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Fear-avoidance model of chronic pain the next generation

(2012) CLINICAL JOURNAL OF PAIN. 28(6). p.475-483
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Abstract
Objective: The fear-avoidance (FA) model of chronic pain describes how individuals experiencing acute pain may become trapped into a vicious circle of chronic disability and suffering. We propose to extend the FA model by adopting a motivational perspective on chronic pain and disability. Methods: A narrative review. Results: There is ample evidence to support the validity of the FA model as originally formulated. There are, however, some key challenges that call for a next generation of the FA model. First, the FA model has its roots in psychopathology, and investigators will have to find a way to account for findings that do not easily fit within such framework. Second, the FA model needs to address the dynamics and complexities of disability and functional recovery. Third, the FA model should incorporate the idea that pain-related fear and avoidance occurs in a context of multiple and often competing personal goals. Discussion: To address these 3 key challenges, we argue that the next generation of the FA model needs to more explicitly adopt a motivational perspective, one that is built around the organizing powers of goals and self-regulatory processes. Using this framework, the FA model is recast as capturing the persistent but futile attempts to solve pain-related problems to protect and restore life goals.
Keywords
SELF-REGULATION, EXPOSURE IN-VIVO, PROSPECTIVE SEQUENTIAL-ANALYSIS, LOW-BACK-PAIN, PERSONAL GOALS, MUSCULOSKELETAL PAIN, UNATTAINABLE GOALS, WOMENS PURSUIT, CURRENT STATE, HEALTH, pain, fear, anxiety, motivation, avoidance, goals, self-regulation

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Citation

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Chicago
Crombez, Geert, Christopher Eccleston, Stefaan Van Damme, Johan WS Vlaeyen, and Paul Karoly. 2012. “Fear-avoidance Model of Chronic Pain the Next Generation.” Clinical Journal of Pain 28 (6): 475–483.
APA
Crombez, Geert, Eccleston, C., Van Damme, S., Vlaeyen, J. W., & Karoly, P. (2012). Fear-avoidance model of chronic pain the next generation. CLINICAL JOURNAL OF PAIN, 28(6), 475–483.
Vancouver
1.
Crombez G, Eccleston C, Van Damme S, Vlaeyen JW, Karoly P. Fear-avoidance model of chronic pain the next generation. CLINICAL JOURNAL OF PAIN. 2012;28(6):475–83.
MLA
Crombez, Geert, Christopher Eccleston, Stefaan Van Damme, et al. “Fear-avoidance Model of Chronic Pain the Next Generation.” CLINICAL JOURNAL OF PAIN 28.6 (2012): 475–483. Print.
@article{2960547,
  abstract     = {Objective: The fear-avoidance (FA) model of chronic pain describes how individuals experiencing acute pain may become trapped into a vicious circle of chronic disability and suffering. We propose to extend the FA model by adopting a motivational perspective on chronic pain and disability. Methods: A narrative review. Results: There is ample evidence to support the validity of the FA model as originally formulated. There are, however, some key challenges that call for a next generation of the FA model. First, the FA model has its roots in psychopathology, and investigators will have to find a way to account for findings that do not easily fit within such framework. Second, the FA model needs to address the dynamics and complexities of disability and functional recovery. Third, the FA model should incorporate the idea that pain-related fear and avoidance occurs in a context of multiple and often competing personal goals. Discussion: To address these 3 key challenges, we argue that the next generation of the FA model needs to more explicitly adopt a motivational perspective, one that is built around the organizing powers of goals and self-regulatory processes. Using this framework, the FA model is recast as capturing the persistent but futile attempts to solve pain-related problems to protect and restore life goals.},
  author       = {Crombez, Geert and Eccleston, Christopher and Van Damme, Stefaan and Vlaeyen, Johan WS and Karoly, Paul},
  issn         = {0749-8047},
  journal      = {CLINICAL JOURNAL OF PAIN},
  language     = {eng},
  number       = {6},
  pages        = {475--483},
  title        = {Fear-avoidance model of chronic pain the next generation},
  url          = {http://dx.doi.org/10.1097/AJP.0b013e3182385392},
  volume       = {28},
  year         = {2012},
}

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