Pain fear avoidance and pain acceptance: a cross-sectional study comparing their influence on adjustment to chronic pain across three samples of patients.

BACKGROUND Prior studies found that pain fear avoidance and pain acceptance are significantly associated with adjustment to chronic pain. PURPOSE The purpose of this study is to compare the influence of pain fear avoidance and pain acceptance on adjustment to chronic pain across three samples: patients with chronic back pain treated at primary care centres, patients with heterogeneous pain conditions treated at a pain clinic and patients with pain associated with inflammatory bowel disease. METHODS Structural equation modelling was used to test for differences between groups in the linear relationships between variables. RESULTS The model had the best fit for the group of patients with back pain. Three significant relationships were equal across the groups: experiential avoidance on pain fear avoidance, pain intensity on pain fear avoidance, and pain fear avoidance on negative mood. CONCLUSIONS The associations between both pain fear avoidance and pain acceptance and adjustment to chronic pain vary depending on the pain condition and the type of health care centres where the patients are treated.