Samenvatting
Aan pijn gerelateerde angst kan een belangrijke rol spelen in het ontstaan en het blijven bestaan van een chronisch pijnprobleem. ‘Exposure in vivo’-therapie richt zich op het reduceren van deze angst, met als doel de toename van participatie en de afname van ervaren beperkingen. In dit hoofdstuk wordt deze therapievorm uitgebreid besproken. Eerst wordt er ingegaan op de achterliggende theorie, waarna de praktijk aan bod komt aan de hand van drie stappen: (1) afname van de PHODA (photograph series of daily activities), om verwachte schadelijkheid van activiteiten en/of bewegingen in kaart te brengen, alsook om meer inzicht te verkrijgen in catastrofale gedachten en angsten daaromtrent, (2) educatie, waarin er aandacht is voor de neurofysiologie achter pijn en pijngewaarwording, alsook voor het vreesvermijdingsmodel, en (3) Exposure in vivo met gedragsexperimenten, waarbij de patiënt wordt blootgesteld aan situaties die angst oproepen en er gedragsexperimenten worden uitgevoerd om catastrofale cognities uit te dagen. Tot slot worden verscheidene manieren besproken om de behandeling te optimaliseren.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Literatuur
Claes, N., Goossens, M. E. J. B., & Vlaeyen, J. W. S. (2016). De rol van angst bij pijn: Theoretische aspecten. In J. A. Verbunt & R. J. E. M. Smeets (Red.), Graded exposure: Een cognitief gedragsmatige aanpak van chronische pijn (pag. 5–18). Houten: Bohn Stafleu van Loghum – Springer.
Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008). Optimizing inhibitory learning during exposure therapy. Behaviour Research and Therapy, 46(1), 5–27.
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23.
Dubbers, A. T., Vikström, M. H., & Jong, J. R. de (2003). The Photograph series of Daily Activities (PHODA-UE): cervical spine and shoulder. Heerlen/Maastricht, the Netherlands: Zuyd University, Institute for Rehabilitation Research (iRv), Universiteit Maastricht.
Eijssen, I., Hartingsveldt, M. van, & Verkerk, G. (2018). COPM: De nieuwe Nederlandse vertaling. Ergotherapie Magazine, 3, 32–35.
Hofmann, S. G. (2008). Cognitive processes during fear acquisition and extinction in animals and humans: Implications for exposure therapy of anxiety disorders. Clinical Psychology Review, 28(2), 199–210.
Hollander, M. den, Goossens, M. E. J. B., Jong, J. R. de, Ruijgrok, J., Oosterhof, J., Onghena, P., et al. (2016). Expose or protect? A randomized controlled trial of exposure in vivo versus physiotherapy in patients with complex regional pain syndrome type 1. Pain, 157(10), 2318–2329.
Jelinek, S., Germes, D., Leyckes, N., & Jong, J. R. de (2003). The photograph series of daily activities (PHODA-LE): Lower extremities. Heerlen/Maastricht, the. Netherlands: Zuyd University, Institute for Rehabilitation Research (iRv), Universiteit Maastricht.
Jong, J. R. de, Vangronsveld, K., Peters, M. L., Goossens, M. E. J. B., Onghena, P., Bulté, I., et al. (2008). Reduction of pain-related fear and disability in post-traumatic neck pain: A replicated single-case experimental study of exposure in vivo. Journal of Pain, 9(12), 1123–1134.
Jong, J. R. de, Vlaeyen, J. W. S., Eijsden, M. van, Loo, C., & Onghena, P. (2012). Reduction of pain-related fear and increased function and participation in work-related upper extremity pain (WRUEP): Effects of exposure in vivo. Pain, 153, 2109–2118.
Jong, J. R. de, Vlaeyen, J. W. S., Onghena, P., Cuypers, C., Hollander, M. den, & Ruijgrok, J. (2005a). Reduction of pain-related fear in complex regional pain syndrome type I: the application of graded exposure in vivo. Pain, 116, 264–275.
Jong, J. R. de, Vlaeyen, J. W. S., Onghena, P., Goossens, M. E. J. B., Geilen, M., & Mulder, H. (2005b). Fear of movement/(re)injury in chronic low back pain: Education or exposure in vivo as mediator to fear reduction? Clinical Journal of Pain, 21, 9–17.
