropriateness, feasibility of data collection, acceptability of TOR (adherence to sessions), and treatment satisfaction across all sites. We will also collect data on secondary implementation outcomes, as well as pain severity, physical and emotional function, coping skills, and adverse events. Outcomes will be assessed at baseline, posttreatment, and at the 3-month follow-up. RESULTS Enrollment for the RCT is estimated to begin in June 2021. The target date of completion of the feasibility RCT is April 2024. The institutional review board approval has been obtained (January 2020). CONCLUSIONS This investigation examines the multisite feasibility of TOR administered via live videoconferencing in adult patients with acute orthopedic injuries. If feasible, the next step is a multisite, hybrid efficacy-effectiveness trial of TOR versus MEUC. Preventive psychosocial interventions can provide a new way to improve patient and provider satisfaction and decrease suffering and health care costs among patients with orthopedic injuries who are at risk for chronic pain and disability. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/28155.
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Affiliation(s)
- Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States
| | - James Doorley
- Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - A Rani Elwy
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI, United States.,Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, United States
| | - Cale Jacobs
- Department of Orthopaedic Surgery & Sports Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Neal Chen
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - John Esposito
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - David Laverty
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
| | - Paul E Matuszewski
- Department of Orthopaedic Surgery & Sports Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Amirreza Fatehi
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
| | - Lucy C Bowers
- Department of Orthopaedic Surgery & Sports Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States
| | - Mitchel Harris
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, United States
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Choi S, Park SG. Effects of anxiety-related psychological states on music-induced analgesia in cold pressor pain responses. Explore (NY) 2021; 18:25-30. [PMID: 33846083 DOI: 10.1016/j.explore.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 03/08/2021] [Accepted: 03/16/2021] [Indexed: 11/25/2022]
Abstract
CONTEXT The analgesic effect of music has long been reported. OBJECTIVE To assess how anxiety-related psychological states affect the analgesic effect of music using the cold pressor task (CPT). DESIGN A 3-period × 3-sequence crossover design was adopted; three conditions were used: "no sound," "music-listening," and "news-listening." SETTING PARTICIPANTS: Forty-nine participants were included. INTERVENTIONS After completing five anxiety-related psychological instruments (Anxiety Sensitivity Index [ASI]-16, ASI-Revised, State-Trait Anxiety Inventory [STAI]-S, STAI-T, and Pain Anxiety Symptoms Scale-20), the participants were allocated to the low- or high-anxiety group. The high- and low-anxiety groups were defined based on cutoff points according to the distributions and characteristics of the five instruments. MAIN OUTCOME MEASURES Pain responses, such as pain tolerance time, pain intensity, and pain unpleasantness, were measured on the CPT. Pain responses in the music-listening condition were also compared to those in the other two conditions via pairwise comparisons within each anxiety group. RESULTS The Cronbach alpha of the five instruments ranged from 0.866 to 0.95, indicating that they were reliable. Pain responses in the music-listening condition in the low-anxiety groups based on any of the five scales were significantly different from those in the other conditions, but this effect was not found in the high-anxiety groups. This study demonstrates that anxiety-related psychological states can predict the analgesic effect of music on pain responses measured by the CPT and suggests that music may be beneficial as a pain management tool in low-anxiety groups.
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Affiliation(s)
- Suvin Choi
- Da Vinci College of General Education, Chung-Ang University, Seoul, Korea
| | - Sang-Gue Park
- Department of Applied Statistics, Chung-Ang University, Seoul, Korea.
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Kim S, Bae DW, Park SG, Park JW. The impact of Pain-related emotions on migraine. Sci Rep 2021; 11:577. [PMID: 33436778 PMCID: PMC7804193 DOI: 10.1038/s41598-020-80094-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
The response to pain is highly individual and can be influenced by complex emotional perception. This study aims to investigate the status of the pain-related emotional response, and the influence on headache characteristics and disability in migraine. We studied the pain-related emotional response in 145 consecutive migraine patients using the Pain Anxiety Symptoms Scale (PASS), the Pain Catastrophizing Scale (PCS), and the Pain Sensitivity Questionnaire (PSQ) and compared them with 106 healthy controls. We investigated the relationship between emotional factors and migraine characteristics. The effect of pain-related emotion on migraine-related disability assessed with the Headache Impact Test-6 (HIT-6) and the Migraine Disability Assessment (MIDAS). Migraine patients showed significantly higher scores on total PASS (p < 0.001), PCS (p < 0.001) and PSQ (p = 0.002) compared to the healthy controls. The HIT-6 was weakly correlated with PASS (r = 0.390, p < 0.001) and PCS (r = 0.354, p < 0.001). PASS-Total (p = 0.001), headache frequency (p = 0.003), and HADS-Anxiety (p = 0.028) were independent variables associated with HIT-6. Headache frequency (p < 0.001) was an independent variable associated with MIDAS. The structural equation model indicated that headache severity has direct loading on emotion and subsequently influenced migraine-related disability. Disability has a significant effect on the frequency of abortive medication use. Migraine patients have altered emotional responses to pain perception. Pain-related anxiety made an important contribution to headache-related disability. The present results suggest that the management of disability by considering various pain-related emotional factors may be necessary for the therapeutic aspects of migraine.
