Elsevier

The Journal of Pain

Volume 12, Issue 10, October 2011, Pages 1049-1058
The Journal of Pain

Original Report
Activity Patterns in Chronic Pain: Underlying Dimensions and Associations With Disability and Depressed Mood

https://doi.org/10.1016/j.jpain.2011.04.009Get rights and content
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Abstract

Activity patterns are believed to play an important role in the development and perpetuation of chronic pain. So far, 3 important activity patterns have been studied: avoidance behavior, persistence behavior, and pacing behavior. Yet, empirical evidence is limited and inconclusive about the relationships between these activity patterns and important outcomes. Therefore, the present study was aimed at identifying activity patterns by means of factor analyses and determining their relationship with disability and depressive symptomatology in participants with chronic pain (N = 132). Items across different measurement instruments pertaining to 1 particular activity pattern were aggregated, and submitted to factor analysis. Results from 3 separate factor analyses revealed 6 distinct activity patterns: pain avoidance, activity avoidance, task-contingent persistence, excessive persistence, pain-contingent persistence, and pacing. In line with our hypotheses, pain and activity avoidance, and excessive persistence, were related to higher levels of disability and depressive symptomatology. In contrast to hypotheses, pacing was associated with worse outcomes as well. Interestingly, task-contingent persistence was related to lower levels of disability and depressive symptomatology. When controlling for pain and the other activity patterns, excessive persistence and activity avoidance were the most detrimental in terms of relations with depressed mood or disability. Task-contingent persistence appeared to be the least detrimental.

Perspective

Our findings suggest the existence of several activity patterns, which are differentially related to disability and depressive symptomatology, in participants with chronic pain. The present results are discussed in the light of previous findings, and may provide a new impetus for future studies on activity patterns in chronic pain research.

Key words

Activity patterns
avoidance
pacing
persistence
disability
chronic pain
depression

Cited by (0)

Supported by the Council for Medical and Health Research of the Netherlands (Zon-MW), Grant nr. 14350042. Contribution of Johan W.S. Vlaeyen was supported by the NWO Social Sciences Research Council of The Netherlands, Grant nr. 453-04-003. Participation of Dr. Roelofs was supported by the EFIC-Grünenthal Grant (EGG).