The Structural Model of Relationships between Pain Vulnerability, Catastrophizing, Fear and Pain Adjustment in Patients with Chronic Musculoskeletal Pain

Nowadays, fear-avoidance model is the best model for the assessment and treatment of chronic musculoskeletal pain in which, the role of the pain vulnerability (neuroticism, experiential avoidance and negative affect) is not well defined. The purpose of present study was to evaluate the structural pattern of the relationships between the pain vulnerability, catastrophizing, fear of pain and pain adjustment (pain intensity and inability) in the framework fear-avoidance model.
Patients with chronic musculoskeletal pain were selected from hospitals and private clinics in Isfahan city, Iran, during 2015 using convenience sampling method. They participated in the research by filling out six questionnaires: NEO Five-Factor Inventory (NEO-FFI), Positive and Negative Affect Schedule (PANAS), Acceptance and Action Questionnaire (AAQ), Pain Catastrophizing Scale (PCS), Tampa Scale Kinesiophobia (TSK) and Graded Chronic Pain Scale (GCP). Data were analyzed using structural equation modeling method.
Findings: Pain vulnerability had significant direct effects on catastrophizing and catastrophizing on fear of pain and fear of pain on pain adjustment (P The results of this research showed that pain vulnerability could predict pain adjustment in the framework fear-avoidance model. Therefore, reducing pain vulnerability can reduce pain intensity and inability in patients with chronic musculoskeletal pain.