Assessment of pain-related fear in individuals with chronic painful conditions

Manasi M Mittinty,1 Daniel W McNeil,2,3 David S Brennan,1 Cameron L Randall,4 Murthy N Mittinty,5 Lisa Jamieson1 1Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia; 2Department of Dental Practice and Rural Health, School of Dentistry, West Virginia University, Morgantown, WV, USA; 3Department of Psychology, Eberly College of Arts and Sciences, West Virginia University, Morgantown, WV, USA; 4Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, WA, USA; 5School of Public Health, The University of Adelaide, Adelaide, SA, Australia Background: Heightened fear and anxiety related to pain may result in emotional and behavioral avoidance responses causing disability, distress, and depression. Fear and anxiety associated with pain can potentially change the course of the pain experience. It is plausible that fear and anxiety related to pain affect the duration and frequency of pain experienced by the patient. Aim: The study aimed to examine the applicability of the Fear of Pain Questionnaire-III (FPQ-III) in identifying who are likely to report longer duration and greater frequency of pain experience. Methods: To test this hypothesis, a cross-sectional study was conducted with 579 individuals from a community-based sample living with chronic pain. The factor structure and validity of FPQ-III in the community-based sample were also tested. Results: The findings suggest higher fear of severe pain but lower fear of medical pain, associated with longer duration and more frequent pain experience. The analysis also confirmed the three-factor structure of FPQ-III, demonstrating good internal consistency for fear of severe pain (0.71) and fear of medical pain (0.73) and acceptable range for fear of minor pain (0.65). Conclusion: These findings suggest that the FPQ-III can be potentially applied to identify individuals at risk for prolonged continuous pain and as a screening tool to measure fear and anxiety related to pain. Keywords: fear of pain, fear related to pain, chronic pain, duration of pain, frequency of pai