BACKGROUND Biased interpretations of ambiguous bodily threat situations characterise youth with chronic pain, and have been associated with functional disability for this population. Despite predictions by the fear-avoidance model of chronic pain, that fear and avoidance of pain explain the association between threat perceptions and disability, this has not yet been explored in youth with chronic pain. The current study aimed to address this gap by investigating these proposed relationships, in addition to the association between bodily threat interpretations and daily aspects of disability (as well as social, and emotional impairments). METHOD Sixty-eight adolescents aged 11-18 years old with a clinical diagnosis of chronic pain completed an extended version of the Adolescent Interpretations of Bodily Threat task to assess interpretations of bodily and social threat situations, alongside measures of disability and fear and avoidance of pain. RESULTS Using mediation analysis, fear and avoidance of pain statistically accounted for the relationship between negative bodily threat interpretations and functional disability. Significant associations were also demonstrated between negative bodily threat interpretations and adolescent-reported impairments in daily, emotional and social impairments. Data revealed a significant relationship between negative social interpretations and daily functional disability. CONCLUSIONS Findings indicate the clinical relevance of bodily and social threat interpretations, and fear and avoidance of pain, for this population and raise further questions regarding the content-specificity of threat interpretations.

中文翻译：

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青少年慢性疼痛患者的偏见威胁解释、恐惧和避免疼痛与疼痛相关残疾之间的关联

背景 对不明确的身体威胁情况的偏见解释是患有慢性疼痛的青年的特征，并且与该人群的功能障碍有关。尽管慢性疼痛的恐惧回避模型做出了预测，恐惧和回避疼痛解释了威胁感知与残疾之间的关联，但尚未在患有慢性疼痛的青年中进行探索。目前的研究旨在通过调查这些提议的关系来解决这一差距，此外还有身体威胁解释与残疾的日常方面（以及社交和情感障碍）之间的关联。方法 68 名 11-18 岁临床诊断为慢性疼痛的青少年完成了青少年身体威胁解释任务的扩展版本，以评估对身体和社会威胁情况的解释，以及残疾、恐惧和避免疼痛的措施. 结果 使用中介分析，恐惧和避免疼痛在统计上解释了负面身体威胁解释与功能障碍之间的关系。负面的身体威胁解释与青少年报告的日常、情绪和社交障碍之间的显着关联也得到了证明。数据显示负面社会解释与日常功能障碍之间存在显着关系。