Abstract
Within a biopsychosocial framework, psychological factors are thought to play an important
role in the onset and progression of chronic pain. The cognitive-behavioral fear-avoidance
model of chronic pain suggests that pain-related fear contributes to the development
and maintenance of pain-related disability. However, investigations of the relation
between pain-related fear and disability have demonstrated considerable between-study
variation. The main goal of the current meta-analysis was to synthesize findings of
studies investigating cross-sectional associations between pain-related fear and disability
in order to estimate the magnitude of this relation. We also tested potential moderators,
including type of measure used, demographic characteristics, and relevant pain characteristics.
Searches in PubMed and PsycINFO yielded a total of 46 independent samples (N = 9,579)
that reported correlations between pain-related fear and disability among persons
experiencing acute or chronic pain. Effect size estimates were generated using a random-effects
model and artifact distribution method. The positive relation between pain-related
fear and disability was observed to be moderate to large in magnitude, and stable
across demographic and pain characteristics. Although some variability was observed
across pain-related fear measures, results were largely consistent with the fear-avoidance
model of chronic pain.
Perspective
Results of this meta-analysis indicate a robust, positive association between pain-related
fear and disability, which can be classified as moderate to large in magnitude. Consistent
with the fear-avoidance model of chronic pain, these findings suggest that pain-related
fear may be an important target for treatments intended to reduce pain-related disability.
Key words
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Article info
Publication history
Published online: July 15, 2013
Footnotes
This project was supported by Grant No. R21DA034285 awarded to J.W.D. by the National Institute on Drug Abuse.
All authors have no conflicts of interest.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
