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De rol van angst bij de ontwikkeling en instandhouding van chronische pijn

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gedrag en gezondheid

Summary

The role of anxiety-related constructs in the onset and exacerbation of chronic pain

Chronic pain is an important health problem in present society, involving major personal and societal costs. Therefore, it is important to identify the factors and mechanisms that underlie the development and maintenance of chronic pain. The biopsychosocial view on pain acknowledges the influence of biological, psychological and social factors in (chronic) pain. Among the psychological factors, an important role is assigned to emotional and affective factors, like anxiety. The link between pain and anxiety can be adaptive in some cases, since the fear of pain acts as a warning signal and a protective mechanism against potential tissue damage. However, fear of pain is also considered to be a building stone for the transition from acute to chronic pain. Besides the fear of pain, anxiety sensitivity, injury/illness sensitivity, and pain catastrophizing have been proposed as important contributors to the onset and maintenance of chronic pain. The exact role of these anxiety and fear constructs in pain processes has been studied in both clinical and healthy populations. Up to now, results of these studies have demonstrated the relation between these constructs and subjective pain experiences, physical, and cognitive impairments. It can be concluded that anxiety and fear constructs that are related to pain are important to be considered in the explanation and treatment of chronic pain disorders.

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Figuur 1
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Notes

  1. In dit artikel worden zowel de term ’vrees’ als ’angst’gehanteerd. Hoewel beide termen vaak door elkaar heen gebruikt worden, wordt in de literatuur een conceptueel onderscheid gemaakt tussen beide begrippen, waarbij vrees gekenmerkt wordt door de gerichtheid op een duidelijk aanwijsbaar object terwijl angst veeleer onbestemd is (Asmundson, Norton & Vlaeyen, 2004). In de praktijk gaan vrees en angst vaak samen en beïnvloeden zij elkaar wederzijds. In overeenstemming met de meest gebruikte term in de literatuur gebruiken wij in dit artikel ’pijngerelateerde vrees’ als verwijzing naar het specifiek angstgerelateerde construct dat is opgenomen in het vreesvermijdingsmodel. De fundamentele angsten worden opgevat als algemenere angstconstructen, die gekenmerkt worden door hun gerichtheid op een bepaald domein (lichamelijke sensaties, ziekte en verwonding).

Literatuur

  • Asmundson, G.J.G., Norton, P.J., & Veloso, F. (1999). Anxiety sensitivity and fear of pain in patients with recurring headaches. Behaviour Research and Therapy, 37, 703-713.

    Article  CAS  PubMed  Google Scholar 

  • Asmundson, G.J.G., Norton, P.J., & Vlaeyen, J.W.S. (2004). Fear-avoidance models of chronic pain: an overview. In G.J. Asmundson, J.W. Vlaeyen & G. Crombez (Eds.), Understanding and treating fear of pain (pp. 3-50). New York: Oxford University Press.

    Google Scholar 

  • Asmundson, G.J.G., Carleton, R.N., & Ekong, J. (2006). Dot probe evaluation of selective attentional processing of pain cues in patients with chronic headaches. Pain, 114, 250- 256.

    Article  Google Scholar 

  • Asmundson, G.J.G., Wright, K.D., & Hadjistavropoulos, H.D. (2000). Anxiety sensitivity and disabling chronic health conditions: state of the art and future directions. Scandinavian Journal of Behaviour Therapy, 29, 100-117.

    Article  Google Scholar 

  • Crombez, G., Eccleston, C., Baeyens, F., & Eelen, P. (1998). When somatic information threatens, catastrophic thinking enhances attentional interference. Pain, 75, 187-198.

    Article  CAS  PubMed  Google Scholar 

  • Crombez, G., Vlaeyen, J.W.S., Heuts, P.H.G.T., & Lysens R. (1999) Fear of pain is more disabling than pain itself. Evidence on the role of pain-related fear in chronic back pain disability. Pain, 80, 329-340.

    Article  CAS  PubMed  Google Scholar 

  • De Houwer, J. (2003). The Extrinsic Affective Simon Task. Experimental Psychology, 50, 77-85.

    PubMed  Google Scholar 

  • Eysenck, M. W. (1997). Anxiety and Cognition: A Unified Theory. Hove: Psychology Press/Erlbaum.

    Google Scholar 

  • Gatchel, R.J., Peng, Y.B., Peters, M.L., Fuchs, P.N., & Turk, D.C. (2006). The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin, in druk.

