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Purpose: This study investigated the role of anxiety sensitivity, resilience, pain catastrophizing, depression, pain fear-avoidance beliefs, and pain intensity in patients with acute back pain-related disability., Method: Two hundred and thirty-two patients with acute back pain completed questionnaires on anxiety sensitivity, resilience, pain catastrophizing, fear-avoidance beliefs, depression, pain intensity, and disability., Results: A structural equation modelling analysis revealed that anxiety sensitivity was associated with pain catastrophizing, and resilience was associated with lower levels of depression. Pain catastrophizing was positively associated with fear-avoidance beliefs and pain intensity. Depression was associated with fear-avoidance beliefs, but was not associated with pain intensity. Finally, catastrophizing, fear-avoidance beliefs, and pain intensity were positively and significantly associated with acute back pain-related disability., Conclusion: Although fear-avoidance beliefs and pain intensity were associated with disability, the results showed that pain catastrophizing was a central variable in the pain experience and had significant direct associations with disability when pain was acute. Anxiety sensitivity appeared to be an important antecedent of catastrophizing, whereas the influence of resilience on the acute back pain experience was limited to its relationship with depression.

Background: Few instruments are available that have adequate psychometric properties for assessing daily functioning in patients with musculoskeletal pain. In addition, none of these instruments assesses the perceived decrease in levels of daily activities after the onset of pain., Objective: To review the psychometric qualities of the Impairment and Functioning Inventory (IFI) for patients with chronic pain., Design: Cross-sectional study., Setting: Four public primary care centers and a public pain clinic., Patients: A total of 483 patients with back pain who were treated at primary care centers and 137 patients with various pain conditions who were treated at a pain clinic., Methods: To analyze factorial validity, a confirmatory factor analysis was performed via structural equation modeling. To measure internal consistency, Cronbach's α coefficients were calculated. To assess convergent validity, Pearson correlation coefficients were computed between the 2 scales of the IFI and the measures of the Roland Morris Questionnaire. Criterion validity and generalizability were analyzed by regression analysis via structural equation modeling using the LISREL 8.30 software package., Main Outcome Measures: The IFI for patients with chronic pain., Results: A revised version of the IFI (IFI-R) is presented that consists of 30 items with 2 related subscales: Daily Functioning and Impairment (perceived current level of functioning compared with the level of functioning before pain onset). Both subscales were significantly correlated with disability. Depression, pain intensity, and pain anxiety had a negative association with functioning and a positive association with impairment. On the other hand, pain catastrophizing had a negative association with functioning and pain hypervigilance had a positive association with impairment due to pain., Conclusions: The IFI-R appears to be a valid and reliable measurement tool for the assessment of perceived daily functioning and impairment in people with chronic pain., (Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)

Purpose: Recent attention has focused on resilience as an important process in the experience and management of chronic pain. In this context, resilience is considered as a psychological factor that promotes adaptive responses to pain and pain-related life adversities. Current research suggests that it is a relevant variable in the prediction of pain adjustment among chronic pain patients. Recently, it was adapted the Resilience Scale to patients suffering chronic musculoskeletal pain (RS-18). The aims of this study were to confirm the internal structure of the RS-18 and to present new empirical evidence regarding its validity., Methods: A sample of 592 patients with chronic musculoskeletal back pain completed a battery of instruments to assess resilience, anxiety sensitivity, catastrophizing, fear-avoidance beliefs, hypervigilance, pain acceptance, and pain adjustment variables (pain intensity, emotional distress, functional impairment, and daily functioning)., Results: Confirmatory factor analysis supported the validity of the RS-18 and a single-factor solution. A series of moderated multiple regression analysis showed that resilience is a relevant psychological variable that not only independently predicts better pain adjustment, but also moderates the relationships between several psychological pain-related variables and pain adjustment variables., Conclusions: These findings give empirical support to the consideration of resilience as a protective variable in chronic pain adjustment and highlight the consideration that improving resilient behaviour could be an important target for the treatment of pain patients.

Background: Prior studies found a range of psychological factors related to the perception of pain, maintenance of pain and disability., Purpose: The aim of this study was to investigate the role of pain fear-avoidance and pain acceptance in chronic pain adjustment. The influence of two diathesis variables (resilience and experiential avoidance) was also analyzed., Methods: The sample was composed of 686 patients with chronic spinal pain. Structural equation modelling analyses were used to test the hypothetical model., Results: Experiential avoidance was associated with pain fear-avoidance, and resilience was strongly associated with pain acceptance. Pain acceptance was negatively associated with negative mood, functional impairment and pain intensity. However, pain fear-avoidance was positively and significantly associated with negative mood but had no association with pain intensity. There was a path from functional impairment to pain fear-avoidance., Conclusions: Resilience and experiential avoidance appear as variables which could explain individual differences in pain experience.

Background: The Spanish version of the Pain Vigilance and Awareness Questionnaire has not been validated., Purpose: The aims of this study were to examine the factor structure of the Spanish version of the Pain Vigilance and Awareness Questionnaire and present empirical evidence regarding its validity., Method: A sample of 468 chronic back pain patients completed a battery of instruments to assess fear-avoidance beliefs, pain anxiety, pain catastrophizing, pain vigilance and awareness, pain acceptance, depression, anxiety, disability, and pain intensity., Results: Confirmatory factor analysis supported the validity of a nine-item version with two subscales: Active Vigilance and Passive Awareness. Both subscales and the total score were positively and significantly correlated with other fear-related constructs: fear-avoidance beliefs, pain anxiety, and pain catastrophizing. Regression analyses showed that Active Vigilance and the two subscales of the Fear-Avoidance Beliefs Questionnaire were significantly associated with higher anxiety and that the Acceptance Activity Engagement subscale was significantly associated with lower anxiety. The Fear-Avoidance Beliefs Questionnaire-Physical subscale was associated with higher disability and the Acceptance Pain Willingness subscale was associated with lower disability. The Fear-Avoidance Beliefs Questionnaire-Work subscale was significantly associated with higher pain intensity and depression; the Acceptance Activity Engagement and Pain Willingness subscales were significantly associated with lower pain intensity and depression., Conclusion: The Spanish version of the Pain Vigilance and Awareness Questionnaire is a reliable and valid instrument. Pain Acceptance and Fear Avoidance beliefs are better predictors of adjustment to pain than pain hypervigilance.

Study Design: A cross-sectional study., Objective: To analyze the relationship between resilience, acceptance, coping, and adjustment to spinal chronic pain., Summary of Background Data: Several studies have concluded that resilience is relevant in predicting pain and physical functioning among patients with chronic pain. Although resilience may have a role in preventing or living with chronic pain, there is little research on the effects of resilience on adjustment among patients with chronic pain., Methods: Multivariate multiple regression by structural equation modeling was performed to simultaneously determine the influence of all the predictor variables on all the dependent variables. The sample was composed of 299 patients (138 men and 161 women) suffering from chronic spinal pain. : Higher levels of resilience were associated with higher levels of pain acceptance and active coping strategies. Active coping and acceptance were associated with higher levels of adjustment to pain., Conclusion: Positive personality characteristics could play a crucial role in patient adjustment, and thus clinicians should take into account the positive path to capacity to better understand the chronic pain experience.