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Pain Research and Management
Volume 2016, Article ID 8281926, 7 pages
Research Article

The Relation between the Fear-Avoidance Model and Constructs from the Social Cognitive Theory in Acute WAD

Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Box 883, 721 23 Västerås, Sweden

Received 30 March 2016; Accepted 26 October 2016

Academic Editor: Frauke Musial

Copyright © 2016 Maria Sandborgh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In the fear-avoidance (FA) model social cognitive constructs could add to explaining the disabling process in whiplash associated disorder (WAD). The aim was to exemplify the possible input from Social Cognitive Theory on the FA model. Specifically the role of functional self-efficacy and perceived responses from a spouse/intimate partner was studied. A cross-sectional and correlational design was used. Data from 64 patients with acute WAD were used. Measures were pain intensity measured with a numerical rating scale, the Pain Disability Index, support, punishing responses, solicitous responses, and distracting responses subscales from the Multidimensional Pain Inventory, the Catastrophizing subscale from the Coping Strategies Questionnaire, the Tampa Scale of Kinesiophobia, and the Self-Efficacy Scale. Bivariate correlational, simple linear regression, and multiple regression analyses were used. In the statistical prediction models high pain intensity indicated high punishing responses, which indicated high catastrophizing. High catastrophizing indicated high fear of movement, which indicated low self-efficacy. Low self-efficacy indicated high disability, which indicated high pain intensity. All independent variables together explained 66.4% of the variance in pain disability, . Results suggest a possible link between one aspect of the social environment, perceived punishing responses from a spouse/intimate partner, pain intensity, and catastrophizing. Further, results support a mediating role of self-efficacy between fear of movement and disability in WAD.