Understanding Fear-Avoidance Beliefs and Chronic Pain
It has been well-established that patients with chronic pain will often avoid activities that may exacerbate their pain. In the basic fear-avoidance model, if individuals are especially sensitive to the negative experience of pain, this will result in pain-related fear of movement, avoidance of daily activities that may result in pain, as well as hypervigilance or over monitoring of bodily sensations of potential increase in pain. This fear-avoidance can, in turn, result in physical de-conditioning, depression, as well as disability/avoidance of work, recreation, and/or family activities.
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Clinical research has clearly revealed that this construct of fear-avoidance is closely associated with increased pain, physical disability, and long-term sick leave in chronic pain patients. Because it is so prevalent in chronic pain patients, psychometrically-sound instruments have been developed to measure fear-avoidance, such as the Fear of Daily Activities Questionnaire (FDAQ), the Tampa Scale of Kinesiophobia (TSK), and the more recent Fear-Avoidance Components Scale (FACS). Fortunately, there are now treatment techniques that can successfully reduce fear-avoidance beliefs and behaviors in patients with pain.
The significance of fear-avoidance beliefs in chronic pain patients
Methods for measuring fear-avoidance beliefs
Methods for treating fear-avoidance beliefs in chronic pain patients
Robert J Gatchel
Dr. Gatchel received his BA in Psychology, Summa Cum Laude, in 1969 from the State University of New York at Stony Brook, and his Ph.D. in Clinical Psychology in 1973 from the University of Wisconsin. He is also a Diplomate of the American Board of Professional Psychology (ABPP). Dr. Gatchel is currently a Distinguished Professor of the Department of Psychology, College of Science, as well as the Nancy P & John G Penson Endowed Professor of Clinical Health Psychology, at The University of Texas at Arlington. In addition, he is the Director of the Center of Excellence for the Study of Health & Chronic Illnesses. Moreover, he is a Clinical Professor at The Eugene McDermott Center for Pain Management, Department of Anesthesiology & Pain Management, at The University of Texas Southwestern Medical Center at Dallas.Dr. Gatchel has been a major advocate for the biopsychosocial approach to chronic pain. This approach is now viewed as the most heuristic model for better understanding the etiology, assessment, treatment, and prevention of chronic pain. Dr. Gatchel has conducted extensive evidence-based clinical research in this area, much of it continuously funded for the past 30 years by grants from the National Institutes of Health (NIH), National Science Foundation (NSF) and the Department of Defense (DOD). He was also the recipient of a prestigious Senior Scientist Award from NIH. His major areas of clinical and research expertise include the following: the biopsychosocial approach to the etiology, assessment, treatment and prevention of chronic stress and pain behavior; the comorbidity of physical and mental health disorders; and clinical health psychology. He has published over 376 journal articles, 130 book chapters and has authored or edited 27 books. Dr. Gatchel has received numerous national and international awards and honors associated with his work in pain assessment and management.