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Affiliation(s)
- Seonghoon Kim
- Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dae-Woong Bae
- Department of Neurology, St. Vincent's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Gue Park
- Department of Applied Statistics, Chung-Ang University, Seoul, Republic of Korea
| | - Jeong-Wook Park
- Department of Neurology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Forssell H, Teerijoki‐Oksa T, Puukka P, Estlander A. Symptom severity in burning mouth syndrome associates with psychological factors. J Oral Rehabil 2020; 47:713-719. [DOI: 10.1111/joor.12966] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/12/2020] [Accepted: 03/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Heli Forssell
- Department of Oral and Maxillofacial Surgery Institute of Dentistry University of Turku Turku Finland
| | - Tuija Teerijoki‐Oksa
- Department of Oral and Maxillofacial Diseases Turku University Hospital Turku Finland
| | - Pauli Puukka
- Department of Health National Institute for Health and Welfare Turku Finland
| | - Ann‐Mari Estlander
- Pain Clinic Department of Anaesthesiology, Intensive Care and Pain MedicineHelsinki University Hospital and University of Helsinki Helsinki Finland
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Martinez-Calderon J, Flores-Cortes M, Morales-Asencio JM, Luque-Suarez A. Pain-Related Fear, Pain Intensity and Function in Individuals With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2019; 20:1394-1415. [DOI: 10.1016/j.jpain.2019.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 04/01/2019] [Accepted: 04/29/2019] [Indexed: 12/26/2022]
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Pain interference type and level guide the assessment process in chronic pain: Categorizing pain patients entering tertiary pain treatment with the Brief Pain Inventory. PLoS One 2019; 14:e0221437. [PMID: 31430355 PMCID: PMC6701883 DOI: 10.1371/journal.pone.0221437] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Chronic pain patients enter treatment with different problem profiles making careful assessment a necessity for more individualized treatment plans. In this cross-sectional study we assigned 320 patients entering tertiary multidisciplinary pain treatment into four categories based on whether they scored low or high on the activity and the affective pain interference dimensions of the Brief Pain Inventory (BPI). To determine whether this categorization system delineates issues that should be assessed further, the categories were compared with ANOVA and MANOVA analyses on three domains: variables affecting physical well-being (body mass index, exercise, substance use), psychological resources (mood), and pain-specific psychological factors (pain anxiety, pain acceptance). The results indicated that subjects who scored low on both interference dimensions compared similarly in weight: mean Body Mass Index (BMI) 27.0 (SD 6.0) kg/m2, and exercise: mean of 2.4 (SD 1.7) exercising sessions over 20 minutes per week, to the general population, had no depressive symptoms on average: mean Beck Depression Index II (BDI-II) score 11.7 (SD 7.5), and had the most favorable psychological reactions to pain relative to the other categories: mean total Pain Anxiety Symptoms Scale-20 (PASS-20) score 36.4 (SD 17.9). In contrast, when interference was high on activity, more physical well-being problems were evident e.g. weight: mean BMI 31.0 (SD 7.3) kg/m2, diminished exercise: mean of 1.5 (SD 1.6) exercising sessions per week, and avoidance behavior: mean PASS-20 Escape/Avoidance subscale 3.7 (95% CI: 1.7 to 5.8) scores higher in comparison to activity interference remaining low. With high affective interference, more depressive symptoms: mean BDI-II score 17.7 (SD 7.3), and more cognitive pain anxiety: mean PASS-20 Cognitive Anxiety subscale 2.8 (95% CI 0.7 to 4.8) scores higher in comparison to affective interference remaining low, emerged. Having high interference on both dimensions indicated accumulated risks for reduced physical well-being: mean BMI 29.9 (SD 6.1) kg/m2, mean of 1.2 (SD 1.7) exercising sessions per week, mood problems: mean BDI-II 20.3 (SD 10.6), and negative psychological reactions to pain: mean total PASS-20 score 53.2 (18.4). The results suggest that low interference on both dimensions may allow assessment with only physician consultations, while high interference on either dimension may call attention to distinct issues to be addressed with the help of a physiotherapist or a psychologist, whereas high interference on both dimensions highlights the need for a full multidisciplinary assessment.
