Oregon Health and Science University, Portland, OR, USA.
Pain Res Manag. 2011 May-Jun;16(3):178-82. doi: 10.1155/2011/296298.
The fear-avoidance model of chronic pain posits that fear of pain is associated with fear and avoidance of activity, which can lead to deconditioning and persistence of pain and disability. Despite being well supported in adults, little is known about the role of fear-avoidance beliefs regarding physical activity in children. Research has shown that parental protectiveness contributes to activity limitations in children; however, no studies have examined relationships between protectiveness, and fear and avoidance.
To conduct a cross-sectional study to provide additional information regarding the reliability and validity of the Fear-Avoidance Beliefs Questionnaire physical activity subscale among adolescents with chronic pain; examine fear-avoidance beliefs and depressive symptoms as concurrent predictors of physical activity limitations; and test competing models using fear-avoidance beliefs as mediators and moderators of the association between parental protectiveness and activity limitations.
Adolescents (n=42) 11 to 17 years of age with chronic pain completed questionnaires assessing pain intensity, fear-avoidance beliefs, depressive symptoms and physical activity limitations. Their parents completed questionnaires regarding protectiveness and adolescent activity limitations.
The Fear-Avoidance Beliefs Questionnaire physical activity subscale was useful for assessing fear-avoidance beliefs in the present population. In support of hypotheses, greater fear-avoidance beliefs were associated with greater activity limitations, above pain intensity and depressive symptoms. Support was found for fear-avoidance beliefs as mediators of the association between parental protectiveness and activity limitations. Tests of moderation were not significant.
Fear-avoidance beliefs may be an important target for interventions focused on decreasing activity limitations in youth with chronic pain. Future research should investigate these associations longitudinally.
慢性疼痛的恐惧回避模型认为，对疼痛的恐惧与对活动的恐惧和回避有关，这可能导致失能和疼痛及残疾的持续存在。尽管在成年人中得到了很好的支持，但对于儿童中与体力活动相关的恐惧回避信念在慢性疼痛中的作用知之甚少。研究表明，父母的保护欲会导致儿童活动受限；然而，尚无研究探讨保护欲与恐惧和回避之间的关系。
进行横断面研究，提供关于青少年慢性疼痛患者的恐惧回避信念问卷体力活动分量表的信度和效度的更多信息；检验恐惧回避信念和抑郁症状作为体力活动受限的并发预测因素；并测试使用恐惧回避信念作为父母保护与活动受限之间关系的中介和调节因素的竞争模型。
11 至 17 岁患有慢性疼痛的青少年完成了评估疼痛强度、恐惧回避信念、抑郁症状和体力活动受限的问卷。他们的父母完成了关于保护和青少年活动受限的问卷。
恐惧回避信念问卷体力活动分量表可用于评估本研究人群的恐惧回避信念。支持假设，更大的恐惧回避信念与更大的活动受限有关，超过疼痛强度和抑郁症状。恐惧回避信念作为父母保护与活动受限之间关系的中介因素得到了支持。调节测试不显著。
恐惧回避信念可能是针对减少青少年慢性疼痛患者活动受限的干预措施的一个重要目标。未来的研究应该从纵向角度探讨这些关联。
