Pain-related fear predicts disability, but not pain severity: a path analytic approach of the fear-avoidance model.

Two studies are reported that tested the fear-avoidance (FA) model using path analytic techniques. In study 1, 429 employees with back pain at baseline and back pain at 18 months follow-up completed questionnaires assessing sociodemographic information, pain severity, negative affect, pain-related fear, and disability. Results indicated that pain severity at baseline predicted pain-related fear and disability at follow-up, and that pain-related fear is rather a consequence than an antecedent of pain severity. Results further revealed that the disposition to experience negative affect has a low impact upon pain severity and disability, and is best viewed as a precursor of pain-related fear. Study 2 included 238 employees without back pain at baseline, but who developed back pain at 1 year follow-up. A similar model as in study 1 was tested. Overall, results are in line with those of study 1. Results are discussed in terms of theoretical relevance and clinical implications. Copyright 2010 European Federation of International Association for the Study of Pain Chapters. Published by Elsevier Ltd. All rights reserved.