title: Avoidance behavior in chronic pain research: a cold case revisited.
abstract: In chronic musculoskeletal pain, avoidance behavior is a prominent behavioral characteristic that can manifest itself in various ways. It is also considered a crucial component in the development and maintenance of chronic pain-related disability, supposedly fueled by pain-related fear and catastrophic beliefs. Despite the frequent occurrence of avoidance behavior and its potential impact on quality of life, relatively little research has been dedicated to the nature of avoidance in chronic pain and its assessment, leaving its underlying mechanisms poorly understood. In the current paper, we stipulate some of the existing parallels between chronic pain research and more basic fear and anxiety research inspired by modern learning theories. After a brief introduction, we discuss avoidance theories that are likely apt to be applied to chronic pain, including avoidance as a response that can affect fear responding, and the role of avoidant decision making and motivational context. Finally, we will outline how these theories may impact clinical treatment.
authors.affiliation: Research Group Health Psychology, University of Leuven, Belgium. Electronic address: stephanievolders@hotmail.com.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Volders
authors.affiliation: Center for the Psychology of Learning and Experimental Psychopathology, University of Leuven, Belgium; Center of Excellence on Generalization Research, University of Leuven, Belgium.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Boddez
authors.affiliation: Research Group Health Psychology, University of Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: De Peuter
authors.affiliation: Research Group Health Psychology, University of Leuven, Belgium; Center of Excellence on Generalization Research, University of Leuven, Belgium.
authors.forename: Ann
authors.initials: A
authors.lastname: Meulders
authors.affiliation: Research Group Health Psychology, University of Leuven, Belgium; Center of Excellence on Generalization Research, University of Leuven, Belgium; Department of Clinical Psychological Science, Maastricht University, The Netherlands.
authors.forename: Johan W S
authors.initials: JW
authors.lastname: Vlaeyen
mesh_terms: D001007:Anxiety / Q000523:psychology*; D001362:Avoidance Learning; D059350:Chronic Pain / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D059352:Musculoskeletal Pain / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*
keywords: Avoidance behavior; Chronic pain; Fear; Learning; Motivation