Avoidance behavior in chronic pain research: a cold case revisited
Open accessAbstract
In chronic musculoskeletal pain, avoidance behavior is a prominent behavioral characteristic that can manifest itself in various ways. It is also considered a crucial component in the development and maintenance of chronic pain-related disability, supposedly fueled by pain-related fear and catastrophic beliefs. Despite the frequent occurrence of avoidance behavior and its potential impact on quality of life, relatively little research has been dedicated to the nature of avoidance in chronic pain and its assessment, leaving its underlying mechanisms poorly understood. In the current paper, we stipulate some of the existing parallels between chronic pain research and more basic fear and anxiety research inspired by modern learning theories. After a brief introduction, we discuss avoidance theories that are likely apt to be applied to chronic pain, including avoidance as a response that can affect fear responding, and the role of avoidant decision making and motivational context. Finally, we will outline how these theories may impact clinical treatment.
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There is evidence for chronic pain-related alterations in several cortical regions important for pain perception, including primary and secondary somatosensory cortices, insular and anterior cingulate cortices, prefrontal cortices, and many subcortical areas.
“Currently, there is evidence for chronic pain-related alterations a number of cortical regions that are considered to be important for the perception of pain including the primary and secondary somatosensory cortices, insular and anterior cingulate cortices, the prefrontal cortices, and many subcortical areas.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [380]
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- Authors
- Volders, S., Boddez, Y., De Peuter, S., Meulders, A., & Vlaeyen, J. W. S.
- Affiliations
- KU Leuven (BE)
- Maastricht University (NL)
- Corresponding author
- Volders, Stéphanie
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 64
- Pages
- 31-37
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W1998092963
- Cited by
- 97
- References
- 120
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 8 · 2023: 13 · 2022: 9 · 2021: 8 · 2020: 17 · 2019: 7 · 2018: 6 · 2017: 7 · 2016: 7 · 2015: 1
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- green
- lirias.kuleuven.be
- Licence
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- avoidance behavior, chronic musculoskeletal pain, fear-avoidance beliefs, decision avoidance, motivational context, pain assessment, pain management
- MeSH terms
- Anxiety, Avoidance Learning, Fear, Humans, Models, Psychological, Quality of Life, Chronic Pain, Musculoskeletal Pain
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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