Fear-avoidance, pain acceptance and adjustment to chronic pain: a cross-sectional study on a sample of 686 patients with chronic spinal pain.
BACKGROUND
Prior studies found a range of psychological factors related to the perception of pain, maintenance of pain and disability.


OBJECTIVE
The aim of this study was to investigate the role of pain fear-avoidance and pain acceptance in chronic pain adjustment. The influence of two diathesis variables (resilience and experiential avoidance) was also analyzed.


METHODS
The sample was composed of 686 patients with chronic spinal pain. Structural equation modelling analyses were used to test the hypothetical model.


RESULTS
Experiential avoidance was associated with pain fear-avoidance, and resilience was strongly associated with pain acceptance. Pain acceptance was negatively associated with negative mood, functional impairment and pain intensity. However, pain fear-avoidance was positively and significantly associated with negative mood but had no association with pain intensity. There was a path from functional impairment to pain fear-avoidance.


CONCLUSIONS
Resilience and experiential avoidance appear as variables which could explain individual differences in pain experience.
Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Campus de Teatinos, 29071, Málaga, Spain, cramirez@uma.es.
Carmen
C
Ramírez-Maestre
Rosa
R
Esteve
Alicia
A
López-Martínez
D000223:Adaptation, Psychological / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001416:Back Pain / Q000523:psychology*; D059350:Chronic Pain / Q000523:psychology*; D003430:Cross-Sectional Studies; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013122:Spinal Diseases / Q000523:psychology*; D055815:Young Adult