Fear-avoidance model of chronic pain

The next generation

Geert Crombez, Christopher Eccleston, Stefaan Van Damme, Johan W S Vlaeyen, Paul Karoly

Research output: Contribution to journalArticle

341 Citations (Scopus)

Abstract

Objective: The fear-avoidance (FA) model of chronic pain describes how individuals experiencing acute pain may become trapped into a vicious circle of chronic disability and suffering. We propose to extend the FA model by adopting a motivational perspective on chronic pain and disability. Methods: A narrative review. Results: There is ample evidence to support the validity of the FA model as originally formulated. There are, however, some key challenges that call for a next generation of the FA model. First, the FA model has its roots in psychopathology, and investigators will have to find a way to account for findings that do not easily fit within such framework. Second, the FA model needs to address the dynamics and complexities of disability and functional recovery. Third, the FA model should incorporate the idea that pain-related fear and avoidance occurs in a context of multiple and often competing personal goals. Discussion: To address these 3 key challenges, we argue that the next generation of the FA model needs to more explicitly adopt a motivational perspective, one that is built around the organizing powers of goals and self-regulatory processes. Using this framework, the FA model is recast as capturing the persistent but futile attempts to solve pain-related problems to protect and restore life goals.

Original languageEnglish (US)
Pages (from-to)475-483
Number of pages9
JournalClinical Journal of Pain
Volume28
Issue number6
DOIs
StatePublished - Jul 2012

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Chronic Pain
Fear
Pain
Acute Pain
Psychopathology
Psychological Stress
Research Personnel

Keywords

  • Anxiety
  • Avoidance
  • Fear
  • Goals
  • Motivation
  • Pain
  • Selfregulation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Fear-avoidance model of chronic pain : The next generation. / Crombez, Geert; Eccleston, Christopher; Van Damme, Stefaan; Vlaeyen, Johan W S; Karoly, Paul.

In: Clinical Journal of Pain, Vol. 28, No. 6, 07.2012, p. 475-483.

Research output: Contribution to journalArticle

Crombez, G, Eccleston, C, Van Damme, S, Vlaeyen, JWS & Karoly, P 2012, 'Fear-avoidance model of chronic pain: The next generation', Clinical Journal of Pain, vol. 28, no. 6, pp. 475-483. https://doi.org/10.1097/AJP.0b013e3182385392
Crombez, Geert ; Eccleston, Christopher ; Van Damme, Stefaan ; Vlaeyen, Johan W S ; Karoly, Paul. / Fear-avoidance model of chronic pain : The next generation. In: Clinical Journal of Pain. 2012 ; Vol. 28, No. 6. pp. 475-483.
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