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Endurance and avoidance response patterns in pain patients: Application of action control theory in pain research

  • Background Identifying pain-related response patterns and understanding functional mechanisms of symptom formation and recovery are important for improving treatment. Objectives We aimed to replicate pain-related avoidance-endurance response patterns associated with the Fear-Avoidance Model, and its extension, the Avoidance-Endurance Model, and examined their differences in secondary measures of stress, action control (i.e., dispositional action vs. state orientation), coping, and health. Methods Latent profile analysis (LPA) was conducted on self-report data from 536 patients with chronic non-specific low back pain at the beginning of an inpatient rehabilitation program. Measures of stress (i.e., pain, life stress) and action control were analyzed as covariates regarding their influence on the formation of different pain response profiles. Measures of coping and health were examined as dependent variables. Results Partially in line with our assumptions, we found three pain response profiles of distress-avoidance, eustress-endurance, and low-endurance responses that are depending on the level of perceived stress and action control. Distress-avoidance responders emerged as the most burdened, dysfunctional patient group concerning measures of stress, action control, maladaptive coping, and health. Eustress-endurance responders showed one of the highest levels of action versus state orientation, as well as the highest levels of adaptive coping and physical activity. Low-endurance responders reported lower levels of stress as well as equal levels of action versus state orientation, maladaptive coping, and health compared to eustress-endurance responders; however, equally low levels of adaptive coping and physical activity compared to distress-avoidance responders. Conclusions Apart from the partially supported assumptions of the Fear-Avoidance and Avoidance-Endurance Model, perceived stress and dispositional action versus state orientation may play a crucial role in the formation of pain-related avoidance-endurance response patterns that vary in degree of adaptiveness. Results suggest tailoring interventions based on behavioral and functional analysis of pain responses in order to more effectively improve patients quality of life.

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Metadaten
Author:Jana BuchmannORCiD, Nicola BaumannORCiD, Karin Meng, Jana Semrau, Julius Kuhl, Klaus Pfeifer, Miguel Kazén, Heiner Vogel, Hermann Faller
URN:urn:nbn:de:hbz:385-1-18084
DOI:https://doi.org/10.1371/journal.pone.0248875
Parent Title (English):PLoS ONE
Publisher:Public Library of Science (PLoS)
Place of publication:San Francisco
Document Type:Article
Language:English
Date of completion:2021/03/25
Date of publication:2021/03/25
Publishing institution:Universität Trier
Contributing corporation:The publication was funded by the Open Access Fund of Universität Trier and the German Research Foundation (DFG)
Release Date:2022/03/14
Tag:Control theory; Emotions; Patients; Physical activity; Psychological stress
GND Keyword:Ausdauer; Patient; Schmerz; Selbstkontrolle; Stress; Verhaltensmuster; Vermeidung
Volume (for the year ...):2021
Issue / no.:Band 16, Heft 3
Number of pages:25
Institutes:Fachbereich 1 / Psychologie
Dewey Decimal Classification:1 Philosophie und Psychologie / 15 Psychologie / 150 Psychologie
Licence (German):License LogoCC BY: Creative-Commons-Lizenz 4.0 International

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