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.

Work craving theory addresses how work-addicted individuals direct great emotion-regulatory efforts to weave their addictive web of working. They crave work for two main emotional incentives: to overcompensate low self-worth and to escape (i.e., reduce) negative affect, which is strategically achieved through neurotic perfectionism and compulsive working. Work-addicted individuals" strong persistence and self-discipline with respect to work-related activities suggest strong skills in volitional action control. However, their inability to disconnect from work implies low volitional skills. How can work-addicted individuals have poor and strong volitional skills at the same time? To answer this paradox, we elaborated on the relevance of two different volitional modes in work craving: self-regulation (self-maintenance) and self-control (goal maintenance). Four hypotheses were derived from Wojdylo- work craving theory and Kuhl- self-regulation theory: (H1) Work craving is associated with a combination of low self-regulation and high self-control. (H2) Work craving is associated with symptoms of psychological distress. (H3) Low self-regulation is associated with psychological distress symptoms. (H4) Work craving mediates the relationships between self-regulation deficits and psychological distress symptoms at high levels of self-control. Additionally, we aimed at supporting the discriminant validity of work craving with respect to work engagement by showing their different volitional underpinnings. Results of the two studies confirmed our hypotheses: whereas work craving was predicted by high self-control and low self-regulation and associated with higher psychological distress, work engagement was predicted by high self-regulation and high self-control and associated with lower symptoms of psychological distress. Furthermore, work styles mediated the relationship between volitional skills and symptoms of psychological distress. Based on these new insights, several suggestions for prevention and therapeutic interventions for work-addicted individuals are proposed.