Seekatz B, Meng K, Faller H
Abteilung für Medizinische Psychologie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg, Klinikstr. 3, 97070, Würzburg, Deutschland,
Schmerz. 2013 Dec;27(6):612-8. doi: 10.1007/s00482-013-1376-0.
The fear-avoidance model (FAM) has gained widespread acceptance as a conceptual framework predicting chronic pain development. However, there is still a high amount of unexplained variance in the prediction of outcome variables. This study aimed to test depression as a mediator of prospective links between the FAM variables pain intensity, pain-related fear, avoidance behavior and disability in order to achieve a better prediction of model variables.
Single mediation analyses were conducted using path analysis of longitudinal data from patients with chronic back pain (n = 243).
There was at least partial mediation by depression for all prospective relations of FAM variables analyzed. The mediation effects increased the percentage of explained variance of the predicted model variables.
The findings provide support for additional consideration of depressive symptoms to obtain a better understanding of prospective associations between FAM variables. The findings indicate that in the treatment of chronic back pain following a multiple target approach to reduce pain, pain-related fear and avoidance behavior and also depressive symptoms should be considered.
恐惧回避模型（FAM）作为预测慢性疼痛发展的概念框架已得到广泛认可。然而，在预测结果变量方面仍存在大量无法解释的变异。本研究旨在检验抑郁作为FAM变量（疼痛强度、疼痛相关恐惧、回避行为和残疾）之间前瞻性联系的中介变量，以便更好地预测模型变量。
使用来自慢性背痛患者（n = 243）的纵向数据进行路径分析，进行单中介分析。
在所分析的FAM变量的所有前瞻性关系中，抑郁至少起到了部分中介作用。中介效应增加了预测模型变量的可解释变异百分比。
研究结果支持额外考虑抑郁症状，以更好地理解FAM变量之间的前瞻性关联。研究结果表明，在采用多靶点方法治疗慢性背痛以减轻疼痛时，应考虑疼痛相关恐惧、回避行为以及抑郁症状。
