title: [Depressivity as mediator in the fear-avoidance model: a path analysis investigation of patients with chronic back pain].
abstract: BACKGROUND
  The fear-avoidance model (FAM) has gained widespread acceptance as a conceptual framework predicting chronic pain development. However, there is still a high amount of unexplained variance in the prediction of outcome variables. This study aimed to test depression as a mediator of prospective links between the FAM variables pain intensity, pain-related fear, avoidance behavior and disability in order to achieve a better prediction of model variables.
  
  
  METHODS
  Single mediation analyses were conducted using path analysis of longitudinal data from patients with chronic back pain (n = 243).
  
  
  RESULTS
  There was at least partial mediation by depression for all prospective relations of FAM variables analyzed. The mediation effects increased the percentage of explained variance of the predicted model variables.
  
  
  CONCLUSIONS
  The findings provide support for additional consideration of depressive symptoms to obtain a better understanding of prospective associations between FAM variables. The findings indicate that in the treatment of chronic back pain following a multiple target approach to reduce pain, pain-related fear and avoidance behavior and also depressive symptoms should be considered.
authors: Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg, Klinikstr. 3, 97070, Würzburg, Deutschland, b.seekatz@uni-wuerzburg.de.
authors: B
authors: B
authors: Seekatz
authors: K
authors: K
authors: Meng
authors: H
authors: H
authors: Faller
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology*; D001362:Avoidance Learning; D001416:Back Pain / Q000175:diagnosis* / Q000523:psychology*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D055809:Illness Behavior; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000523:psychology; D011379:Prognosis; D011446:Prospective Studies; D013001:Somatoform Disorders / Q000175:diagnosis* / Q000523:psychology*