title: Fear-avoidance beliefs and catastrophizing: occurrence and risk factor in back pain and ADL in the general population.
abstract: Fear-avoidance beliefs and catastrophizing have been shown to be powerful cognitions in the process of developing chronic pain problems and there is a need for increased knowledge in early stages of pain. The objectives of this study were therefore, firstly, to examine the occurrence of fear-avoidance beliefs and catastrophizing in groups with different degrees of non-chronic spinal pain in a general population, and secondly to assess if fear-avoidance beliefs and catastrophizing were related to current ratings of pain and activities of daily living (ADL). The study was a part of a population based back pain project and the study sample consisted of 917 men and women, 35-45 years old, either pain-free or with non-chronic spinal pain. The results showed that fear-avoidance beliefs as well as catastrophizing occur in this general population of non-patients. The levels were moderate and in catastrophizing a 'dose-response' pattern was seen, such that more the catastrophizing was, the more was pain. The study showed two relationships, which were between fear-avoidance and ADL as well as between catastrophizing and pain intensity. Logistic regression analyses were performed with 95% confidence intervals and the odds ratio for fear-avoidance beliefs and ADL was 2.5 and for catastrophizing and pain 1.8, both with confidence interval above unity. The results suggest that fear-avoidance beliefs and catastrophizing may play an active part in the transition from acute to chronic pain and clinical implications include screening and early intervention.
authors.affiliation: Neurotec Department, Division of Physiotherapy, Karolinska Institute, Stockholm, Sweden Department of Health Promotion for Personnel, Örebro University Hospital, SE-701 85 Örebro, Sweden Department of Occupational and Environmental Medicine, Örebro University Hospital, SE-701 85 Örebro, Sweden.
authors.forename: Nina
authors.initials: N
authors.lastname: Buer
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Linton
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D001362:Avoidance Learning; D001416:Back Pain / Q000453:epidemiology / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D016017:Odds Ratio; D012307:Risk Factors; D018709:Statistics, Nonparametric