Pain-Related Fear: A Critical Review of the Related Measures

Abstract

Objectives: In regards to pain-related fear, this study aimed to: (1) identify existing measures and review their measurement properties, and (2) identify the optimum measure for specific constructs of fear-avoidance, pain-related fear, fear of movement, and kinesiophobia. Design: Systematic literature search for instruments designed to measure fear of pain in patients with persistent musculoskeletal pain. Psychometric properties were evaluated by adjusted Wind criteria. Results: Five questionnaires (Fear-Avoidance Beliefs Questionnaire (FABQ), Fear-Avoidance of Pain Scale (FAPS), Fear of Pain Questionnaire (FPQ), Pain and Anxiety Symptoms Scale (PASS), and the Tampa Scale for Kinesiophobia (TSK)) were included in the review. The main findings were that for most questionnaires, there was no underlying conceptual model to support the questionnaire's construct. Psychometric properties were evaluated by diverse methods, which complicated comparisons of different versions of the same questionnaires. Construct validity and responsiveness was generally not supported and/or untested. Conclusion: The weak construct validity implies that no measure can currently identify who is fearful. The lack of evidence for responsiveness restricts the current use of the instruments to identify clinically relevant change from treatment. Finally, more theoretically driven research is needed to support the construct and thus the measurement of pain-related fear.

Adjustment to fibromyalgia: The role of domain‐specific self‐efficacy and acceptance

“…A review, which included fibromyalgia patients, estimated the internal reliability as high (Lundberg, Grimby-Ekman, Verbunt, & Simmonds, 2011).…”

Fear Avoidance Beliefs and Disability among Women with Low Back Pain

“…The current study involved Saudi females who had experienced nonspecific chronic LBP for more than 3 months duration. Previous studies have also involved chronic conditions, but none has exclusively considered that in females [10]. The descriptive analysis on the sample showed the predominance of the minimal disability population.…”

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High Disease Activity May Increase Fear-Avoidance Beliefs in Rheumatoid Arthritis

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“…Finally, mFABQ total score was sum of these two scores. All scores dichotomized as low (mFABQ physical activity score [0-6], mFABQ work score [0][1][2][3][4][5][6][7][8][9][10][11][12] and mFABQ total score [0-18]) or high (mFABQ physical activity score [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], mFABQ work score and mFABQ total score ) according to medians of a previous study. 19 All patients were literate and none of the patients had pathological finding in the examinations that may influence the questionnaire.…”