The Fear Avoidance Model Disentangled: Improving the Clinical Utility of the Fear Avoidance Model

Pincus, Tamar, Smeets, Rob J. E. M., Simmonds, Maureen J. and Sullivan, Michael J. L.

(2010)

Pincus, Tamar, Smeets, Rob J. E. M., Simmonds, Maureen J. and Sullivan, Michael J. L. (2010) The Fear Avoidance Model Disentangled: Improving the Clinical Utility of the Fear Avoidance Model. Clinical Journal of Pain, 26 (9).

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Abstract

Background: The model of fear avoidance proposes that fear of movement in back pain patients is an obstacle to recovery and leads over time to increased disability. Therefore, fear of movement should be targeted explicitly by interventions. Aims: To review the evidence (1) for the causal components proposed by the model, and (2) about interventions that attempt to reduce fear of movement. In addition, we aim to propose alternatives and extensions to the current model in order to increase the clinical utility of the model. Methods: A collaborative narrative review. Results: The fear avoidance model needs to be conceptually expanded and further tested to provide adequate and appropriate clinical utility. Currently, although there is experimental support for the model, observational studies in patients show contradictory results. Interventions based on the model have not delivered convincing results, only partly due to methodological shortcomings. Some assumptions inherent in the current model need adjusting, and other factors should be incorporated to indicate subgroupings within patients high in avoidance behavior. In addition, both theoretical and methodological limitations were identified in measurements of fear and avoidance. Conclusions: Future research should elucidate whether the proposed subgrouping of patients with avoidance behavior is helpful. Further research should focus on developing more accurate and psychometrically sound assessment tools as well as targeted interventions to improve activities and participation of patients with chronic disabling musculoskeletal pain disorders.

Information about this Version

This is a Submitted version
This version's date is: 2010
This item is not peer reviewed

Link to this Version

https://repository.royalholloway.ac.uk/items/d8bbafd5-e62f-0359-3979-f8ebf6a80d81/9/

Item TypeJournal Article
TitleThe Fear Avoidance Model Disentangled: Improving the Clinical Utility of the Fear Avoidance Model
AuthorsPincus, Tamar
Smeets, Rob J. E. M.
Simmonds, Maureen J.
Sullivan, Michael J. L.
Uncontrolled Keywordsfear avoidance, subgrouping, pain, LOW-BACK-PAIN, EXPOSURE IN-VIVO, CHRONIC MUSCULOSKELETAL PAIN, RANDOMIZED CONTROLLED-TRIAL, PROGNOSTIC-FACTORS, RISK FACTOR, FOLLOW-UP, BASE-LINE, DISABILITY, KINESIOPHOBIA
DepartmentsFaculty of Science\Psychology

Identifiers

doihttp://dx.doi.org/10.1097/AJP.0b013e3181f15d45

Deposited by Research Information System (atira) on 18-Nov-2014 in Royal Holloway Research Online.Last modified on 18-Nov-2014


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