Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study

Abstract

Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factor in the transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they arc associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidme and cabstrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5. but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early pint in the development of pain and associated activity problems in people with back pain. Theoretically. our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.     

Psychosocial factors associated with hiv testing amongst scottish gay men

This article describes the relationship between HIV testing and a range of psychosocial, sexual and socio-demographic variables. Trained research staff distributed a self-report questionnaire in the gay bars of Glasgow and Edinburgh, in May 2000. Questionnaires were completed by 803 men (a response rate of 78%). We present the results of both bivariate and multivariate analyses identifying key variables associated with never having had an HIV test. Thus we outline some psychosocial barriers to HIV testing. Multivariate analysis indicated that the most important factor associated with never having tested was fear of a positive result; this was particularly true for those men who reported higher levels of risky sexual conduct. We discuss the relevance of these findings in terms of presenting a psychosocial agenda which demands that stigma and the social exclusion of HIV positive people should be addressed before gay men are encouraged to seek HIV testing.     

青少年抑郁情绪的发展轨迹:界定亚群组及其影响因素

本研究意在分性别考察中国青少年抑郁情绪的发展轨迹及其影响因素。785名男生和859名女生参加了3轮追踪研究,初始测量阶段的年龄跨度为10~16岁,平均年龄分别为12.99±1.84和12.96±1.87岁。采用流调中心抑郁量表(CES-D)简版测量青少年的抑郁情绪。模型拟合的结果显示男女生的抑郁情绪在10~19岁时段皆呈线性增长趋势,其中男生分为两个亚群组,人际关系解释了部分变异;女生分为4个亚群组,学业压力和人际关系均解释了部分变异。     

Life Cycle Welfare: Trends and Differences

A cohort analysis of United States General Social Science Survey data since 1972 reveals that the life cycle trend in average happiness is remarkably flat. Throughout the life course, however, whites are typically happier than blacks, and more educated persons are happier than their less educated counterparts. In recent years the black-white differential has narrowed moderately, and – although there is no consistent difference by gender – the happiness of females has declined relative to males. Some psychologists assert that happiness is largely determined by genetic or personality traits, but the persistence of life cycle differences by race and education suggests that external socio-economic circumstances are important influences on happiness.     

Resilience to Childhood Abuse and Neglect in College Students

This study examined the prevalence of a history of childhood maltreatment in a college sample and identified the relationship between being maltreated as a child and later college adjustment in men and women. Results indicate that men who had been maltreated in childhood had more resilient outcomes in college than women who had been maltreated in childhood. Negative life events and protective factors acted as mediators in the relationship between childhood maltreatment and college adjustment for women, and protective factors acted as a moderator in the relationship between childhood maltreatment and college adjustment for men.     

旅游决策影响因素研究

本研究采用自编的《旅游决策影响因素问卷》,对旅游决策的影响因素,进行了调查研究。结果发现．旅游决策的影响因素．可以分成六个类别．即旅游服务因素、社会支持因素、群体支持因素、个人心理因素、个人社会经济因素,以及其他因素。此外．旅游决策还受决策者的人口统计学特征的制约。     

老子之道及其创生因子探究

"道"是老子哲学体系中的核心,老子不仅提出虚空的道是宇宙的本体,是无法用语言来描述的,而且说明道是混成之物,即道是有精妙的内部结构属性的,并从不同的侧面说明了认识"道"是混成之物的路径。道是由无限创生因子混融而成的系统,宇宙在创生及万物演化的过程中,道或无限的创生因子始终起着根本性的作用,即宇宙间的一切事物现象都是道所为。道是由创生因子混融而成的思想观点,可为现代宇宙论的发展提供新的思维维度,为科学探索真空世界的奥秘提供新的研究途径,推进现代宇宙学的进步。     

Comparison of Maternal Perceptions of Preterm and Fullterm Infants

We compared maternal attitudes and feelings in two groups of mother–infant dyads: 25 mothers with preterm newborns (M=30.9 weeks of gestational age) and 25 mothers with fullterm newborns (M=39.7 weeks of gestational age). Both groups were matched for infant sex, age (corrected in preterms) and birth order as well as for maternal age and education. Semi-structured interviews were used to collect data on maternal attitudes and feelings about pregnancy and the first contacts with the newborn. Mothers completed rating scales to indicate the specific behavioural problems they perceived in their infants at 6 weeks and 3 months of (corrected) age. Observations of infant responses to visual and/or auditory stimuli were made at 6 weeks and 3 months in a laboratory setting. At 3 months, each infant was administered the Bayley Scale of Mental Development. There were no differences in maternal attitudes and feelings between the two groups of mothers prior to the birth. However, significant differences appeared after birth and indicated increased anxiety in mothers of preterm infants. Significantly more 6-week-old preterm infants were perceived by their mothers as irritable and to cry more than fullterm infants. At the age of 3 months, both groups of infants differed only in terms of irritability. Differences between the two groups of mother–infant dyads, age-related changes in these differences and relationships between maternal evaluations and the laboratory-based assessments are discussed in the context of contrasts in the stability of behavioural regulation in preterm and fullterm infants.     

Dimensions of Early Childhood Behavior Problems: Stability and Predictors of Change from 18 to 30 Months

The prevalence, structure, stability, and predictors of change in early behavior problems were examined in a population-based sample of Norwegian children at 18 and 30 months of age (N = 750). A clear factor structure involving four dimensions emerged at both assessment times: Two factors were characterized by externalizing behaviors and were labeled Social Adjustment and Overactive-Inattentive; one factor tapped internalizing problems and was labeled Emotional Adjustment; and the fourth, related to general immaturity, was labeled Regulation. Specific patterns of child and family risk factors were associated with stability and change over the two time points for each factor. Children with stable problems had the most problematic characteristics on all significant predictors, followed by children with problems at one, but not both, time points. The data suggest that it is possible to identify risk factors for stable problems at 18 months, allowing some prediction of those children whose problems will persist over early childhood. Since specific risk factors emerged for specific types of behavior problems, the results may provide some much-needed guidance to early intervention efforts.     

The Therapeutic Factors Inventory: Development of a Scale

Although Yalom's (1995) framework of the therapeutic factors facilitating outcome in group has been accepted by group specialists, no empirically based instrument assesses all of these factors. The Therapeutic Factors Inventory (TFI), with 11 scales based on the therapeutic factors, has been designed to fill this gap. This article summarizes the development and preliminary reliability testing of the TFI. Each scale of the instrument demonstrated high internal consistency; however, one scale obtained unacceptably low test-retest reliability. Further validity testing is needed. Implications of these findings are discussed.