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.     

Type D personality predicts poor medication adherence in myocardial infarction patients

Type D personality, the combination of negative affectivity (NA) and social inhibition (SI), is an emerging risk factor in cardiovascular disease. This study aimed to examine one possible behavioural mechanism to explain the link between Type D and ill-health. It was hypothesised that Type D personality would predict medication adherence in myocardial infarction (MI) patients. In a prospective study, 192 MI patients (54 females and 138 males) completed measures of Type D personality and provided demographic and medical information 1 week post-MI, and then 131 patients went on to complete a self-report measure of medication adherence 3 months post-MI. It was found that Type D personality predicts adherence to medication, after controlling for demographic and clinical risk factors. Critically, the constituent components of Type D, NA and SI, interact to predict medication adherence, after controlling for the effects of each component separately. Poor adherence to medication may represent one mechanism to explain why Type D cardiac patients experience poor clinical outcome, in comparison to non-Type D patients. Interventions, which target the self-management of medication, may be useful in these high-risk patients.     

Book Review of Health and the Construction of the Individual. J. Ogden. London: Routledge, 2002. i–viii + 130 pages ISBN 0415233070

Abstract

Recent theoretical and empirical research has challenged the assumption of health psychologists employing social cognitive models that beliefs can confidently be inferred on the basis of questionnaire responses. It is charged that responses to questionnaires are a function of the intelligibility of the items, constructs and theoretical framework to survey participants. To investigate this contention, cognitions specified by Protection Motivation Theory (PMT) were measured with respect to intentions to use a condom and intentions to use dental floss. Three alternative formats of a questionnaire which varied the order of presentation of PMT items were distributed to student samples. Analyses showed that while questionnaire format did not affect the reliability of cognition measures, there was some variation in the significance and strength of correlations between PMT cognitions across formats. Individual differences in social desirability and salience of the target behaviour had small and predictable effects upon reliabilities and intercorrelations. Implications for the measurement of health beliefs and the status of questionnaire responses are outlined and suggestions are made for controlling bias associated with respondents' capacity to “read” a questionnaire.     

Validity of the Rey Visual Design Learning Test in Primary and Secondary School Children

Studies on adults have revealed a disadvantageous effect of negative emotional stimuli on executive functions (EF), and it is suggested that this effect is amplified in children. The present study’s aim was to assess how emotional facial expressions affected working memory in 9- to 12-year-olds, using a working memory task with emotional facial expressions as stimuli. Additionally, we explored how degree of internalizing and externalizing symptoms in typically developing children was related to performance on the same task. Before employing the working memory task with emotional facial expressions as stimuli, an independent sample of 9- to 12-year-olds was asked to recognize the facial expressions intended to serve as stimuli for the working memory task and to rate the facial expressions on the degree to which the emotion was expressed and for arousal to obtain a baseline for how children during this age recognize and react to facial expressions. The first study revealed that children rated the facial expressions with similar intensity and arousal across age. When employing the working memory task with facial expressions, results revealed that negatively valenced expressions impaired working memory more than neutral and positively valenced expressions. The ability to successfully complete the working memory task increased between 9 to 12 years of age. Children’s total problems were associated with poorer performance on the working memory task with facial expressions. Results on the effect of emotion on working memory are discussed in light of recent models and empirical findings on how emotional information might interact and interfere with cognitive processes such as working memory.     

Life design counselling effects on the career adaptability of learners in a selective independent school setting

This collective case study applied life design counselling to augment the career adaptability of learners in a South African independent school setting. Five purposively selected learners attending Grade 11 (age range: 16–18) completed eight group-based life design counselling sessions. Data on their career adaptability pre- and post-intervention were gathered from sessional notes. The data were thematically analysed. Following the intervention the participants displayed improved career adaptability as evidenced by their demonstrated efforts to address aspects related to career concern, control, curiosity and confidence. Life design counselling appeared to have a positive effect on the career adaptability of learners in an independent school setting.     

Career Counselling: The Usefulness of the Career Interest Profile (CIP)

This study reports the findings from exploratory career counselling with Italian undergraduate university students using the Career Interest Profile (CIP). The participants (n = 178, females = 51.69%; mean age 22.28, SD = 1.59 years) received elective career counselling on campus. The students completed the CIP and the Self-Directed Search (SDS). Data were analyzed using both qualitative and quantitative approaches. The CIP yielded satisfactory results with regard to trustworthiness and intercorrelations with the SDS and provides career counsellors with a useful instrument for the identification of interest profiles of Italian undergraduate university students. Participants reported being enabled to explore prospective career interest areas using career-story narratives for constructing life trajectories and enhanced development of their career stories.     

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No abstract available for this article.     

Assessment of dental anxiety: A facet approach

Dental anxiety is a complicated phenomenon, and its multicomponent nature is often not acknowledged in existing measurement instruments. Using a facet design, a new Dental Anxiety Inventory (DAI) was constructed. Facets chosen were: time (made up of four elements: at home, on your way to the denstist, in the denstist's waiting room, in the dental chair), situation (three elements: introductory aspects, dentist-patient interaction, actual dental treatment), and reaction (three elements: subjective feelings, physical reactions, cognitive reactions). Psychometric qualities of the DAI are good. The internal structure of the DAI was studied by linear and nonlinear techniques, and was partially recovered from the data. The construct and criterion validity of the DAI was supported in several studies.