Association of fear-avoidance and self-efficacy on pain disability in individuals with co-morbid post-traumatic stress and chronic pain

Anna Devlin, Sara Casey, Scott Williams, Melita Giummarra

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This study investigated relationships between post-traumatic stress symptoms (PTSS) and pain disability. Fifty people with chronic pain (probable PTSD, n = 22) completed measures assessing pain interference, PTSS, fear avoidance, and pain self-efficacy. We hypothesized that people with probable PTSD would have higher fear avoidance and lower pain self-efficacy; and that PTSS would be indirectly associated with pain disability via fear avoidance and self-efficacy. People with probable PTSD had higher fear avoidance, but there were no differences in self-efficacy, pain severity or disability. There was an indirect association between PTSS and pain disability via fear avoidance, but not via self-efficacy.

Original languageEnglish
Pages (from-to)188-198
Number of pages11
JournalJournal of Health Psychology
Issue number1
Publication statusPublished - Jan 2022


  • fear avoidance
  • pain
  • post-traumatic stress
  • self-efficacy
  • trauma

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