Leeuw Maaike, Goossens Mariëlle E J B, Linton Steven J, Crombez Geert, Boersma Katja, Vlaeyen Johan W S
Department of Medical, Clinical, and Experimental Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
J Behav Med. 2007 Feb;30(1):77-94. doi: 10.1007/s10865-006-9085-0. Epub 2006 Dec 20.
Research studies focusing on the fear-avoidance model have expanded considerably since the review by Vlaeyen and Linton (Vlaeyen J. W. S. & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317--332). The fear-avoidance model is a cognitive-behavioral account that explains why a minority of acute low back pain sufferers develop a chronic pain problem. This paper reviews the current state of scientific evidence for the individual components of the model: pain severity, pain catastrophizing, attention to pain, escape/avoidance behavior, disability, disuse, and vulnerabilities. Furthermore, support for the contribution of pain-related fear in the inception of low back pain, the development of chronic low back pain from an acute episode, and the maintenance of enduring pain, will be highlighted. Finally, available evidence on recent clinical applications is provided, and unresolved issues that need further exploration are discussed.
自弗莱扬和林顿进行综述以来（弗莱扬 J. W. S. & 林顿，S. J.（2000 年）。恐惧回避及其在慢性肌肉骨骼疼痛中的后果：最新进展。疼痛，85(3)，317 - 332），聚焦于恐惧回避模型的研究显著增加。恐惧回避模型是一种认知行为理论，解释了为什么少数急性下背痛患者会发展为慢性疼痛问题。本文综述了该模型各个组成部分的科学证据现状：疼痛严重程度、疼痛灾难化、对疼痛的关注、逃避/回避行为、残疾、废用和易损性。此外，还将强调疼痛相关恐惧在腰痛起始、急性发作发展为慢性腰痛以及持续性疼痛维持中的作用。最后，提供了关于近期临床应用的现有证据，并讨论了需要进一步探索的未解决问题。
