Longitudinal Analysis Supports a Fear-Avoidance Model That Incorporates Pain Resilience Alongside Pain Catastrophizing

2019 ◽  
Vol 54 (5) ◽  
pp. 335-345 ◽  
Author(s):  
P Maxwell Slepian ◽  
Brett Ankawi ◽  
Christopher R France
Keyword(s):  
Self Efficacy ◽  
Predictive Power ◽  
Pain Catastrophizing ◽  
Survey Study ◽  
Equation Modeling ◽  
Mcgill Pain Questionnaire ◽  
Depression Symptoms ◽  
Fear Avoidance ◽  
Fear Avoidance Model ◽  
Physical Dysfunction

Abstract Background The fear-avoidance model of chronic pain holds that individuals who catastrophize in response to injury are at risk for pain-related fear and avoidance behavior, and ultimately prolonged pain and disability. Purpose Based on the hypothesis that the predictive power of the fear-avoidance model would be enhanced by consideration of positive psychological constructs, the present study examined inclusion of pain resilience and self-efficacy in the model. Methods Men and women (N = 343) who experienced a recent episode of back pain were recruited in a longitudinal online survey study. Over a 3-month interval, participants repeated the Pain Resilience Scale, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Pain Self-Efficacy Questionnaire, the McGill Pain Questionnaire, and NIH-recommended measures of pain, depressive symptoms, and physical dysfunction. Structural equation modeling assessed the combined contribution of pain resilience and pain catastrophizing to 3-month outcomes through the simultaneous combination of kinesiophobia and self-efficacy. Results An expanded fear-avoidance model that incorporated pain resilience and self-efficacy provided a good fit to the data, Χ2 (df = 14, N = 343) = 42.09, p = .0001, RMSEA = 0.076 (90% CI: 0.05, 0.10), CFI = 0.97, SRMR = 0.03, with higher levels of pain resilience associated with improved 3-month outcomes on measures of pain intensity, physical dysfunction, and depression symptoms. Conclusions This study supports the notion that the predictive power of the fear-avoidance model of pain is enhanced when individual differences in both pain-related vulnerability (e.g., catastrophizing) and pain-related protective resources (e.g., resilience) are considered.

scholarly journals The influence of cognitions, emotions and behavioral factors on treatment outcomes in musculoskeletal shoulder pain: a systematic review

2019 ◽  
Vol 33 (6) ◽  
pp. 980-991 ◽  
Author(s):  
Liesbet De Baets ◽  
Thomas Matheve ◽  
Mira Meeus ◽  
Filip Struyf ◽  
Annick Timmermans
Keyword(s):  
Surgical Treatment ◽  
Shoulder Pain ◽  
Self Efficacy ◽  
Pain Catastrophizing ◽  
Behavioral Factors ◽  
Fear Avoidance ◽  
Mediating Role ◽  
Predictive Role ◽  
Moderating Role

Objective: To examine the predictive, moderating and mediating role of cognitive, emotional and behavioral factors on pain and disability following shoulder treatment. Data sources: Electronic databases (PubMed, Web of Science, Embase and PsycINFO) were searched until 14 January 2019. Study selection: Studies including persons with musculoskeletal shoulder pain that describe the predictive, moderating or mediating role of baseline cognitive, emotional or behavioral factors on pain or disability following treatment were selected. Results: A total of 23 articles, describing 21 studies and involving 3769 participants, were included. Three studies had a high risk of bias. There was no predictive role of baseline depression, anxiety, coping, somatization or distress on pain or disability across types of shoulder treatment. No predictive role of fear-avoidance beliefs was identified in patients receiving physiotherapy, which contrasted to the results found when surgical treatment was applied. Baseline catastrophizing was also not predictive for pain or disability in patients receiving physiotherapy. After conservative medical treatments, results on the predictive role of catastrophizing were inconclusive. Treatment expectations and baseline self-efficacy predicted pain and disability in patients receiving physiotherapy, which was not the case in patients receiving conservative medical treatment. Finally, there was a moderating role for optimism in the relationship between pain catastrophizing and disability in patients receiving physiotherapy. Conclusion: There is evidence that expectations of recovery and self-efficacy have a predictive role and optimism a moderating role on pain and/or disability following physiotherapy for musculoskeletal shoulder pain. After surgical treatment, fear-avoidance is a predictor of pain and disability.

