ArticleSchmerz (Berlin, Germany)2026
[Avoidance-endurance fast screen : AEFS validation with one- and two-level response scaling in healthy subjects].
Article in Schmerz (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
objectivesChronic pain affects an enormous number of patients in Germany. Therefore, early detection is important using easy, quick and reasonable screening methods. The avoidance-endurance fast screen is currently available in two different versions: one asking for pain-related behaviour in light and severe pain and the other assessing overall severe pain-related behaviour. In this study we aim to examine the agreement between both scales and for the first time describe the role of protective psychological features such as resilience and self-compassion in this model. MATERIALS AND
methodsEpidemiological cross-sectional study (n = 278) of a healthy cohort occasionally experiencing pain (< 3 months). The analysis was done using standard descriptive statistics, correlations (Spearman's rho) and deductive statistics (t-tests and one-factor ANOVA with post hoc Bonferroni correction) and effect sizes (Cohen's d). Matching of the instruments was calculated with Cohen's kappa.
resultsThe results showed a moderate agreement for the two versions. A validity check of the subgroups resulted in comparable findings. The one-level version scored higher in terms of pain persistence which caused subgroup changes from adaptive to eustress-endurance responses and from fear-avoidance to distress-endurance responses. The distress-endurance subgroup had significantly lower values of the trait self-compassion.
conclusionsBased on the results of this study, the quality of agreement between the two AEFS versions is considered strong. Without the comparison between mild and strong pain, endurance behaviour was reported more often. According to these findings, overestimation of pain persistence behaviour using the one-level version might result. Therefore, future studies should re-evaluate the cut-offs. As reported in previous studies, protective psychological features showed the highest scores in the eustress-endurance subgroup.
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