Chronic pain: Avoidance or endurance?

  • Karsdorp P
  • Vlaeyen J
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Comments on the original article, 'Fear-avoidance- and endurance-related responses to pain: Development and validation of the Avoidance-Endurance Questionnaire (AEQ),' by M. I. Hasenbring, D. Hallner, and A. C. Rusu (see record [rid]2009-08762-013[/rid]). In the last decade several novel theoretical models have been developed trying to delineate subgroups of patients with chronic pain that are characterized by either excessive avoidance or persistence behaviour (e.g. Van Houdenhove 1986; Hasenbring, 2000). However, evidence for these models is scarce. One of these models is the avoidance-endurance model proposed by Hasenbring et al. (2009) in this issue of EJP. According to this model, two subgroups of patients may be classified based on specific affective, cognitive, and behavioural responses. This study is one of the first providing supportive evidence for the avoidance-endurance model. Particularly new about it is that it delineates patients developing chronic pain as a result of endurance behaviour. However, caution is warranted in generalizing from the results as the findings are correlational and therefore do not elucidate the exact mechanisms by which endurance responses contribute to pain and disability. We reflect on the three endurance responses, persistence behaviour, suppression of pain-related thoughts, and positive affect separately and raise some theoretical questions about the mechanisms by which these responses influence pain and disability levels. (PsycINFO Database Record (c) 2016 APA, all rights reserved)




Karsdorp, P. A., & Vlaeyen, J. W. S. (2009). Chronic pain: Avoidance or endurance? European Journal of Pain, 13(6), 551–553.

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