title: The Fear-avoidance Components Scale (FACS): Development and Psychometric Evaluation of a New Measure of Pain-related Fear Avoidance.
abstract: Pain-related fear avoidance (FA), a common problem for patients with painful medical conditions, involves pain-related catastrophizing cognitions, hypervigilance, and avoidance behaviors, which can ultimately lead to decreased functioning, depression, and disability. Several patient-reported instruments have been developed to measure FA, but they have been criticized for limited construct validity, inadequate item specificity, lack of cutoff scores, and missing important FA components. The Fear-Avoidance Components Scale (FACS) is a new patient-reported measure designed to comprehensively evaluate FA in patients with painful medical conditions. It combines important components of FA found in prior FA scales, while trying to correct some of their deficiencies, within a framework of the most current FA model. Psychometric evaluation of the FACS found high internal consistency (α = 0.92) and high test/retest reliability (r = 0.90-0.94, P < 0.01). FACS scores differentiated between 2 separate chronic pain patient samples and a nonpatient comparison group. When clinically relevant severity levels were created, FACS severity scores were highly associated with FA-related patient-reported psychosocial and objective lifting performance variables. These results suggest that the FACS is a psychometrically strong and reliable measure that can help healthcare providers assess FA-related barriers to function and recovery.
authors.affiliation: PRIDE Research Foundation, Dallas, Texas, U.S.A.
authors.forename: Randy
authors.initials: R
authors.lastname: Neblett
authors.affiliation: Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
authors.forename: Tom G
authors.initials: TG
authors.lastname: Mayer
authors.affiliation: PRIDE Research Foundation, Dallas, Texas, U.S.A.
authors.forename: Meredith M
authors.initials: MM
authors.lastname: Hartzell
authors.affiliation: PRIDE Research Foundation, Dallas, Texas, U.S.A.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Williams
authors.affiliation: Department of Psychology, College of Science, The University of Texas at Arlington, Arlington, Texas, U.S.A.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Gatchel
mesh_terms: D000328:Adult; D058443:Catastrophization / Q000523:psychology; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Fear-avoidance Components Scale; assessment; behavioral medicine; fear avoidance; musculoskeletal disorders; pain; psychometrics; rehabilitation