UNDERSTANDING AND TREATING FEAR OF PAIN; ED. BY GORDON J.G. ASMUNDSON

People who suffer from chronic pain are typically found to be more anxious and fearful of pain than those who do not. Recent evidence has shown that the pain itself serves as a mechanism through which chronic pain is maintained over time. Even once the muscle or tissue damage is healed, a fear of further pain can lead to avoidance behavior, which over time, leads to deconditioning (e.g. decreased mobility, weight gain). This in turn leads to further experiences, negative expectancies, and strengthened avoidance. It is the reciprocal relationship between fear and avoidance that is thought to be responsible for maintaining pain behavior and disability. With fear of pain known to cause significant suffering and functional disability, there is a need for a greater understanding of this condition. This is the first book to explore this topic. It starts by introducing the current theoretical positions regarding pain-related fear and anxiety along with relevant empirical findings. It then provides comprehensive coverage of assessment issues and treatment strategies. Finally, the book suggests further areas for investigation. Pain-related fear and anxiety are now receiving considerable attention, and efficient and effective treatments are fast becoming available. This book will help guide and extend our understanding of a condition that has been shown to be associated with substantial suffering and disability. Contents......Page 16 About the Editors......Page 18 Contributors......Page 20 Abbreviations......Page 22 Part I Theoretical foundations and empirical findings......Page 24 1 Fear-avoidance models of chronic pain: An overview......Page 26 2 Pain-related fear and avoidance: A conditioning perspective......Page 48 3 A behavioral analysis of pain-related fear responses......Page 74 4 The role of hypervigilance in the experience of pain......Page 94 5 Negative affectivity, catastrophizing, and anxiety sensitivity......Page 114 6 Attitudes toward physical activity: The role of implicit versus explicit associations......Page 140 7 Disuse and physical deconditioning in chronic low back pain......Page 162 Part II Assessment......Page 184 8 The object of fear in pain......Page 186 9 Assessment of fear and anxiety associated with pain: Conceptualization, methods, and measures......Page 212 10 The role of fear-avoidance in the early identification of patients risking the development of disability......Page 236 11 Patient–therapist relationships among patients with pain-related fear......Page 260 Part III Treatment......Page 288 12 The management of pain-related fear in primary care......Page 290 13 Cognitive–behavioral therapy for chronic pain: An overview with specific reference to fear and avoidance......Page 316 14 Fear reduction in chronic pain: Graded exposure in vivo with behavioral experiments......Page 336 Part IV Conclusions and future directions......Page 368 15 Future challenges and research directions in fear of pain......Page 370 C......Page 384 D......Page 385 F......Page 386 N......Page 387 P......Page 388 U......Page 389 W......Page 390 People who suffer from chronic pain are typically found to be more anxious and fearful of pain than those who do not. Recent evidence has shown that the fear itself serves as a mechanism through which chronic pain is maintained over time. Even once the muscle or tissue damage is healed, a fear of further pain can lead to avoidance behaviour, which over time, leads to deconditioning (e.g. decreased mobility, weight gain). This in turn leads to further pain experiences, negative expectancies, and strengthened avoidance. It is the reciprocal relationship between fear and avoidance that is thought to be responsible for maintaining pain behaviour and disability. With fear of pain known to cause significant suffering and functional disability, there is a need for a greater understanding of this condition. This is the first book to explore this topic. It starts by introducing the current theoretical positions regarding pain-related fear and anxiety along with relevant empirical findings. It then provides comprehensive coverage of assessment issues and treatment strategies. Finally, the book suggests further areas for investigation. Pain-related fear and anxiety are now receiving considerable attention, and efficient and effective treatments are fast becoming available. This book will help guide and extend our understanding of a condition that has been shown to be associated with substantial suffering and disability. People who suffer from chronic pain are typically found to be more anxious and fearful of pain than those who do not. Studies have shown how the pain itself can serve as a mechanism through which chronic pain is maintained over time, through a chain of behavioural processes. This is the first book to detail the theory, research and clinically applicable issues of a condition - fear of pain - one known to cause significant suffering and functionaldisability