Abstract

Background. Anxiety sensitivity (AS) and experiential avoidance (EA) have been shown to have an interactive effect on the response an individual has to chronic pain (CP) potentially resulting in long term negative outcomes. Objective. The current study attempted to (1) identify distinct CP subgroups based on their level of EA and AS and (2) compare the subgroups in terms of mood and disability. Methods. Individuals with CP were recruited from an academic pain clinic. Individuals were assessed for demographic, psychosocial, and personality measures at baseline and 1-year follow-up. A cluster analysis was conducted to identify distinct subgroups of patients based on their level of EA and AS. Differences in clinical outcomes were compared using the Repeated Measures MANOVA. Results. From a total of 229 participants, five clusters were formed. Subgroups with lower levels of AS but similar high levels of EA did not differ in outcomes. Mood impairment was significantly greater among those with high levels of EA compared to lower levels (p < 0.05). Significant improvement in disability (p < 0.05) was only seen among those with lower levels of EA and AS. Conclusions. This cluster analysis demonstrated that EA had a greater influence on mood impairment, while both EA and AS levels affected disability outcomes among individuals with CP.

Highlights

  • Anxiety plays a significant role in a patient’s response to pain

  • The booklet consisted of background information related to the patient’s demographic characteristics and the following questionnaires: Anxiety Sensitivity Index (ASI), Acceptance to Action Questionnaire (AAQ), average pain intensity, Depression Anxiety Stress Scales-Short Form (DASS-SF), and Pain Disability Index (PDI)

  • The two-step cluster analysis divided participants into five clusters based on levels of Anxiety sensitivity (AS) and experiential avoidance (EA)

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Summary

Introduction

Anxiety plays a significant role in a patient’s response to pain. A key concept of anxiety is anxiety sensitivity (AS), which is defined as the fear of anxiety-related sensations; fear of bodily sensations due to beliefs that these sensations will have a negative somatic, cognitive, or social consequence [1]. AS may result in maladaptive coping among individuals with chronic pain, leading to negative outcomes. For some patients the daily struggles of chronic pain become overwhelming, especially if they have high levels of AS. This can compel individuals to present experiential avoidant behavior and become self-protective and avoidant of potential threats related to pain. Anxiety sensitivity (AS) and experiential avoidance (EA) have been shown to have an interactive effect on the response an individual has to chronic pain (CP) potentially resulting in long term negative outcomes. This cluster analysis demonstrated that EA had a greater influence on mood impairment, while both EA and AS levels affected disability outcomes among individuals with CP

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