Development and Validation of the Athlete Fear Avoidance Questionnaire

Dover, Geoffrey; Amar, Vanessa

doi:10.4085/1062-6050-49.3.75

Cited by 52 publications

(106 citation statements)

References 24 publications

(34 reference statements)

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“…This may have driven lower disability in athletes. It is of note, however, that avoidance behaviour seems to play a role in athletes's LBP nonetheless, which is in accordance with previous research (Dover & Amar, ).…”

Section: Discussionsupporting

confidence: 92%

“…in non‐athletes and not in athletes. Dover and Amar () stated that current instruments assessing FAR are inappropriate in athletes, as athletes have specific contents of fear and avoidance, such as return to play or their team role. This might lead to an underestimation of FAR in athletes.…”

Section: Discussionmentioning

confidence: 99%

“…Also FAR have been observed in athletic populations (Deroche et al, ; Dover & Amar, ; Hsu, Meierbachtol, George, & Chmielewski, ; Jones & Parker, ). There is some evidence for the notion that pain‐free athletes report less catastrophizing (Ghazaie et al, ; Sullivan, Tripp, Rodgers, & Stanish, ) and avoidance behaviour than non‐athletes (Sharma, Sandhu, & Shenoy, ), while another study did not show such differences (Azevedo & Samulski, ).…”

Section: Introductionmentioning

confidence: 96%

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Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Gajsar

Titze

Levenig

et al. 2019

European Journal of Pain

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Background Dysfunctional psychological pain responses, namely fear‐avoidance (FAR), including catastrophizing and helplessness, as well as endurance‐related responses (ER), including thought suppression and overactivity, have been shown to be risk factors for persistent low back pain (LBP). Literature suggests that athletes may differ from non‐athletes regarding psychological responses to pain. Objectives This study set out to compare FAR and ER between athletes and non‐athletes with LBP. It was hypothesized that athletes would report less frequent FAR and more frequent ER, and that both FAR and ER are associated with LBP intensity and disability. Methods The 173 athletes and 93 non‐athletes cross‐sectionally reported how frequently they employ FAR and ER on the Avoidance‐Endurance Questionnaire (AEQ), as well as LBP intensity and disability on the Chronic Pain Grade Questionnaire (CPGS). MANOVA was applied to compare FAR and ER between athletes and non‐athletes. Hierarchical multiple linear regression models were used to determine the unique associations between FAR and ER with LBP intensity and disability. Results Athletes reported lower frequencies of behavioural avoidance than non‐athletes, but no other FAR variables differed between the groups. Frequencies of ER did not differ between athletes and non‐athletes. Regression analysis indicated substantial associations of FAR with LBP intensity, as well as of FAR and ER with disability in athletes and non‐athletes. Conclusions The results of the present study suggest that athletes and non‐athletes with LBP differ regarding behavioural avoidance, but overall, differences regarding pain responses are marginal. FAR and ER are both reported in athletes and non‐athletes and contribute to disability in both groups. Significance Athletes train to endure pain in the course of athletic socialization, at least in the context of exercise. However, there is sparsity of knowledge about psychological pain responses in athletes with low back pain and whether they differ from those in non‐athletes. The results of this comparative study suggest that endurance responses are more frequent than avoidance responses among athletes and non‐athletes alike. However, both types of responses seem relevant to clinical pain management in athletes as well as non‐athletes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

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Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Gajsar

Titze

Levenig

et al. 2019

European Journal of Pain

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“…The construct validity was shown by significant correlations of the AFAQ with the Pain Catastrophizing Scale (r = 0.58, p < 0.001), Fear Avoidance Beliefs Questionnaire (FABQ-total score (r = 0.279, p = 0.005), and the FABQ-physical activity score (r = 0.352, p < 0.001). On the other hand, there was no significant correlation between the AFAQ and FABQ-work score (r = 0.137, p = 0.176), because the latter reflects work-related concerns that do not apply to athletes [34].…”

Section: Athlete Fear Avoidance Questionnaire (Afaq)mentioning

confidence: 87%

“…The AFAQ is a 10-item instrument designed to measure sports-injury-related fear avoidance in athletes [34]. All items are scored on a 5-point Likert scale (1-5) from "Not at all" to "Completely agree."…”

