Fear-avoidance, pain acceptance and adjustment to chronic pain: a cross-sectional study on a sample of 686 patients with chronic spinal pain.

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.