Predictors of the Pain Perception and Self-Efficacy for Pain Control in Patients with Fibromyalgia

2011 ◽  
Vol 14 (1) ◽  
pp. 366-373 ◽  
Author(s):  
Ana I. Sánchez ◽  
M. Pilar Martínez ◽  
Elena Miró ◽  
Ana Medina
Keyword(s):  
Self Efficacy ◽  
Pain Perception ◽  
Pain Catastrophizing ◽  
Short Form ◽  
Depression Scale ◽  
The Self ◽  
Mcgill Pain Questionnaire ◽  
Efficacy Expectations ◽  
And Coping ◽  
Pain Anxiety Symptoms Scale

Objective: This study analyzes the role of a number of cognitive-affective dimensions in the experience and coping of pain in patients with fibromyalgia (FM). Specifically, it was examined whether anxiety, depression, pain catastrophizing and pain-related anxiety predict the pain perception and the self-efficacy expectations in these patients.Method: Seventy-four fibromyalgia patients were asked to complete a questionnaire survey including theChronic Pain Self-Efficacy Scale, theHospital Anxiety and Depression Scale, thePain Anxiety Symptoms Scale-20, thePain Catastrophizing Scale, and theShort-form McGill Pain Questionnaire. Results: Some relevant correlation and predicting patterns were identified. Physiological anxiety was the best predictor of the sensorial dimension of pain. Pain fear was a significant predictor of the pain intensity. Helplessness was the best predictor of the affective dimension of pain, whereas depression was a significant predicting variable of the self-efficacy expectations.Conclusions: This study shows the relevance of the pain-related anxiety in the pain perception, and of the depression in the self-efficacy expectations in FM patients. Clinical applications of the findings and further research lines in this area are discussed.

Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain

Pain ◽  
2010 ◽  
Vol 148 (1) ◽  
pp. 120-127 ◽  
Author(s):  
Robert Schütze ◽  
Clare Rees ◽  
Minette Preece ◽  
Mark Schütze
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Fear Avoidance ◽  
Fear Avoidance Model

scholarly journals Pain Neuroscience Education Combined with Therapeutic Exercises Provides Added Benefit in the Treatment of Chronic Neck Pain

2021 ◽  
Vol 18 (16) ◽  
pp. 8848
Author(s):  
Norollah Javdaneh ◽  
Atle Hole Saeterbakken ◽  
Arash Shams ◽  
Amir Hossein Barati
Keyword(s):  
Neck Pain ◽  
Self Efficacy ◽  
Pain Catastrophizing ◽  
Chronic Neck Pain ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Therapeutic Exercises ◽  
Neuroscience Education

Background: Chronic neck pain is common in the adult general population. Although the etiology of chronic neck pain is under debate, it is clear that chronic neck pain is multifactorial, with both physical and psychosocial contributors. Objective: To determine whether adding pain neuroscience education (PNE) to therapeutic exercises improved their pain–disability index, pain catastrophizing, fear–avoidance beliefs, and pain self-efficacy in subjects with chronic nonspecific neck pain. Methods: This study was a three-arm randomized control trial. Seventy-two patients with chronic nonspecific neck pain were allocated to three groups: therapeutic exercises alone (n = 24), combined (therapeutic exercises + PNE; (n = 24), and a control group (n = 24). Each program took place three times a week, lasting for six weeks. The disability index, pain catastrophizing, fear–avoidance beliefs, and pain self-efficacy measured by the Neck Pain and Disability Scale (NPAD), Pain Catastrophizing Scale (PCS), Fear–Avoidance Beliefs Questionnaire (FABQ), and Pain Self-Efficacy Questionnaire (PSEQ), respectively. Participants were assessed before and after the six-week intervention, and there was no further follow-up. Results: For the outcomes NPAD, PSC, and FABQ, combined intervention demonstrated more significant improvements than therapeutic exercises alone (p ≤ 0.05), whereas no differences were observed between the two intervention groups for PSEQ (p = 0.99). In addition, significant differences were favoring experimental groups versus control for all outcomes (p ≤ 0.001). Conclusion: Therapeutic exercises combined with pain neuroscience education reduced the pain–disability index, pain catastrophizing, and fear–avoidance beliefs more than therapeutic exercises alone in patients with chronic neck pain. For pain self-efficacy, there was no statistically significant difference between the two intervention groups; however, the combined group had a more significant effect than therapeutic exercises alone. Further studies with longer periods and follow-up are required.