Leeuw, M., Goossens, M. E., Breukelen, G. J. van, Boersma, K., & Vlaeyen, J. W. S. (2007). Measuring perceived harmfulness of physical activities in patients with chronic low back pain: The photograph series of daily activities-short electronic version. Journal of Pain, 8(11), 840–849.
Leeuw, M., Goossens, M. E. J. B., Breukelen, G. J. P. van, Jong, J. R. de, Heuts, P. H. T. G., Smeets, R. J. E. M., et al. (2008). Exposure in vivo versus operant graded activity in chronic low back pain patients: Results of a randomized controlled trial. Pain, 138, 192–207.
Lethem, J., Slade, P. D., Troup, J. D., & Bentley, G. (1983). Outline of a fear-avoidance model of exaggerated pain perception-I. Behaviour Research and Therapy, 21(4), 401–408.
Lissek, S., Powers, A. S., McClure, E. B., Phelps, E. A., Woldehawariat, G., Grillon, C., et al. (2005). Classical fear conditioning in the anxiety disorders: A meta-analysis. Behaviour Research and Therapy, 43(11), 1391–1424.
Meuret, A. E., Seidel, A., Rosenfield, B., Hofmann, S. G., & Rosenfield, D. (2012). Does fear reactivity during exposure predict panic symptom reduction? Journal of Consulting and Clinical Psychology, 80(5), 773–785.
Slade, P. D., Troup, J. D., Lethem, J., & Bentley, G. (1983). The fear-avoidance model of exaggerated pain perception-II. Behaviour Research and Therapy, 21(4), 409–416.
Trost, Z., France, C. R., & Thomas, J. S. (2008). Exposure to movement in chronic back pain: Evidence of successful generalization across a reaching task. Pain, 137(1), 26–33.
Verbunt, J. A., Nijhuis, A., Vikstrom, M., Stevens, A., Haga, N., Jong, J. R. de, et al. (2015). The psychometric characteristics of an assessment instrument for perceived harmfulness in adolescents with musculoskeletal pain (PHODA-youth). European Journal of Pain, 19(5), 695–705.
Verbunt, J. A., & Smeets, R. J. E. M. (Eds.). (2016). Graded exposure. Houten: Bohn Stafleu van Loghum.
Vlaeyen, J. W. S., Crombez, G., & Linton, S. J. (2016). The fear-avoidance model of pain. Pain, 157(8), 1588–1589.
Vlaeyen, J. W. S., Jong, J. R. de, Geilen, M., Heuts, P. H., & Breukelen, G. van (2001). Graded exposure in vivo in the treatment of pain-related fear: A replicated single-case experimental design in four patients with chronic low back pain. Behaviour Research and Therapy, 39(2), 151–166.
Vlaeyen, J. W. S., Jong, J. R. de, Geilen, M., Heuts, P. H., & Breukelen, G. van (2002a). The treatment of fear of movement/(re)injury in chronic low back pain: Further evidence on the effectiveness of exposure in vivo. Clinical Journal of Pain, 18(4), 251–261.
Vlaeyen, J. W. S., Jong, J. R. de, Onghena, P., Kerckhoffs-Hanssen, M., & Kole-Snijders, A. M. (2002b). Can pain-related fear be reduced? The application of cognitive-behavioural exposure in vivo. Pain Research and Management, 7(3), 144–153.
Vlaeyen, J. W. S., Kole-Snijders, A. M., Rotteveel, A. M., Ruesink, R., & Heuts, P. H. (1995). The role of fear of movement/(re)injury in pain disability. Journal of Occupational Rehabilitation, 5, 235–252.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Bohn Stafleu van Loghum is een imprint van Springer Media B.V., onderdeel van Springer Nature
About this chapter
Cite this chapter
de Jong, J., Timmers, I. (2019). Exposure in vivo. In: Verbunt, J., Swaan, J., Schiphorst Preuper, H., Schreurs, K. (eds) Handboek pijnrevalidatie. Bohn Stafleu van Loghum, Houten. https://doi.org/10.1007/978-90-368-2230-5_17
Download citation
DOI: https://doi.org/10.1007/978-90-368-2230-5_17
Published:
Publisher Name: Bohn Stafleu van Loghum, Houten
Print ISBN: 978-90-368-2229-9
Online ISBN: 978-90-368-2230-5
eBook Packages: Dutch language eBook collection