BACKGROUND The fear-avoidance model of chronic pain holds that individuals who catastrophize in response to injury are at risk for pain-related fear and avoidance behavior, and ultimately prolonged pain and disability. PURPOSE Based on the hypothesis that the predictive power of the fear-avoidance model would be enhanced by consideration of positive psychological constructs, the present study examined inclusion of pain resilience and self-efficacy in the model. METHODS Men and women (N = 343) who experienced a recent episode of back pain were recruited in a longitudinal online survey study. Over a 3-month interval, participants repeated the Pain Resilience Scale, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Pain Self-Efficacy Questionnaire, the McGill Pain Questionnaire, and NIH-recommended measures of pain, depressive symptoms, and physical dysfunction. Structural equation modeling assessed the combined contribution of pain resilience and pain catastrophizing to 3-month outcomes through the simultaneous combination of kinesiophobia and self-efficacy. RESULTS An expanded fear-avoidance model that incorporated pain resilience and self-efficacy provided a good fit to the data, Χ2 (df = 14, N = 343) = 42.09, p = .0001, RMSEA = 0.076 (90% CI: 0.05, 0.10), CFI = 0.97, SRMR = 0.03, with higher levels of pain resilience associated with improved 3-month outcomes on measures of pain intensity, physical dysfunction, and depression symptoms. CONCLUSIONS This study supports the notion that the predictive power of the fear-avoidance model of pain is enhanced when individual differences in both pain-related vulnerability (e.g., catastrophizing) and pain-related protective resources (e.g., resilience) are considered.

中文翻译：

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纵向分析支持恐惧回避模型，该模型将痛苦的复原力与灾难性灾难并入。

背景技术慢性疼痛的避免恐惧模型认为，因伤害而灾难性的个体处于与疼痛相关的恐惧和避免行为的危险之中，并最终导致长时间的疼痛和残疾。目的基于以下假设：通过考虑积极的心理建构，可以提高恐惧回避模型的预测能力，本研究研究了模型中包括的疼痛适应能力和自我效能感。方法在纵向在线调查研究中招募了最近发生背痛的男性和女性（N = 343）。在三个月的时间间隔内，参与者重复进行疼痛适应能力量表，疼痛灾难性量表，运动恐惧症的坦帕量表，疼痛自我效能调查表，麦吉尔疼痛调查表以及NIH推荐的疼痛，抑郁症状，和身体机能障碍。结构方程模型通过同时结合运动恐惧症和自我效能感来评估疼痛复原力和灾难性疼痛对3个月结局的综合贡献。结果结合了疼痛适应能力和自我效能感的扩展的避免恐惧模型非常适合该数据，Χ2（df = 14，N = 343）= 42.09，p = .0001，RMSEA = 0.076（90％CI：0.05） （0.10），CFI = 0.97，SRMR = 0.03，并且在缓解疼痛强度，身体机能障碍和抑郁症状方面，三个月的预后改善与较高的疼痛适应能力有关。结论本研究支持以下观念：当两种与疼痛相关的脆弱性（例如，