Understanding fintech continuance: perspectives from self-efficacy and ECT-IS theories

2020 ◽  
Vol 120 (9) ◽  
pp. 1659-1689 ◽  
Author(s):  
Wen-Lung Shiau ◽  
Ye Yuan ◽  
Xiaodie Pu ◽  
Soumya Ray ◽  
Charlie C. Chen
Keyword(s):  
Self Efficacy ◽  
Structural Equation ◽  
Predictive Power ◽  
Partial Least Square ◽  
Perceived Usefulness ◽  
Least Square ◽  
Equation Modeling ◽  
Content Type ◽  
Domain Specific ◽  
The Relationship

PurposeThe purpose of this study is to clarify theory and identify factors that could explain the level of fintech continuance intentions with an expectation confirmation model that integrates self-efficacy theory.Design/methodology/approachWith data collected from 753 fintech users, this study applies partial least square structural equation modeling to compare and select the research model with the most predictive power.FindingsThe results show that financial self-efficacy, technological self-efficacy and confirmation positively affect perceived usefulness. Among these factors, financial self-efficacy and technological self-efficacy have both direct and indirect effects through confirmation on perceived usefulness. Perceived usefulness and confirmation are positively related to satisfaction. Finally, perceived usefulness and satisfaction positively influence fintech continuance intentions.Originality/valueTo the best of our knowledge, this is one of the earliest studies that investigates the effect of domain-specific self-efficacy on fintech continuance intentions, which enriches the existing research on fintech and deepens our understanding of users' fintech continuance intentions. We distinguish between financial self-efficacy and technological self-efficacy and specify the relationship between self-efficacy and continuance intentions. Moreover, this study highlights the importance of assessing a model's predictive power using the PLSpredict technique and provides a reference for model selection.

The relationship between chronic musculoskeletal pain, anxiety and mindfulness: Adjustments to the Fear-Avoidance Model of Chronic Pain

2017 ◽  
Vol 17 (1) ◽  
pp. 156-166 ◽  
Author(s):  
Katherine B. Curtin ◽  
Deborah Norris
Keyword(s):  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Pain Catastrophizing ◽  
Pain Severity ◽  
Fear Avoidance ◽  
Pain Anxiety ◽  
Fear Avoidance Model ◽  
Chronic Pain Patients ◽  
The Relationship ◽  
Pain Patients

AbstractBackground and purposeThe Fear-Avoidance Model of Chronic Pain proposed by Vlaeyen and Linton states individuals enter a cycle of chronic pain due to predisposing psychological factors, such as negative affectivity, negative appraisal or anxiety sensitivity. They do not, however, address the closely related concept of anxious rumination. Although Vlaeyen and Linton suggest cognitive-behavioral treatment methods for chronic pain patients who exhibit pain-related fear, they do not consider mindfulness treatments. This cross-sectional study investigated the relationship between chronic musculoskeletal pain (CMP), ruminative anxiety and mindfulness to determine if (1) ruminative anxiety is a risk factor for developing chronic pain and (2) mindfulness is a potential treatment for breaking the cycle of chronic pain.MethodsMiddle-aged adults ages 35-50 years (N = 201) with self-reported CMP were recruited online. Participants completed standardized questionnaires assessing elements of chronic pain, anxiety, and mindfulness.ResultsRuminative anxiety was positively correlated with pain catastrophizing, pain-related fear and avoidance, pain interference, and pain severity but negatively correlated with mindfulness. High ruminative anxiety level predicted significantly higher elements of chronic pain and significantly lower level of mindfulness. Mindfulness significantly predicted variance (R2) in chronic pain and anxiety outcomes. Pain severity, ruminative anxiety, pain catastrophizing, pain-related fear and avoidance, and mindfulness significantly predicted 70.0% of the variance in pain interference, with pain severity, ruminative anxiety and mindfulness being unique predictors.ConclusionsThe present study provides insight into the strength and direction of the relationships between ruminative anxiety, mindfulness and chronic pain in a CMP population, demonstrating the unique associations between specific mindfulness factors and chronic pain elements.ImplicationsIt is possible that ruminative anxiety and mindfulness should be added into the Fear-Avoidance Model of Chronic Pain, with ruminative anxiety as a psychological vulnerability and mindfulness as an effective treatment strategy that breaks the cycle of chronic pain. This updated Fear-Avoidance Model should be explored further to determine the specific mechanism of mindfulness on chronic pain and anxiety and which of the five facets of mindfulness are most important to clinical improvements. This could help clinicians develop individualized mindfulness treatment plans for chronic pain patients.

