This page is incomplete. It displays memoes and/or notes.
The concept of fear-avoidance in the context of cognitive-behavioral therapy for pain.
...it is a natural tendency to avoid distressing emotions, thoughts, memories, sensations or situations. Avoidance is a feature of all the anxiety disorders and avoidant personality disorder.... [Treatment is through graded exposure, goal is] habituation of physiological anxiety, extinction of fears, and provision of op....
Dobson, D. and Dobson, K. S., "Evidence-Based Practice of Cognitive-Behavioral Therapy", Guildford Press, 2009, 109
The fear-avoidance model emphasizes the importance of fear that physical activity will cause pain and (re)injury.
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 196
The [fear-avoidance] model proposes that, following injury or the onset of symptoms, a person might remain active despite the pain, and this will result in recovery. [Verifiable??] Those who engage in avoidance are more likely to do this if they successfully avoid pain. Avoidance is more likely in persons with a tenden....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 304
The tenets of contemporary fear-avoidance models can be summarized as follows: When pain is perceived following injury, an individual's idiosyncratic beliefs will determine the extent to which pain is catastrophically interpreted. [MORE NONSENSICAL CATEGORICAL THINKING.] A catastrophic interpretation of pain gives rise....
Gatchel, R. J., Peng, Y. B., Peters, M. L., Fuchs, P. N., and Turk, D. C., "The BioPsychoSocial Approach to Chronic Pain: Scientific Advances and Future Directions", Psychological Bulletin, Vol. 133, No. 4: 2007 (Biopsychosocial Approach to Chronic Pain.pdf), 603
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art
Abstract In an attempt to explain how and why some individuals with musculoskeletal pain develop a chronic pain syndrome, Lethem et al. (Lethem J, Slade PD, Troup JDG, Bentley G. Outline of fear-avoidance model of exaggerated....
Vlaeyen JW, Linton SJ, "Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.", Pain 85: 2000
Stress reactivity seems to be especially high in patients with high levels of fear of movement or reinjury as predicted by the diathesis-stress model of chronic pain. [Diathesis = vulnerability. This theory derives from psychopathologies, so it is difficult to know whether adherents consider chronic pain as a psychopat....
Turk, Dennis, and Melzack, Ronald, "Handbook of Pain Assessment", The Guildford Press, 2011, 154
Patients with low back pain have demonstrated poor behavioral persistence in various exercise tasks, and their performance on these tasks was independent of physical exertion or actual self-reports of pain but, instead, was related to previous pain reports. These patients appear to have a negative view of their abiliti....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 259
[This may be a good example of circular reasoning and the failure to consider alternate (and simpler) explanations.]
For example, studies that found decreased cognitive task performance in fearful LBP patients interpreted this to be the result of pain-related fear directing attention to pain (Crombez et al. 1999a, 20....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 80
[P. 79, Fig. 1 is a diagram of fear-avoidance model. The model might be amended to say "Recoverable injury" instead of "injury", to indicate that the type of injury is significant.]
[Another definition for catastrophizing.] Until recently, the research literature on the fear-avoidance model did not ascribe a role of....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 79-80
Avoidance refers to behavior aimed at postponing or preventing an aversive situation from occurring (Kanfer and Philips, 1970). Although in case of chronic pain it is not possible to avoid the pain, it is possible to avoid the perceived threat, in this case the activities that are assumed to increase pain or (re)injury.....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 81-2
Recent studies indeed demonstrated fear avoidance beliefs to be present in pain-free people. For example, pain-free people in the general population reported pain-related fear comparable to, or only slightly lower, than acute and chronic pain patients. Furthermore, misconceptions, such as the belief that LBP is caused b....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 83-4
To date, only two studies examined the interrelationships of various elements of the fear-avoidance model simultaneously using structural equation modeling....Although not allowing for causal inferences, which actually constitute the basic premises of the model, these studies do support the associations between various....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 82
An intriguing question concerns the etiology of pain catastrophizing and pain-related fear. Are there certain vulnerabilities that predispose individuals to overly attach negative appraisals to pain?...there is evidence that pain-related fear is related to anxiety sensitivity (Asmundson et al. 2000; Zvolensky et al. 200....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 82
In note 1051, we have several constructs: pain catastrophizing; pain-related fear; anxiety sensitivity; injury/illness sensitivity; negative affectivity (neuroticism); fear avoidance beliefs. Pain itself, however, is not one of them. I have trouble understanding why this should be? Are there some criteria of a valid con....
