Beyond pain: The role of fear and avoidance in chronicity

Author(s): Norton, P. J., Norton, G. R.

Journal/Book: Clin Psychol Rev. 1999; 19: the Boulevard Langford Lane, Kidlington, Oxford Ox5 1GB, England. Pergamon-Elsevier Science Ltd. 97-119.

Abstract: The purpose of the present article is to provide unification to a number of somewhat disparate themes in the chronic pain and phobia literature. First, we present a summary review of the early writings and current theoretical perspectives regarding the role of avoidance in the maintenance of chronic pain. Second, we present an integrative review of recent empirical investigations of fear and avoidance in patients with chronic musculoskeletal pain, relating the findings to existing cognitive-behavioral theoretical positions. We also discuss several new and emerging lines of investigation, specifically related to information processing and anxiety sensitivity, which appear to be closely linked to pain-related avoidance behavior. Finally, we discuss the implications of the recent empirical findings for the assessment and treatment of individuals who experience disabling chronic musculoskeletal pain and suggest possible avenues for future investigation.

Note: Article Asmundson GJG, Clin Res & Dev Program, Regina Hlth Dist, 2180 23rd Ave, Regina, SK S4S 0A5, CANADA

Keyword(s): LOW-BACK-PAIN; ANXIETY SYMPTOMS SCALE; CHRONIC MUSCULOSKELETAL PAIN; COPING STRATEGIES; THEORETICAL PERSPECTIVES; PSYCHOLOGICAL-FACTORS; PERSISTENT PAIN; SENSITIVITY; QUESTIONNAIRE; ADJUSTMENT

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