title: Is there an association between fear avoidance beliefs, and pain and disability in patients with orofacial pain?
abstract: Numerous psychosocial factors have been shown to contribute to the development and perpetuation of orofacial pain. One well-recognized model for explaining the link between psychosocial factors and chronic pain is the fear avoidance model. To date, this proposed link has not been studied in subjects with orofacial pain. During the initial evaluation of subjects with orofacial pain, we collected data on fear avoidance beliefs using the Fear Avoidance Beliefs Questionnaire, and disability and pain. At between 6 and 8 weeks follow-up, we re-collected these data, as well as data addressing subjects' perceived change in their condition. Data were analyzed using correlation coefficients and linear regression. Fear avoidance beliefs at intake were inversely correlated with intake disability, There were no significant associations between fear avoidance beliefs at initial evaluation or in changes in fear avoidance beliefs during the 6-8 weeks follow-up period; and changes in disability, pain or perceived change in condition at 6-8 weeks follow-up. Of note, fear avoidance beliefs increased over the follow-up period, despite improvements in all outcome measures. There was insufficient evidence to suggest that high levels of fear avoidance beliefs at initial evaluation are associated with higher levels of disability or pain at intake, or with change in disability, pain or perceived change in condition at 6-8 weeks follow-up. Similarly, there was insufficient evidence to suggest that changes in fear avoidance beliefs during treatment are associated with any of these outcome measures.
authors.affiliation: School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA.
authors.forename: S L
authors.identifier: http://orcid.org/0000-0003-3605-9533
authors.initials: SL
authors.lastname: Edmond
authors.affiliation: School of Health Sciences, Stockton University, Galloway, NJ, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Enriquez
authors.affiliation: School of Health Professions, Rutgers, The State University of New Jersey, Newark, NJ, USA.|Professional Physical Therapy and Training, LLC, Madison, NJ, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Millner
authors.affiliation: Department of Diagnostic Sciences, Rutgers, School of Dental Medicine Center for Temporomandibular Disorders and Orofacial Pain, The State University of New Jersey, Newark, NJ, USA.
authors.forename: C
authors.initials: C
authors.lastname: Nasri-Heir
authors.affiliation: Department of Diagnostic Sciences, Rutgers, School of Dental Medicine Center for Temporomandibular Disorders and Orofacial Pain, The State University of New Jersey, Newark, NJ, USA.
authors.forename: G M
authors.initials: GM
authors.lastname: Heir
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000328:Adult; D000368:Aged; D001362:Avoidance Learning / Q000502:physiology; D015928:Cognitive Behavioral Therapy; D004185:Disability Evaluation; D005157:Facial Pain / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: disability evaluation; orofacial pain; pain; psychosocial factors; rehabilitation; treatment outcome