Section: Athlete Fear Avoidance Questionnaire (Afaq)mentioning

confidence: 99%

Fear Avoidance Beliefs in College Athletes with a History of Ankle Sprain

2020

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Ankle sprains are the most prevalent injuries, and elevated fear avoidance beliefs after ankle sprain episodes could inhibit athletic performance and contribute to residual symptoms, such as functional and/or mechanical instability. However, it remains unclear how fear avoidance beliefs differ according to conditions of posttraumatic sequelae. The purpose of this study was to determine whether fear of movement/reinjury differed between individuals with and without functional ankle instability (FI, NFI) and healthy controls (CON) and to examine the relationship between fear and ankle joint laxity by sex. Participants (115 male athletes, 105 female athletes) completed the Identification of Functional Ankle Instability, Athlete Fear Avoidance Questionnaire (AFAQ), Tampa Scale for Kinesiophobia (TSK), and ankle joint laxity test. Total 168 athletes (79 males, 89 females) data were eligible for analysis. The results demonstrated that fear of movement/reinjury was lower in individuals in the absence of functional ankle instability although they experienced ankle sprain (FI; TSK=38.6±4.5, AFAQ=27.4±6.2, NFI; TSK=35.7±5.6, AFAQ=24.5±6.6). The fear of movement/reinjury had correlation with ankle joint laxity only in female athletes (TSK; r=0.285, p=0.013, AFAQ; r 0=0.322, p=0.045).

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Translation, cultural adaptation and validation of the Swahili Pain Catastrophizing Scale among refugees who survived torture and/or war trauma in Kenya: An observational study

Kibet,

Phillips,

Latrous

et al. 2024

Health Science Reports

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Background and AimsAccurate assessment of any patient relies on the use of appropriate measurements which are culturally‐ and linguistically‐applicable and valid. The following study aimed to translate, cross‐culturally adapt and test the nomological validity, structural validity, internal consistency, test‐retest reliability, sensitivity‐to‐change and feasibility of the Swahili version of the Pain Catastrophizing Scale (Swa‐PCS) among refugees who survived torture/war trauma living with chronic pain in Kenya.MethodsAn observational study was conducted. Translation and cultural adaptation of the original PCS for the Swahili‐speaking refugee population in Kenya, who survived torture or war trauma was undertaken. Following this process, a validation study was conducted on the newly‐adapted instrument, to ascertain the psychometric properties (nomological validity, structural validity, internal consistency, test‐retest reliability, sensitivity‐to change, and ceiling and floor effects).ResultsFifty participants were included in this study. Correlations between pain catastrophization and fear‐avoidance behavior measures were significant (r = 0.538, p < 0.01). Ceiling effects were 42−48% with no floor effects. Standard errors of measurement values were between 0.938 and 3.38. Minimal‐detectable‐change values were between 2.17 and 7.82. Internal consistency was satisfactory to good, for the whole and subsections respectively (range α = 0.693−0.845). Magnification had the lowest α. Test−retest reliability was also satisfactory to good (range ICC = 0.672−0.878). Confirmatory factor analysis confirmed that the Swa‐PCS had three factors which explained the majority of the variance. Root mean square error of approximation and comparative fit index were calculated for goodness‐of‐fit assessment, and were 0.18 and 0.83, respectively.ConclusionThis study showed that the adapted Swa‐PCS displayed overall satisfactory to good internal consistency, test‐retest reliability and sensitivity‐to‐change. Furthermore, the Swa‐PCS scores were related to fear‐avoidance behavior scores as expected (nomological validity). Structural validation of the Swa‐PCS requires further investigation. Further testing of the psychometric properties of the Swa‐PCS is however warranted.

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Development and Validation of the Athlete Fear Avoidance Questionnaire

Abstract: We developed a questionnaire with good internal and external validity. The AFAQ is a scale that measures sport-injury-related fear avoidance in athletes and could be used to identify potential psychological barriers to rehabilitation.

Cited by 52 publications

References 24 publications

Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Psychological pain responses in athletes and non‐athletes with low back pain: Avoidance and endurance matter

Fear Avoidance Beliefs in College Athletes with a History of Ankle Sprain

Translation, cultural adaptation and validation of the Swahili Pain Catastrophizing Scale among refugees who survived torture and/or war trauma in Kenya: An observational study

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