Endurance and avoidance response patterns in pain patients: Application of action control theory in pain research
Identifying pain-related response patterns and understanding functional mechanisms of symptom formation and recovery are important for improving treatment. We aimed to replicate pain-related avoidance-endurance response patterns associated with the Fear-Avoidance Model, and its extension, the Avoida...
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| Veröffentlicht in: | PloS one 2021-03, Vol.16 (3), p.e0248875-e0248875 |
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| creator | Buchmann, Jana Baumann, Nicola Meng, Karin Semrau, Jana Kuhl, Julius Pfeifer, Klaus Kazén, Miguel Vogel, Heiner Faller, Hermann |
| description | Identifying pain-related response patterns and understanding functional mechanisms of symptom formation and recovery are important for improving treatment.
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.
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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0248875 |
| format | Article |
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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.
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.
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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0248875</identifier><identifier>PMID: 33765020</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Anxiety ; Automatic control ; Avoidance ; Avoidance behavior ; Back pain ; Behavior ; Biology and Life Sciences ; Biometrics ; Chronic exposure ; Cluster analysis ; Computer and Information Sciences ; Control theory ; Editing ; Electronic mail ; Endurance ; Engineering and Technology ; Epidemiology ; Exercise ; Fear & phobias ; Funding ; Impulsive behavior ; Low back pain ; Mail ; Medicine and Health Sciences ; Methodology ; Mood ; Pain ; Physical Sciences ; Psychology ; Psychotherapy ; Regression analysis ; Rehabilitation ; Risk factors ; Social Sciences ; Sport science</subject><ispartof>PloS one, 2021-03, Vol.16 (3), p.e0248875-e0248875</ispartof><rights>2021 Buchmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Buchmann et al 2021 Buchmann et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-903b4037d169114c67c9a4f6e70ac32e331f28233aa32d563fd11de5cbb4c5aa3</citedby><cites>FETCH-LOGICAL-c526t-903b4037d169114c67c9a4f6e70ac32e331f28233aa32d563fd11de5cbb4c5aa3</cites><orcidid>0000-0002-6770-7719 ; 0000-0002-4713-6664</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993813/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993813/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23849,27907,27908,53774,53776,79351,79352</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33765020$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Sirois, Fuschia M.</contributor><creatorcontrib>Buchmann, Jana</creatorcontrib><creatorcontrib>Baumann, Nicola</creatorcontrib><creatorcontrib>Meng, Karin</creatorcontrib><creatorcontrib>Semrau, Jana</creatorcontrib><creatorcontrib>Kuhl, Julius</creatorcontrib><creatorcontrib>Pfeifer, Klaus</creatorcontrib><creatorcontrib>Kazén, Miguel</creatorcontrib><creatorcontrib>Vogel, Heiner</creatorcontrib><creatorcontrib>Faller, Hermann</creatorcontrib><title>Endurance and avoidance response patterns in pain patients: Application of action control theory in pain research</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Identifying pain-related response patterns and understanding functional mechanisms of symptom formation and recovery are important for improving treatment.
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.
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.
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.
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.</description><subject>Anxiety</subject><subject>Automatic control</subject><subject>Avoidance</subject><subject>Avoidance behavior</subject><subject>Back pain</subject><subject>Behavior</subject><subject>Biology and Life Sciences</subject><subject>Biometrics</subject><subject>Chronic exposure</subject><subject>Cluster analysis</subject><subject>Computer and Information Sciences</subject><subject>Control theory</subject><subject>Editing</subject><subject>Electronic mail</subject><subject>Endurance</subject><subject>Engineering and Technology</subject><subject>Epidemiology</subject><subject>Exercise</subject><subject>Fear & phobias</subject><subject>Funding</subject><subject>Impulsive behavior</subject><subject>Low back pain</subject><subject>Mail</subject><subject>Medicine and Health 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and avoidance response patterns in pain patients: Application of action control theory in pain research</title><author>Buchmann, Jana ; Baumann, Nicola ; Meng, Karin ; Semrau, Jana ; Kuhl, Julius ; Pfeifer, Klaus ; Kazén, Miguel ; Vogel, Heiner ; Faller, Hermann</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c526t-903b4037d169114c67c9a4f6e70ac32e331f28233aa32d563fd11de5cbb4c5aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anxiety</topic><topic>Automatic control</topic><topic>Avoidance</topic><topic>Avoidance behavior</topic><topic>Back pain</topic><topic>Behavior</topic><topic>Biology and Life Sciences</topic><topic>Biometrics</topic><topic>Chronic exposure</topic><topic>Cluster analysis</topic><topic>Computer and Information Sciences</topic><topic>Control theory</topic><topic>Editing</topic><topic>Electronic mail</topic><topic>Endurance</topic><topic>Engineering 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research</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-03-25</date><risdate>2021</risdate><volume>16</volume><issue>3</issue><spage>e0248875</spage><epage>e0248875</epage><pages>e0248875-e0248875</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Identifying pain-related response patterns and understanding functional mechanisms of symptom formation and recovery are important for improving treatment.
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.
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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33765020</pmid><doi>10.1371/journal.pone.0248875</doi><orcidid>https://orcid.org/0000-0002-6770-7719</orcidid><orcidid>https://orcid.org/0000-0002-4713-6664</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anxiety Automatic control Avoidance Avoidance behavior Back pain Behavior Biology and Life Sciences Biometrics Chronic exposure Cluster analysis Computer and Information Sciences Control theory Editing Electronic mail Endurance Engineering and Technology Epidemiology Exercise Fear & phobias Funding Impulsive behavior Low back pain Medicine and Health Sciences Methodology Mood Pain Physical Sciences Psychology Psychotherapy Regression analysis Rehabilitation Risk factors Social Sciences Sport science |
| title | Endurance and avoidance response patterns in pain patients: Application of action control theory in pain research |
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