Hangartner, Ross, "Personal note", Anon, 2015
The accompanying physical arousal [i.e., arousal accompanying fear] may exacerbate the pain and reinforce patients' beliefs regarding the pervasiveness of their disability. If patients view disability as an inevitable and appropriate reaction to their pain and if they believe that activity is dangerous and that pain is....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 259
Due to differences in stringency in evaluating studies for their reviews, Linton (2000) concluded that fear avoidance beliefs were associated with both the inception and continuation of LBP, whereas Pincus et al. (2002) concluded that there was too little support for this conclusion and that instead distress and depress....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 83
...The other possible maintaining factor is avoidance/escape behavior. When CLBP patients have detected a threatening situation, in this case a potential dangerous activity, they will either escape from the activity by not performing it at all, or avoid the activity by submaximal performance or the use of safety behavio....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 83
Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study.
Abstract
Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factor in the transition from acute to chronic pain. However,....
Linton SJ, Buer N, Vlaeyen J, Hellsing AL., "Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study.", Psychology and Health 14: 2000
As the pain symptoms persist, an expanding number of situations may elicit anxiety and anticipation of pain. Depression, pain, and dependence on medication may follow, thereby further intensifying the pain–tension cycle. Thus, psychological expectations may lead to modified behavior, which in turn produces physical chan....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 269
A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important.
Abstract
BACKGROUND: Tailored treatments are topical in pain rehabilitation. One key issue for correlational studies is the identifica....
Asenlof, P. and Soderlund, A., "A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important.", Clinical Rehabilitation 24: 2010
Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.
Abstract
In an attempt to explain how and why some individuals with musculoskeletal pain develop a chronic pain syndrome, Lethem et al. (Lethem J, Slade PD, Troup JDG, Bentley G. Outline of fear-avoidance model of exaggerate....
Vlaeyen JW, Linton SJ, "Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art.", Pain 85: 2000
The acquisition of fear of movement-related pain and associative learning: a novel pain-relevant human fear conditioning paradigm.
Abstract
Current fear-avoidance models consider fear of pain as a key factor in the development of chronic musculoskeletal pain. Generally, the idea is that by virtue of the formatio....
(Meulders et al. 2011)
Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain.
Abstract
Pain self-efficacy and fear of movement have been proposed to explain how pain can lead to disability for patients with chronic low back pain. However the extent t....
Costa, Lda C., Maher CG, McAuley JH, Hancock MJ, Smeets RJ., "Self-efficacy is more important than fear of movement in mediating the relationship between pain and disability in chronic low back pain.", European Journal of Pain 13: 2011
The expectation of painful stimulation may also be enhanced by the fact that patients tend to be more likely to remember pain when they are in a pain state than when they are not (Wright and Morley 1995). Thus they may selectively focus on stimuli that predict pain and become overly avoidant. [IS THIS any different from....
McMahon, S. B., Koltzenberg, M., Tracy, I., and Turk, D. C., "Wall and Melzack's Textbook of Pain", Elsevier Saunders, 2013, 262
Three recent findings in fear research are notable. First, people with a phobia (intense irrational fear) do not necessarily have a history of being exposed to a traumatic incident (Hermans et al. 2006). Second, during extinction procedures, no unlearning takes place, but rather new learning that leaves the original ass....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 78
Pain-related fear and anxiety can best be defined as the fear that emerges when stimuli that are related to pain are perceived as a main threat. The fear and anxiety response comprises psychophysiological (e.g. heightened muscle reactivity), behavioral (e.g. escape and avoidance behavior), as well as cognitive (e.g. ca....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 78
...pain-related fear could hamper the formation of this [therapeutic] alliance.
Patients’ pain-related fear may be fed by the interaction with health care providers. It might be possible that not only the health care providers’ facial expressions, but also the threatening diagnostic labels they use (e.g. back injury....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 84-5
In acute stages of pain, when the pain is the result of an acute injury, pain-related fear is likely to be adaptive as it will direct attention towards the injury, thereby enhancing the probability of necessary care, e.g. by withdrawal from usual activities so that healing process is facilitated. However, in the case of....
Leeuw M, Goossens MEJB, Linton SJ, Crombez G, Boersma, K and Vlaeyen, JWS, "The Fear-Avoidance Model of Musculoskeletal Pain: Current State of Scientific Evidence", Journal of Behavioral Medicine 30: 2006, 87-88
End of included memoes/notes