The Role of Career Self-Efficacy on the Effect of Parental Career Behaviors on Career Exploration: A Study on School of Tourism and Hotel Management’ Students

2016 ◽  
Vol 3 (1) ◽  
pp. 143 ◽  
Author(s):  
Selahattin Kanten ◽  
Pelin Kanten ◽  
Murat Yeşiltaş
Keyword(s):  
Undergraduate Students ◽  
Self Efficacy ◽  
Structural Equation ◽  
Career Exploration ◽  
Equation Modeling ◽  
Survey Method ◽  
Hotel Management ◽  
Mediating Role ◽  
The Impact

This study aims to investigate the impact of parental career behaviors on undergraduate student’s career exploration and the mediating role of career self-efficacy. In the literature it is suggested that some social and individual factors facilitate students’ career exploration. Therefore, parental career behaviors and career self-efficacy is considered as predictors of student’s career exploration attitudes within the scope of the study. In this respect, data which are collected from 405 undergraduate students having an education on tourism and hotel management field by the survey method are analyzed by using the structural equation modeling. The results of the study indicate that parental career behaviors which are addressed support; interference and lack of engagement have a significant effect on student’s career exploration behaviors such as intended-systematic exploration, environment exploration and self-exploration. In addition, it has been found that one of the dimensions of parental career behaviors addressed as a lack of engagement has a significant effect on career self-efficacy levels of students. However, research results indicate that student’s career self-efficacy has a significant effect on only the self-exploration dimension. On the other hand, career self-efficacy has a partial mediating role between lack of engagement attitudes of parents and career exploration behaviors of students.

Identification of socio-cognitive determinants of parental sun protection behaviors to optimize intervention development

2020 ◽  
Author(s):  
Karlijn Thoonen ◽  
Liesbeth van Osch ◽  
Rik Crutzen ◽  
Hein de Vries ◽  
Francine Schneider
Keyword(s):  
Skin Cancer ◽  
Self Efficacy ◽  
Sun Exposure ◽  
Action Planning ◽  
Later Life ◽  
Sun Protection ◽  
Survey Study ◽  
Skin Cancer Prevention ◽  
Sun Safety ◽  
Cognitive Determinants

Background: Adequate sun safety during childhood is crucial for decreasing skin cancer risk in later life. Although parents are an essential target group in applying sun protection measures for their children, interventions are often not directed at parents. This study identifies the most relevant determinants in predicting parental sun protection intentions and behaviors to provide guidance for future intervention development.Methods: A longitudinal survey study with two measurements was conducted among Dutch parents (N=670) of children (4-12 years old). Twenty-seven socio-cognitive determinants were examined in terms of relevance regarding four parental sun protection behaviors in different sun exposure situations. The CIBER approach was used to visualize room for improvement (sample means) on all determinants and their association strengths (correlations) with sun protection intentions and behaviors.Results: Behavior-specific rather than generic determinants were most relevant in explaining all sun protection behaviors. Of these determinants, attitude, self-efficacy and action planning, and especially parental feelings of difficulty in performing sun protection behaviors, were most relevant. Altogether, the explained variance of all socio-cognitive determinants was highest for shade-seeking behavior (R2= .41 and .43) and lowest for supportive behavior (R2=.19 and .29) in both planned and incidental sun exposure situations respectively.Discussion: This study provides detailed insight into relevant socio-cognitive determinants of parental sun protection behaviors in various sun exposure situations. This insight provides guidance for composing parental skin cancer prevention interventions. Future composition of sun safety interventions should emphasize on enhancing parental feelings of self-efficacy, especially for shade-seeking and clothing behaviors.

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