Social, blood/injury, and agoraphobic fears in patients with physically unexplained chronic pain: are they clinically significant?

Recently, there has been increased interest in the extent to which chronic pain patients fear and avoid activities that are thought to be related to the experience of pain. To date, however, few studies have evaluated the nature and extent of nonpain fears in these patients. The purpose of the present study was to address this paucity. The Fear Questionnaire was administered to 130 patients with physically unexplained chronic pain and 93 patients with a chronic condition unrelated to pain. Results indicated that the chronic pain patients were more fearful and avoidant of social interactions/situations and blood/injury than were the patient controls. Agoraphobia was minimal and did not differ significantly between groups. As well, the proportions of chronic pain patients indicating definite avoidance of particular situations related to blood/injury phobia (i.e., injection/minor surgery, hospitals, sight of blood, and thoughts of injury/illness) and social phobia (i.e., being watched/stared at, and speaking/acting to an audience) were significantly greater when compared to the patient controls. These results indicate that nonpain fear and avoidance are common in patients with chronic pain. Implications regarding the significance of these fears and avoidance behaviours on the experience and maintenance of pain symptoms and related disability are discussed.