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De rol van angst bij pijn: theoretische aspecten

  • Chapter
Graded Exposure

Samenvatting

Chronische pijn wordt tegenwoordig vanuit een biopsychosociaal perspectief benaderd, met aandacht voor zowel biologische, psychologische als sociale factoren. Een van de invloedrijkste biopsychosociale modellen voor chronische pijn is het vreesvermijdingsmodel. Volgens dit model is pijngerelateerde angst – oftewel een vaak buitensporige vermijdingsreactie op geanticipeerde pijn – een prominente factor in zowel de ontwikkeling als het behoud van chronische pijnproblemen. Deze pijngerelateerde angst komt meestal tot stand via associatieve leerprocessen, namelijk via pavloviaanse ofwel instrumentele conditionering, rechtstreeks contact, observatie van anderen, of verbale informatie, en is meetbaar aan de hand van verbale, gedragsmatige en psychofysiologische responsen. Pijngerelateerde angst leidt niet alleen tot vermijding van pijnlijke activiteiten, maar kan ook generaliseren tot een veralgemeende inactiviteit, die vaak gepaard gaat met een negatief affect. Door de zeer grote invloed van de angst voor pijn op het dagelijks leven is het reduceren van pijngerelateerde angst vaak een doelwit van behandelingen die patiënten met pijn trachten te activeren. Vaak wordt een beroep gedaan op extinctieprocedures, waarbij de patiënt wordt blootgesteld aan de angst uitlokkende stimuli; dit stelt hem in staat de verwachting dat er catastrofale gevolgen optreden, uit te dagen. Exposure wordt beschouwd als het klinische equivalent van een typische extinctieprocedure.

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Authors and Affiliations

  1. Vakgroep Gezondheidspsychologie, KU Leuven, Leuven, Belgium

    N. Claes

  2. Vakgroep Revalidatiegeneeskunde, Vakgroep Clinical Psychological Science, Universiteit Maastricht, Maastricht, The Netherlands

    M. E. J. B. Goossens

  3. KU Leuven, Leuven, Belgium

    J. W. S. Vlaeyen

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  1. N. Claes
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Editors and Affiliations

  1. Zorggroep Adelante en vakgroep revalidatiegeneeskunde, Maastricht UMC, Maastricht, The Netherlands

    J.A. Verbunt

  2. Libra Revalidatie en Audiologie, Universiteit Maastricht, Maastricht, The Netherlands

    R.J.E.M. Smeets

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Claes, N., Goossens, M.E.J.B., Vlaeyen, J.W.S. (2017). De rol van angst bij pijn: theoretische aspecten. In: Verbunt, J., Smeets, R. (eds) Graded Exposure. Bohn Stafleu van Loghum, Houten. https://doi.org/10.1007/978-90-368-1106-4_1

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