The fear-avoidance model of chronic pain: assessing the role of neuroticism and negative affect in pain catastrophizing using structural equation modeling.
BACKGROUND
Previous research on the fear-avoidance model (FAM) of chronic pain suggests that the personality traits of neuroticism and negative affect (NA) influence pain catastrophizing. However, the mechanisms of their influence on pain catastrophizing remain unclear.


OBJECTIVE
This study examined four possible models of relationships between neuroticism, NA, and pain catastrophizing within the FAM framework using structural equation modeling.


METHODS
A total of 401 patients with chronic musculoskeletal pain completed measures of neuroticism, NA, three core FAM components (pain catastrophizing, pain-related fear, and pain anxiety), and adjustment outcomes (pain-related disability and depression).


RESULTS
Regression analyses refuted the possibility that neuroticism and NA moderated each other's effect on pain catastrophic thoughts (p > 0.05). Results of structural equation modeling (SEM) evidenced superior data-model fit for the collapsed models in which neuroticism and NA were two secondary traits underlying a latent construct, negative emotion (disability: comparative fit index (CFI) = 0.93; depression: CFI = 0.91).


CONCLUSIONS
The results offer preliminary evidence that patients presenting with more neurotic symptom and heightened NA probably elicit more catastrophic thoughts about pain.
Department of Psychological Studies and Center for Psychosocial Health & Aging, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, Hong Kong, SAR, China, wingwong@ied.edu.hk.
W S
WS
Wong
H M J
HM
Lam
P P
PP
Chen
Y F
YF
Chow
S
S
Wong
H S
HS
Lim
M P
MP
Jensen
R
R
Fielding
D000328:Adult; D001007:Anxiety / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology*; D058443:Catastrophization / Q000523:psychology*; D059350:Chronic Pain / Q000523:psychology*; D003863:Depression / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications; D006233:Persons with Disabilities / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000523:psychology*; D000075384:Neuroticism; D010147:Pain Measurement / Q000379:methods; D012044:Regression Analysis; D011795:Surveys and Questionnaires