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Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ).
Eur J Pain. 2009 Jul; 13(6):620-8.EJ

Abstract

AIM OF INVESTIGATION

Recent research indicated wide variability regarding pain-related cognitive/affective and behavioral responses to pain, showing that fear-avoidance responses (FAR) and endurance-responses (ER) play a prominent role in the maintenance of low back pain (LBP). Until now, there is a lack of reliable and valid instruments covering FAR and ER.

METHODS

A pool of 60 items, derived from the Kiel Pain Inventory was answered by 191 LBP patients. Principle components analyses (PCA) was used to explore the factor structure creating the Avoidance-Endurance Questionnaire (AEQ). Validity was calculated using the criteria variables pain intensity, disability, chronic pain grades (CPG) and number of sick days, further self-report measures (Fear-Avoidance Beliefs Questionnaire FABQ, Pain Anxiety Symptoms Scale PASS, Tampa Scale of Kinesiophobia TSK and Beck Depression Inventory BDI) evaluating construct validity.

RESULTS

PCA revealed five AEQ-FAR scales with anxiety/depression, catastrophizing, help-/hopelessness, avoidance of social activities, avoidance of physical activities, and four AEQ-ER scales with positive mood, thought suppression, pain persistence behavior and humor/distraction. All scales revealed high internal consistency. As expected, FAR scales showed positive associations with pain, disability and other FAR variables (correlations between r=.26 and r=.58), whereas ER scales showed negative associations (between r=-.19 and -.48). The only exception referred to positive correlations between both, FAR and ER and pain intensity.

CONCLUSIONS

The AEQ has shown as a reliable and valid measure to assess pattern of fear-avoidance and endurance-related responses to pain. Both aspects seem to play a role in the maintenance of LBP.

Authors+Show Affiliations

Dept. of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany. Monika.Hasenbring@ruhr-uni-bochum.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19101182

Citation

Hasenbring, Monika I., et al. "Fear-avoidance- and Endurance-related Responses to Pain: Development and Validation of the Avoidance-Endurance Questionnaire (AEQ)." European Journal of Pain (London, England), vol. 13, no. 6, 2009, pp. 620-8.
Hasenbring MI, Hallner D, Rusu AC. Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ). Eur J Pain. 2009;13(6):620-8.
Hasenbring, M. I., Hallner, D., & Rusu, A. C. (2009). Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ). European Journal of Pain (London, England), 13(6), 620-8. https://doi.org/10.1016/j.ejpain.2008.11.001
Hasenbring MI, Hallner D, Rusu AC. Fear-avoidance- and Endurance-related Responses to Pain: Development and Validation of the Avoidance-Endurance Questionnaire (AEQ). Eur J Pain. 2009;13(6):620-8. PubMed PMID: 19101182.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fear-avoidance- and endurance-related responses to pain: development and validation of the Avoidance-Endurance Questionnaire (AEQ). AU - Hasenbring,Monika I, AU - Hallner,Dirk, AU - Rusu,Adina C, Y1 - 2008/12/19/ PY - 2008/05/06/received PY - 2008/09/30/revised PY - 2008/11/02/accepted PY - 2008/12/23/entrez PY - 2008/12/23/pubmed PY - 2009/8/13/medline SP - 620 EP - 8 JF - European journal of pain (London, England) JO - Eur J Pain VL - 13 IS - 6 N2 - AIM OF INVESTIGATION: Recent research indicated wide variability regarding pain-related cognitive/affective and behavioral responses to pain, showing that fear-avoidance responses (FAR) and endurance-responses (ER) play a prominent role in the maintenance of low back pain (LBP). Until now, there is a lack of reliable and valid instruments covering FAR and ER. METHODS: A pool of 60 items, derived from the Kiel Pain Inventory was answered by 191 LBP patients. Principle components analyses (PCA) was used to explore the factor structure creating the Avoidance-Endurance Questionnaire (AEQ). Validity was calculated using the criteria variables pain intensity, disability, chronic pain grades (CPG) and number of sick days, further self-report measures (Fear-Avoidance Beliefs Questionnaire FABQ, Pain Anxiety Symptoms Scale PASS, Tampa Scale of Kinesiophobia TSK and Beck Depression Inventory BDI) evaluating construct validity. RESULTS: PCA revealed five AEQ-FAR scales with anxiety/depression, catastrophizing, help-/hopelessness, avoidance of social activities, avoidance of physical activities, and four AEQ-ER scales with positive mood, thought suppression, pain persistence behavior and humor/distraction. All scales revealed high internal consistency. As expected, FAR scales showed positive associations with pain, disability and other FAR variables (correlations between r=.26 and r=.58), whereas ER scales showed negative associations (between r=-.19 and -.48). The only exception referred to positive correlations between both, FAR and ER and pain intensity. CONCLUSIONS: The AEQ has shown as a reliable and valid measure to assess pattern of fear-avoidance and endurance-related responses to pain. Both aspects seem to play a role in the maintenance of LBP. SN - 1532-2149 UR - https://www.unboundmedicine.com/medline/citation/19101182/Fear_avoidance__and_endurance_related_responses_to_pain:_development_and_validation_of_the_Avoidance_Endurance_Questionnaire__AEQ__ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1090-3801(08)00218-8 DB - PRIME DP - Unbound Medicine ER -