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Fear-Avoidance, Pain Acceptance and Adjustment to Chronic Pain: A Cross-Sectional Study on a Sample of 686 Patients with Chronic Spinal Pain

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Prior studies found a range of psychological factors related to the perception of pain, maintenance of pain and disability.

Purpose

The aim of this study was to investigate the role of pain fear-avoidance and pain acceptance in chronic pain adjustment. The influence of two diathesis variables (resilience and experiential avoidance) was also analyzed.

Methods

The sample was composed of 686 patients with chronic spinal pain. Structural equation modelling analyses were used to test the hypothetical model.

Results

Experiential avoidance was associated with pain fear-avoidance, and resilience was strongly associated with pain acceptance. Pain acceptance was negatively associated with negative mood, functional impairment and pain intensity. However, pain fear-avoidance was positively and significantly associated with negative mood but had no association with pain intensity. There was a path from functional impairment to pain fear-avoidance.

Conclusions

Resilience and experiential avoidance appear as variables which could explain individual differences in pain experience.

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Acknowledgments

This research was supported by grants from the Spanish Ministry of Science and Innovation (PSI2008-01803/PSIC) and the Andalusian Regional Government (HUM-566; P07-SEJ-3067).

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Ramírez-Maestre, Esteve, and López declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Authors and Affiliations

  1. Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071, Málaga, Spain

    Carmen Ramírez-Maestre PhD, Rosa Esteve PhD & Alicia López-Martínez PhD

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  1. Carmen Ramírez-Maestre PhD
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  2. Rosa Esteve PhD
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  3. Alicia López-Martínez PhD
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Correspondence to Carmen Ramírez-Maestre PhD.

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Ramírez-Maestre, C., Esteve, R. & López-Martínez, A. Fear-Avoidance, Pain Acceptance and Adjustment to Chronic Pain: A Cross-Sectional Study on a Sample of 686 Patients with Chronic Spinal Pain. ann. behav. med. 48, 402–410 (2014). https://doi.org/10.1007/s12160-014-9619-6

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  • DOI: https://doi.org/10.1007/s12160-014-9619-6

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