Microtemporal Relationships in the Fear Avoidance Model: An Ecological Momentary Assessment Study.

Document Type

Article

Publication Date

9-1-2022

Identifier

DOI: 10.1097/AJP.0000000000001058

Abstract

OBJECTIVES: Current literature in pediatric pain evaluates the Fear Avoidance model (FAM) pathways at the trait (or macrotemporal) level, but it is unknown if these pathways also occur at the state (or microtemporal) level. Identifying microtemporal processes can improve our understanding of how the relationships within the Fear Avoidance constructs vary when specific Fear Avoidance variables wax and wane. We hypothesized that changes in FAM constructs would be associated with changes in the next variable in the sequence on a microtemporal level, including: (1) higher pain when there is more pain-related fear, (2) higher pain-related fear when there is more avoidance, and (3) higher avoidance when there is more reported disability.

METHODS: 71 pediatric patients with chronic abdominal pain ( M =13.34 y, SD=2.67 y) reported pain severity, pain-related fear, and avoidance via ecological momentary assessments over 14 days.

RESULTS: Our results indicated significant microtemporal relationships between Fear Avoidance constructs for pain predicting pain-related fear, pain-related fear predicting avoidance, and avoidance predicting disability.

DISCUSSION: The current study suggests that the ways in which the FAM is related to various aspects of pain functioning differs on a state-level, which adds new clinical and research opportunities.

Journal Title

The Clinical journal of pain

Volume

38

Issue

9

First Page

562

Last Page

567

MeSH Keywords

Avoidance Learning; Child; Disability Evaluation; Ecological Momentary Assessment; Fear; Humans; Pain; Phobic Disorders; Surveys and Questionnaires

Keywords

Avoidance Learning; Disability Evaluation; Ecological Momentary Assessment; Fear; Pain; Phobic Disorders; Surveys and Questionnaires

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