A comparison of laboratory measures of escape and avoidance behavior.
Escape and avoidance of the onset of pain and exacerbations of pain can be difficult to distinguish in certain circumstances. This investigation compared measures of participants' (N = 61, 50.8% women) escape and avoidance behavior during an ischemic pain task. Instructions for the ischemic task were manipulated so that one group stopped the task whenever they wanted (eg, before the onset of pain) and another group endured the ischemic pain to tolerance. Delay time before beginning the task and willingness to complete the task were not related to self-reported escape/avoidance (r = -.21, P = .10; r = -.14, P = .30). Also, they were not predicted by fear, anxiety, or catastrophizing. Task duration with the unrestricted stop rule was not related to self-reported escape/avoidance (r = -.13, P = .50) and was not predicted by fear, anxiety, or catastrophizing. However, task duration with the tolerance stop rule was associated with self-reported escape/avoidance (r = -.40, P = .02) and was predicted by catastrophizing (t(29) = -2.92, P < .01). Thus, evidence for the validity of task duration with a tolerance stop rule as a measure of escape from pain or avoidance of pain exacerbation was found.


CONCLUSIONS
Measures of avoidance of pain onset were not supported. However, task duration was a valid measure of escape from pain or avoidance of pain exacerbation with tolerance stop rules. Other measures of escape/avoidance behavior and participants' perceptions of stable or increasing pain level throughout a pain task should be examined.
Dannecker
Erin A
EA
Department of Physical Therapy, University of Missouri, Columbia, Missouri 65211-4250, USA. danneckere@missouri.edu
George
Steven Z
SZ
D000293:Adolescent; D001007:Anxiety / Q000523:psychology; D001362:Avoidance Learning / Q000502:physiology*; D032763:Behavior Control / Q000379:methods; D004924:Escape Reaction / Q000502:physiology*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D013997:Time Factors; D055815:Young Adult
J Opioid Manag. 2007 Mar-Apr;3(2):101-6
17520989
Psychosom Med. 2001 Mar-Apr;63(2):316-23
11292281
Emerg Med J. 2001 May;18(3):205-7
11354213
Pain. 2004 Aug;110(3):512-516
15288391
Behav Res Ther. 2007 Feb;45(2):199-209
16569396
Eur J Pain. 2006 Jul;10(5):457-65
16095935
J Psychosom Res. 1989;33(5):579-89
2795530
Eur J Pain. 2005 Jun;9(3):257-65
15862475
Pain. 2004 Oct;111(3):245-252
15363867
Pain. 1995 Feb;60(2):203-216
7784106
Eur J Pain. 2004 Dec;8(6):511-6
15531218
J Behav Med. 1994 Oct;17(5):511-22
7877159
J Behav Ther Exp Psychiatry. 2006 Jun;37(2):146-58
15882839
Pain. 2000 Apr;85(3):317-332
10781906
J Behav Med. 2000 Aug;23(4):351-65
10984864
Behav Res Ther. 1983;21(4):401-8
6626110
Pain. 1998 Jan;74(1):1-3
9514553
J Behav Med. 2002 Apr;25(2):155-73
11977436
Ann Emerg Med. 1996 Apr;27(4):485-9
8604867
J Behav Med. 2007 Feb;30(1):77-94
17180640
Pain. 2007 Jul;130(1-2):119-25
17240065
Spine (Phila Pa 1976). 1999 Oct 1;24(19):2035-41
10528381
Psychosom Med. 1997 Sep-Oct;59(5):503-11
9316183
J Pain. 2006 Aug;7(8):583-91
16885015
J Behav Med. 1998 Aug;21(4):389-410
9789168
Behav Res Ther. 1998 Feb;36(2):149-64
9613022
Behav Res Ther. 1997 May;35(5):437-44
9149453
Ann Emerg Med. 2001 Dec;38(6):633-8
11719741
Pain. 1987 Mar;28(3):297-307
2952934
Eur J Pain. 2007 Feb;11(2):202-7
16546424
Behav Res Ther. 1993 Sep;31(7):647-52
8216166