  • George, S.Z., Dannecker, E.A., & Robinson, M.E. (2006). Fear of pain, not pain catastrophizing, predicts acute pain intensity, but neither factor predicts tolerance or blood pressure reactivity: An experimental investigation in pain-free individuals. European Journal of Pain, 10, 457- 465.

    Article  PubMed  Google Scholar 

  • Goubert, L., Crombez, G., & De Bourdeaudhuij, I. (2004). Low back pain, disability and back pain myths in a community sample: prevalence and interrelationships. European journal of pain, 8, 385-394.

    Article  PubMed  Google Scholar 

  • Jensen, M., Brant-Zawadzki, M., Obuchowski, N., Modic, M., Malkasian, D., & Ross, J. (1994). Magnetic resonance imaging of the lumbar spine in people without back pain. The New England Journal of Medicine, 331, 69-73.

    Article  CAS  PubMed  Google Scholar 

  • Jong, J.R. de, Vlaeyen, J.W., Onghena, P., Goossens, M.E., Geilen, M., & Mulder, H. (2005). Fear of movement/(re)injury in chronic low back pain: education or exposure in vivo as mediator to fear reduction? Clinical Journal of Pain, 21, 9-17.

    Article  PubMed  Google Scholar 

  • Kerssens, J. J., Verhaak, P. F. M., Bartelds, A. I. M., Sorbi, M. J., & Bensing, J. M. (2002). Unexplained severe chronic pain in general practice. European Journal of Pain, 6, 203-212.

    Article  CAS  PubMed  Google Scholar 

  • Keogh, E., & Asmundson, G.J.G. (2004). Negative affectivity, catastrophizing and anxiety sensitivity. In G.J. Asmundson, J.W. Vlaeyen & G. Crombez (Eds.), Understanding and treating fear of pain (pp. 91- 115). New York: Oxford University Press.

    Google Scholar 

  • Keogh, E., & Cochrane, M. (2002). Anxiety sensitivity, cognitive biases, and the experience of pain. The Journal of Pain, 3, 320-329.

    Article  PubMed  Google Scholar 

  • Keogh, E., Hamid, R., Hamid, S., & Ellery, D. (2004). Investigating the effect of anxiety sensitivity, gender and negative interpretative bias on the perception of chest pain. Pain, 111, 209-217.

    Article  PubMed  Google Scholar 

  • Keogh, E., & Mansoor, L. (2001). Investigating the effects of anxiety sensitivity and coping on the perception of cold pressor pain in healthy women. European Journal of Pain, 5, 11-25.

    Article  CAS  PubMed  Google Scholar 

  • Kori, S. H., Miller, R.P., & Todd, D.D. (1990). Kinesiophobia: A new view of chronic pain behavior. Pain Management, 35-43.

  • Leeuw, M., Vlaeyen, J.W.S., & Goossens, M.E. (2005). Exposure in vivo bij chronische lage rugpijn. De Psycholoog, 40, 174-180.

    Google Scholar 

  • Lethem, J., Slade, P.D., Troup, J.D.G., & Bentley, G. (1983). Outline of a fear-avoidance model of exaggerated pain perception- I. Behaviour Research and Therapy, 21, 401-408.

    Article  CAS  PubMed  Google Scholar 

  • Lilienfeld, S.O. (1996). Anxiety sensitivity is not distinct from trait anxiety. In R.M. Rapee (Ed.), Current controversies in the anxiety disorders (pp. 228-244). New York: The Guilford Press.

    Google Scholar 

  • McNeil, D.W., & Rainwater, A.J. (1998). Development of the Fear of Pain Questionnaire-III. Journal of Behavioral Medicine, 21, 389-410.

    Article  CAS  PubMed  Google Scholar 

  • Peters, M.L., Vlaeyen, J.W.S., & Kunnen, A.M.W. (2002). Is pain-related fear a predictor of somatosensory hypervigilance in chronic low back pain patients? Behaviour Research and Therapy, 40, 85 - 103.

    Article  PubMed  Google Scholar 

  • Peterson, R.A., & Heilbronner, R.L. (1987). The Anxiety Sensitivity Index: construct validity and factor analytic structure. Journal of Anxiety Disorders, 1, 117-121.

    Article  Google Scholar 

  • Picavet, H.S.J., & Schouten, J.S.A.G. (2003). Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3- study. Pain, 102, 167-178.

    Article  CAS  PubMed  Google Scholar 

  • Picavet, H.S., Vlaeyen, J.W., & Schouten, J.S.A.G. (2002). Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. American Journal of Epidemiology, 156, 1028-1034.

    Article  PubMed  Google Scholar 

  • Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141-153.

