title: Adjustment to chronic low back pain--the relative influence of fear-avoidance beliefs, catastrophizing, and appraisals of control.
abstract: The present study investigated the relative extent to which patients' adjustment to chronic low back pain (CLBP) was influenced by their fear-avoidance beliefs, their tendency to catastrophize, and their appraisals of control. Eighty-three CLBP patients completed a series of self-report measures before participating in a physical therapist-led intervention. Hierarchical multiple regression analyses revealed that patients' perceptions of their ability to decrease pain explained a small, but statistically significant, proportion of the variance in pain intensity. In addition, patients' levels of catastrophizing, as well as their fear-avoidance beliefs about both work and physical activity, were independently associated with levels of disability. Interestingly, however, when exploring the relative predictive utility of these three psychological factors, it became evident that fear-avoidance beliefs about physical activity (FABs-PA) were the only significant predictor of patients' disability. Specifically, those patients who exhibited higher levels of FABs-PA tended to report greater levels of disability, even after adjusting for age, sex and pain intensity.
authors.affiliation: Department of Anaesthesia and Pain Management, University of Leicester, Leicester LE5 4PW, UK. s.woby@mmu.ac.uk
authors.forename: Steve R
authors.initials: SR
authors.lastname: Woby
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Watson
authors.forename: Neil K
authors.initials: NK
authors.lastname: Roach
authors.forename: Martin
authors.initials: M
authors.lastname: Urmston
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001294:Attitude to Health; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D017116:Low Back Pain / Q000523:psychology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010147:Pain Measurement; D012044:Regression Analysis