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Cited by 149Musculoskeletal pain and rehabilitationPain Management and TreatmentAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Can Pain‐Related Fear Be Reduced? The Application of Cognitive‐Behavioural Exposure in Vivo

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Vlaeyen, Johan WS, de Jong, Jeroen R, Onghena, Patrick, Kerckhoffs-Hanssen, Maria, Kole-Snijders, Ank MJ·2002·Pain Research and Management
DOI 10.1155/2002/493463
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Abstract

Although cognitive‐behavioural treatments of patients with chronic pain generally are reported to be effective, customization might increase their effectiveness. One possible way to customize treatment is to focus the intervention on the supposed mechanism underlying the transition from acute to chronic pain disability. Evidence is accumulating in support of the conjecture that pain‐related fear and associated avoidance behaviours are crucial in the development and maintenance of chronic pain disability. It seems timely to apply this knowledge to the cognitive‐behavioural management of chronic pain. Two studies are presented here. Study 1 concerns a secondary analysis of data gathered in a clinical trial that was aimed at the examination of the supplementary value of coping skills training when added to an operant‐behavioural treatment in patients with chronic back pain. The results show that, compared with a waiting list control, an operant‐behavioural treatment with or without pain‐coping skills training produced very modest and clinically negligible decreases in pain‐related fear. Study 2 presents the effects of more systematic exposure in vivo treatment with behavioural experiments in two single patients reporting substantial pain‐related fear. Randomization tests for AB designs revealed dramatic changes in pain‐related fear and pain catastrophizing. In both cases, pain intensity also decreased significantly, but at a slower pace. Differences before and after treatment revealed clinically significant improvements in pain vigilance and pain disability.

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  • Similar effects have been reported in 2 case studies each involving 2 patients with chronic musculoskeletal pain.

    “Similar effects have been reported in 2 case studies each involving 2 patients with chronic musculoskeletal pain.”

    From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [142]

    The Abstract describes a replicated single-case study involving two patients with chronic low back pain, and the General Discussion reports reductions in pain-related fear after exposure treatment. The paper does not report two case studies each involving two patients: its other study analyzes clinical-trial data. The cited evidence therefore supports the effects and one two-patient study, but not the claimed number of studies. (LLM, conf=0.89)

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References 59 · Cited by 149

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Authors
Vlaeyen, J. W., de Jong, J. R., Onghena, P., Kerckhoffs-Hanssen, M., & Kole-Snijders, A. M.
Affiliations
  • Maastricht University Medical Centre (NL)
  • KU Leuven (BE)
Corresponding author
Vlaeyen, Johan WS
ORCID
Venue
Pain Research and Management
Publisher
Wiley
Published
2002-01
Volume
7
Issue
3
Pages
144-153
ISSN
  • 1203-6765 (ISSN-L)
  • 1918-1523
DOI
10.1155/2002/493463
OpenAlex
W1871449731
Cited by
149
References
59
Citations by year
2026: 1 · 2025: 3 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 6 · 2018: 3 · 2017: 9 · 2016: 2 · 2015: 8 · 2014: 7 · 2013: 4 · 2012: 10
FWCI
5.49
Type
journal article
Language
en
Open access
Licence
Locations
  • Pain Research and Management (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Council for Medical and Health Research of the Netherlands (904-65-090)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
fear of pain, in vivo exposure, cognitive-behavioral intervention, chronic pain, chronic back pain, pain catastrophizing, coping skills training, avoidance behavior, pain vigilance, pain-related disability, permutation tests
MeSH terms
Adult, Chronic Disease, Conditioning, Operant, Desensitization, Psychologic, Fear, Female, Humans, Male, Middle Aged, Pain, Pain Measurement, Personality Assessment, Prospective Studies, Surveys and Questionnaires, Severity of Illness Index, Meta-Analysis as Topic, Program Evaluation, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Panic Disorder, Cross-Over Studies

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