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Investigating dynamic pain sensitivity in the context of the fear-avoidance model.

dc.contributor.author Bialosky, JE
dc.contributor.author Bishop, Mark D
dc.contributor.author Gay, CW
dc.contributor.author Horn, Maggie Elizabeth
dc.contributor.author Robinson, ME
dc.coverage.spatial England
dc.date.accessioned 2016-09-14T14:12:52Z
dc.date.issued 2015-01
dc.identifier http://www.ncbi.nlm.nih.gov/pubmed/24890100
dc.identifier.uri https://hdl.handle.net/10161/12760
dc.description.abstract BACKGROUND: Although nearly everyone at some point in their lives experiences back pain; the amount of interference with routine activity varies significantly. The fear-avoidance (FA) model of chronic pain explains how psychological variables, such as fear, act as mediating factors influencing the relationship between clinical pain intensity and the amount of interference with daily activities. What remains less clear is how other mediating factors fit within this model. The primary objective of this report was to examine the extent to which a dynamic measure of pain sensitivity provides additional information within the context of the FA model. METHOD: To address our primary objective, classic mediation and moderated mediation analyses were conducted on baseline clinical, psychological and quantitative sensory measures obtained on 67 subjects with back pain (mean age, 31.4 ± 12.1 years; 70% female). RESULTS: There was a moderately strong relationship (r = 0.52; p < 0.01) between clinical pain intensity and interference, explaining about 27% of the variance in the outcome. Mediation analyses confirmed fear partially mediated the total effect of clinical pain intensity on interference (Δβ = 0.27; p < 0.01), and accounted for an additional 16% of the variance. In our FA model, pain sensitivity did not demonstrate additional indirect effects; however, it did moderate the strength of indirect effects of fear. CONCLUSION: This preliminary modelling suggests complex interactions exist between pain-related fear and pain sensitivity measures that further explain individual differences in behaviour.
dc.language eng
dc.relation.ispartof Eur J Pain
dc.relation.isversionof 10.1002/ejp.519
dc.subject Adult
dc.subject Avoidance Learning
dc.subject Catastrophization
dc.subject Disability Evaluation
dc.subject Fear
dc.subject Female
dc.subject Humans
dc.subject Low Back Pain
dc.subject Male
dc.subject Models, Psychological
dc.subject Pain Measurement
dc.subject Pain Threshold
dc.subject Young Adult
dc.title Investigating dynamic pain sensitivity in the context of the fear-avoidance model.
dc.type Journal article
pubs.author-url http://www.ncbi.nlm.nih.gov/pubmed/24890100
pubs.begin-page 48
pubs.end-page 58
pubs.issue 1
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Orthopaedics
pubs.organisational-group Orthopaedics, Physical Therapy
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 19
dc.identifier.eissn 1532-2149


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