Evidence map›Paper›PMID 35727200›Full record

SynthesisEuropean journal of pain (London, England)2022

A meta-analysis of the associations of elements of the fear-avoidance model of chronic pain with negative affect, depression, anxiety, pain-related disability and pain intensity.

Andrew H Rogers, Samantha G Farris

Registry-linked trialAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European journal of pain (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07404384 (Impact of Slow Breathing and Its Interaction With Psychological Variables From the Fear-Avoidance Model of Pain on Heart Rate Variability and Resistance Exercise Performance in Women With Fibromyalgia.), which is not on this map. Cited by 152 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
152citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07404384 naenrolling by invitationnot on this mapstarted 2026, after this paper: background citation

Impact of Slow Breathing and Its Interaction With Psychological Variables From the Fear-Avoidance Model of Pain on Heart Rate Variability and Resistance Exercise Performance in Women With Fibromyalgia.

TypeinterventionalSponsorUniversity of MalagaRan2026 to 2027Enrolled159ConditionsFibromyalgia, Fibromyalgia SyndromeArmsSlow Breathing with Visual Pacer, Slow Breathing without Visual Pacer, Spontaneous Breathing (Active Control)
3 · Its place in the literature

Who cites it

152 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  3. A Systematic Review of Pain Catastrophizing and Chronic Musculoskeletal Pain.Pain management nursing : official journal of the American Society of Pain Management Nurses · 2026
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92 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Andrew H RogersDepartment of Psychology, University of Houston, Houston, Texas, USA.ORCID 0000-0003-0755-8659
Samantha G FarrisDepartment of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveBiopsychosocial conceptualizations of clinical pain conditions recognize the multi-faceted nature of pain experience and its intersection with mental health. A primary cognitive-behavioural framework is the Fear-Avoidance Model, which posits that pain catastrophizing and fear of pain (including avoidance, cognitions and physiological reactivity) are key antecedents to, and drivers of, pain intensity and disability, in addition to pain-related psychological distress. This study aimed to provide a comprehensive analysis of the magnitude of the cross-sectional association between the primary components of the Fear-Avoidance Model (pain catastrophizing, fear of pain, pain vigilance) with negative affect, anxiety, depression, pain intensity and disabilities in studies of clinical pain. DATABASES AND DATA TREATMENT: A search of MEDLINE and PubMed databases resulted in 335 studies that were evaluated in this meta-analytic review, which represented 65,340 participants.

resultsResults from the random effect models indicated a positive, medium- to large-sized association between fear of pain, pain catastrophizing, and pain vigilance measures and outcomes (pain-related negative affect, anxiety, depression and pain-related disability) and medium-sized associations with pain intensity. Fear of pain measurement type was a significant moderator of effects across all outcomes.

conclusionsThese findings provide empirical support, aligned with the components of the fear-avoidance (FA) model, for the relevance of both pain catastrophizing and fear of pain to the pain experience and its intersection with mental health. Implications for the conceptualization of the pain catastrophizing and fear of pain construct and its measurement are discussed. SIGNIFICANCE: This meta-analysis reveals that, among individuals with various pain conditions, pain catastrophizing, fear of pain, and pain vigilance have medium to large associations with pain- related negative affect, anxiety, and depression, pain intensity and disability. Differences in the strength of the associations depend on the type of self-report tool used to assess fear of pain.

Indexed as

Chronic PainAnxietyCatastrophizationCross-Sectional StudiesDepressionFearHumansPain MeasurementPhobic DisordersSurveys and Questionnaires

Identifiers

PMID35727200
PMCPMC9541898

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.