Fear Avoidance and Illness Beliefs in Post-Traumatic Neck Pain
Fear Avoidance and Illness Beliefs in Post-Traumatic Neck Pain
复制标题
DOI：
10.1097/brs.0b013e3182388400
复制
发表时间：
2011-12-01
期刊：
影响因子：
3
通讯作者：
de Jong, Peter J.
中科院分区：
文献类型：
--
作者：
Buitenhuis, Jan;de Jong, Peter J.
研究设计。对相关文献进行描述性概述并引入新的心理模型。目的。讨论了恐惧回避（FA）模型以及疾病信念对创伤后颈部疼痛的潜在重要性。因果信念-焦虑模型是作为 FA 模型的改编而引入的，强调了疾病信念的关键作用。背景数据摘要。尽管 FA 模型最彻底地用于研究慢性腰痛，但它似乎也可以作为其他慢性疼痛疾病（如颈部扭伤）的起点。运动恐惧症和疼痛灾难化构成了 FA 模型的关键组成部分。事实证明，通过影响模型的关键组成部分来打破 FA 循环可能是防止慢性病发展的有效方法。通过使用 FA 模型作为起点，我们提出了因果信念-焦虑模型，并论证了这如何有助于解释慢性颈部扭伤症状，并可能为预防性干预提供线索。结果。在经历颈部肌肉疼痛时，灾难化可能会导致人们对这种疼痛的原因产生功能失调的疾病信念。疾病身份和其他信念提供了症状预期和归因，以及对肌肉性颈部疼痛病程的预期。这些负面期望可能会导致不太有利的结果，甚至可能引起症状。因此，将所谓的疾病信念的作用整合到一个适应的 FA 模型（“因果信念-焦虑模型”）中似乎很重要。结论。在临床实践中，深入了解患者对所经历症状的原因的疾病信念似乎很重要。医疗保健专业人员应该意识到功能失调的疾病信念可能产生的有害影响。在早期阶段，有关可能病程的充分解释和信息可能足以防止产生功能失调的疾病信念，从而防止慢性病程的发展。在人口层面，开展教育活动，让人们了解创伤后颈部疼痛的可能原因和现实期望，可以为预防慢性颈部扭伤症状提供有效策略。
Study Design. A descriptive overview of the relevant literature and the introduction of a new psychological model.Objective. The fear-avoidance (FA) model and the potential importance of illness beliefs in post-traumatic neck pain are discussed. The causal beliefs-anxiety model is introduced as an adaptation of the FA model, emphasizing the critical role of illness beliefs.Summary of Background Data. Although the FA model is most thoroughly used to investigate chronic low back pain, it seems also highly relevant as a starting point for other chronic pain conditions like whiplash. Kinesophobia and pain catastrophizing form critical components of the FA model. It has been shown that breaking the FA cycle by affecting the critical components of the model may be an effective method to prevent the development of chronicity.Methods. By using the FA model as a starting point, we present the causal beliefs-anxiety model and argue how this might help explain chronic whiplash symptoms and might provide clues for preventive interventions.Results. On experiencing muscular neck pain, catastrophizing may give rise to dysfunctional illness beliefs regarding the cause of this pain. The illness identity and other beliefs feed symptom expectation and attribution, as well as expectations regarding the course of muscular neck pain. These negative expectations can contribute to a less favorable outcome or may even cause symptoms. Therefore, it seems important to integrate the alleged role of illness beliefs in an adapted FA model, the "causal beliefs-anxiety model."Conclusion. In clinical practice, it seems important to have insight into the patient's illness beliefs about the cause of the experienced symptoms. Health care professionals should be aware of the possible detrimental influence of dysfunctional illness beliefs. In the early stage, adequate explanation and information about the probable course may be sufficient to prevent the generation of dysfunctional illness beliefs thereby preventing the development of a chronic course. At the population level, educational campaigns that inform people about probable causes and realistic expectations regarding post-traumatic neck pain could provide an effective strategy for preventing chronic whiplash symptoms.