    Article  Google Scholar 

  • Reiss, S., Peterson, R.A., Gursky, D. M., & McNally, R.J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1- 8.

    Article  CAS  PubMed  Google Scholar 

  • Roelofs, J., Peters, M.L., Deutz, J., Spijker, C., & Vlaeyen, J.W.S. (2005). The Fear of Pain Questionnaire (FPQ): Further psychometric examination in a non-clinical sample. Pain, 116, 339-346.

    Article  PubMed  Google Scholar 

  • Schmidt, N.B., & Cook, J.H. (1999). Effects of anxiety sensitivity on anxiety and pain during a cold pressor challenge in patients with panic disorder. Behaviour Research and Therapy, 37, 313-323.

    Article  CAS  PubMed  Google Scholar 

  • Sullivan, M.J.L., Bishop, S.R., & Pivik, J. (1995). The pain catastrophizing scale: development and validation. Psychological Assessment, 7, 524-532.

    Article  Google Scholar 

  • Sullivan, M.J.L., Thorn, B., Haythornthwaite, J.A., Keefe, F., Martin, M., Bradley, L.A., & Lefebvre, J.C. (2001). Theoretical perspectives on the relation between catastrophizing and pain. The Clinical Journal of Pain, 17, 52-64.

    Article  CAS  PubMed  Google Scholar 

  • Taylor, S. (1993). The structure of fundamental fears. Journal of Behavioral therapy and Experimental Psychiatry, 24, 289-299.

    Article  CAS  Google Scholar 

  • Taylor, S. (1995). Anxiety sensitivity: theoretical perspectives and recent findings. Behaviour Research and Therapy, 33, 243-258

    Article  CAS  PubMed  Google Scholar 

  • Vancleef, L.M.G., & Peters, M.L. (2006a). Pain catastrophizing, but not anxiety sensitivity or injury/illness sensitivity enhances attentional interference by pain. The Journal of Pain, 7, 23-30.

    Article  Google Scholar 

  • Vancleef, L.M.G. & Peters, M.L. (2006b). Examining content specificity of negative interpretation biases with the Body Sensations Interpretation Questionnaire (BSIQ). Manuscript aangeboden voor publicatie.

  • Vancleef, L.M.G., Peters, M.L., Gilissen, S & Jong, P.J. de (2006). Understanding the role of injury/illness sensitivity and anxiety sensitivity in pain processing: an examination using the Extrinsic Affective Simon Task (EAST). Manuscript aangeboden voor publicatie.

  • Vancleef, L.M.G., Peters, M.L., Roelofs, J., & Asmundson, G. J. (2006). Do fundamental fears differentially contribute to pain related fear and pain catastrophizing? An evaluation of the sensitivity Index. European Journal of Pain, 10, 527-536.

    Article  PubMed  Google Scholar 

  • Verhaak, P. F., Kerssens, J. J., Dekker, J., Sorbi, M. J., & Bensing, J. M. (1998). Prevalence of chronic benign pain disorder among adults: a review of the literature. Pain, 77, 231- 239.

    Article  CAS  PubMed  Google Scholar 

  • Vlaeyen, J.W.S., Jong, J.R. de., Leeuw, M., & Crombez, G. (2004). Fear reduction in chronic pain: graded exposure in vivo with behavioral experiments. In G. J. Asmundson, J. W.

  • Vlaeyen & G. Crombez (Eds.), Understanding and treating fear of pain. (pp. 313-343). Oxford: University Press.

  • Vlaeyen, J.W.S., Kole-Snijders, A.M.J., Boeren, R.G.B., & Eek, H. van (1995). Fear of movement / (re) injury in chronic low back pain and its relation to behavioral performance. Pain, 62, 363 - 372.

    Article  CAS  PubMed  Google Scholar 

  • Vlaeyen, J.W.S., & Linton, S.J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85, 317 - 332.

    Article  CAS  PubMed  Google Scholar 

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    Linda M. G. Vancleef

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  1. Linda M. G. Vancleef
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Correspondence to Linda M. G. Vancleef.

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Beide auteurs zijn werkzaam bij het Departement Medische, Klinische en Experimentele Psychologie, Universiteit Maastricht. Correspondentieadres: L. Vancleef, Departement Medische, Klinische en Experimentele Psychologie, Universiteit Maastricht, Postbus 616, 6200 MD Maastricht. E-mail:

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Vancleef, L.M.G., Peters, M.L. De rol van angst bij de ontwikkeling en instandhouding van chronische pijn. PSEG 34, 227–235 (2006). https://doi.org/10.1007/BF03071144

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