Do Fear-Avoidance Beliefs Play a Role on the Association Between Low Back Pain and Sickness Absence? A Prospective Cohort Study Among Female Health Care Workers

Jensen, J. Steen; Karpatschof, Benny; Labriola, Merete; Albertsen, Karen

doi:10.1097/jom.0b013e3181c95b9e

Cited by 71 publications

(61 citation statements)

References 41 publications

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“…17,20,29,45,49,53,57 Recently, it has been suggested that pain-related fear should be considered within a motivational context. More specifically, the experience of pain might not only lead to the development of pain-related fear, but may also activate the goal to control or avoid (further) harm.…”

Section: Introductionmentioning

confidence: 99%

Competing Goals Attenuate Avoidance Behavior in the Context of Pain

Claes¹,

Karos²,

Meulders³

et al. 2014

The Journal of Pain

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Current fear-avoidance models consider pain-related fear as a crucial factor in the development of chronic pain. Yet, pain-related fear often occurs in a context of multiple, competing goals. This study investigated whether pain-related fear and avoidance behavior are attenuated when individuals are faced with a pain avoidance goal and another valued but competing goal, operationalized as obtaining a monetary reward. Fifty-five healthy participants moved a joystick towards different targets. In the experimental condition, a movement to one target (Conditioned Stimulus; CS+) was followed by a painful unconditioned stimulus (pain-US) and a rewarding unconditioned stimulus on 50% (reward-US) of the trials, whereas the CSmovement was not. In the control condition, the CS+ movement was followed by the pain-US only. Results showed that pain-related fear was elevated in response to the CS+ compared to the CS-movement, but that it was not influenced by the reward-US. Interestingly, participants initiated a CS+ movement slower than a CS-movement in the control condition, but not in the experimental condition. Also, in choice trials, participants performed the CS+ movement more frequently in the experimental than in the control condition. These results suggest that the presence of a valued competing goal can attenuate avoidance behavior. Perspective:The current study provides experimental evidence that both pain and competing goals impact on behavioral decision making and avoidance behavior. These results provide experimental support for treatments of chronic pain that include valuable daily life goals pursued by an individual, rather than limiting focus to pain reduction only.

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Section: Introductionmentioning

confidence: 99%

Competing Goals Attenuate Avoidance Behavior in the Context of Pain

Claes¹,

Karos²,

Meulders³

et al. 2014

The Journal of Pain

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“…For low back pain patients, painrelated fear is a risk factor for the development of chronic low back pain through diminished participation in activities of daily life, for greater perceived disability, greater work loss, and more frequent sick leave as well as for poorer treatment performance 14,34 . Several prospective studies suggest that fear-avoidance beliefs may influence the transition from acute to chronic low back pain and associated outcomes, such as disability and sick leave 35,36 .…”

Section: Current State Of Evidencementioning

confidence: 99%

Fear-Avoidance Model of Chronic Pain

Crombez

Eccleston²,

Damme

et al. 2012

The Clinical Journal of Pain

785

690

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Objective: The fear-avoidance (FA) model of chronic pain describes how individuals experiencing acute pain may become trapped into a vicious circle of chronic disability and suffering. We propose to extend the FA model by adopting a motivational perspective on chronic pain and disability. Methods: A narrative reviewResults: There is ample evidence to support the validity of the FA model as originally formulated. There are, however, some key challenges that call for a next generation of the FA model. First, the FA model has its roots in psychopathology, and investigators will have to find a way to account for findings that do not easily fit within such framework. Second, the FA model needs to address the dynamics and complexities of disability and functional recovery. Third, the FA model should incorporate the idea that pain-related fear and avoidance occurs in a context of multiple and often competing personal goals. Discussion:To address these three key challenges, we argue that the next generation of the FA model needs to more explicitly adopt a motivational perspective, one that is built around the organizing powers of goals and self-regulatory processes.Using this framework, the FA model is recast as capturing the persistent but futile attempts to solve pain-related problems in order to protect and restore life goals.

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“…As well as being an independent risk factor for cardiovascular disease (Stansfeld et al 2002, van Amelsvoort et al 2003, it is also very costly with respect to work absenteeism ( Hemingway el al. 1997, Borritz et al 2010, Jensen et al 2010. Over the previous 30 years, high work demands, low decision latitude, and low levels of social support at work, have been identified as important constructs in relation to work related psychological well-being (Karasek, 1979;Johnson and Hall, 1988, van der Doef et al 1999, de Lange et al 2003, Hausser et al 2010.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial work characteristics, need for recovery and musculoskeletal problems predict psychological distress in a sample of British workers

2011

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2From an original sample of 2454 participants free of self-reported psychological distress, 1463 workers completed a 15-month follow-up. Baseline measures included exposure to job demands, decision latitude, social support and need for recovery. Psychological distress was assessed using the General Health Questionnaire at baseline and at follow up. The findings showed that medium and high exposure to job demands and social support increased the risk of reporting psychological distress at 15-months (RR = 1.65 & 1.45). The highest adjusted relative risk was observed for workers reporting a high need for recovery after work (RR 2.12, 1.90), and this finding was independent of the effects of job demands, decision latitude and social support. Neither decision latitude, nor low back problems increased the risk of reporting future psychological distress, although neck problems (RR = 1.66) and hand/wrist problems (RR = 1.45) did. It was concluded that need for recovery appears to be an important indicator of individual workers who are at risk of developing psychological distress long-term.

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Do Fear-Avoidance Beliefs Play a Role on the Association Between Low Back Pain and Sickness Absence? A Prospective Cohort Study Among Female Health Care Workers

Cited by 71 publications

References 41 publications

Competing Goals Attenuate Avoidance Behavior in the Context of Pain

Competing Goals Attenuate Avoidance Behavior in the Context of Pain

Fear-Avoidance Model of Chronic Pain

Psychosocial work characteristics, need for recovery and musculoskeletal problems predict psychological distress in a sample of British workers

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