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Zhou XY, Xu XM, Wang F, Wu SY, Yang YL, Li M, Huang JM, Wei XZ. Validations and psychological properties of a simplified Chinese version of pain anxiety symptoms scale (SC-PASS). Medicine (Baltimore) 2017; 96:e5626. [PMID: 28272194 PMCID: PMC5348142 DOI: 10.1097/md.0000000000005626] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The Pain Anxiety Symptoms Scale (PASS) has been developed to evaluate pain anxiety, which leads to avoidance of daily activities and normal movements. However, a simplified Chinese version of PASS is still not available. Physicians are not aware of which patients are prone to anxiety, and what the risk factors are.To cross-culturally adapt the PASS into a simplified Chinese version and test the reliability and validity. Factors affecting pain anxiety were also explored.The PASS was first translated into a simplified Chinese version according to a forward-backward method. Then, validations were tested including content validity, construct validity, and reliability. Content validity was analyzed by response trend. Construct validity was analyzed by confirmatory factor analysis (CFA), exploratory factor analysis, and priori hypotheses testing. Reliability was analyzed by internal consistency and test-retest reliability. Risk factors of catastrophizing were analyzed by performing multivariate liner regression.A total of 219 patients were included in the study. The scores of items were well distributed. Both CFA and exploratory factor analysis suggested a 2nd-order, 4-factor model, accounting for 65.42% of the total variance according to principle component analysis. SC-PASS obtained good reliability with a Cronbach α = 0.92 and ICC = 0.90. College education, long pain duration, and both married and divorced status were risk factors. Factors reduced pain-related anxiety were no medication assumption, female sex, widowed status, non-Han ethnicity, and having no religious belief.The SC-PASS was applicable in Chinese patients and it was suitable for the clinical uses in mainland China.
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Affiliation(s)
- Xiao-Yi Zhou
- Department of Orthopaedics, Changhai Hospital, Second Military Medical University
| | - Xi-Ming Xu
- Department of Orthopaedics, Changzheng Hospital, Second Military Medical University
| | - Fei Wang
- Department of Orthopaedics, Changhai Hospital, Second Military Medical University
| | - Sui-Yi Wu
- Faculty of Naval Medicine, Second Military Medical University
| | - Yi-Lin Yang
- Department of Orthopaedics, Changhai Hospital, Second Military Medical University
| | - Ming Li
- Department of Orthopaedics, Changhai Hospital, Second Military Medical University
| | | | - Xian-Zhao Wei
- Department of Orthopaedics, Changhai Hospital, Second Military Medical University
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Abstract
Fear-avoidance (FA) beliefs are significantly associated with the experience of pain, especially when the pain becomes chronic in nature. The anticipated threat of intense pain will often result in the constant vigilance and monitoring of pain sensations, which, in turn, can cause even low-intensity sensations of pain to become unbearable for the person. Just the anticipation of increased pain or reinjury can further stimulate avoidance behaviors. A vicious cycle may develop, in which fears of increased pain or reinjury contribute to the avoidance of many activities, leading to inactivity and, ultimately, to greater disability. Anyone who assesses and treats pain-related disability should also be prepared to assess and treat pain-related FA.
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Hartzell MM, Choi Y, Neblett R, Williams M, Mayer TG, Gatchel RJ. Somatization as a Predictor of Outcomes Following Functional Restoration of Chronic Disabling Occupational Musculoskeletal Pain Disorder Patients. ACTA ACUST UNITED AC 2013. [DOI: 10.1111/jabr.12006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | - Tom G. Mayer
- Department of Orthopedic Surgery; University of Texas Southwestern Medical Center
| | - Robert J. Gatchel
- Department of Psychology; College of Science; The University of Texas at Arlington
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