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Biomedical subjects

Johan Vlaeyen

Publications and source records attributed to Johan Vlaeyen.

4 recordsLinked to original sources
PubMed2006

An experimental investigation on attentional interference by threatening fixations of the neck in patients with chronic whiplash syndrome.

Previous studies using a primary task procedure have demonstrated that an experimental pain stimulus interrupts ongoing task performance in healthy volunteers and patients, and that this interruption is intensified by catastrophic thinking about pain and the perceived threat value of the pain stimulus. However, no studies have investigated the interruption of attention by relevant threatening stimuli in specific patient samples. In the present study, 40 patients with chronic whiplash syndrome and 40 healthy controls performed a primary task while simultaneously a potentially threatening neck fixation (i.e., extension and rotation) was imposed. Pain catastrophizing, fear of movement/(re)injury, hypervigilance, and depression were assessed. The patients showed a more pronounced deterioration of performance compared to controls when the neck rotation and extension fixations were introduced. Within the groups, neither catastrophic thinking nor fear predicted the magnitude of the performance deterioration.

Anxiety↗
PubMed2004

Lowering fear-avoidance and enhancing function through exposure in vivo. A multiple baseline study across six patients with back pain.

This study investigated the effects of an exposure in vivo treatment for chronic pain patients with high levels of fear and avoidance. The fear-avoidance model offers an enticing explanation of why some back pain patients develop persistent disability, stressing the role of catastrophic interpretations; largely fueled by beliefs and expectations that activity will cause injury and will worsen the pain problem. Recently, an exposure in vivo treatment was developed that aims to enhance function by directly addressing these fears and expectations. The purpose of this study was to describe the short-term, consequent effect of an exposure in vivo treatment. The study employed a multiple baseline design with six patients who were selected based on their high levels of fear and avoidance. The results demonstrated clear decreases in rated fear and avoidance beliefs while function increased substantially. These improvements were observed even though rated pain intensity actually decreased somewhat. Thus, the results replicate and extend the findings of previous studies to a new setting, with other therapists and a new research design. These results, together with the initial studies, provide a basis for pursuing and further developing the exposure technique and to test it in group designs with larger samples.

Adult↗
PubMed2002

The back pain beliefs of health care providers: are we fear-avoidant?

The purpose of this study was to survey the level of fear-avoidance beliefs for practicing general practitioners and physical therapists and to relate this to self-reported practice behaviors for patients with back pain. To this end, 60 general practitioners and 71 physical therapists were recruited. These participants completed a questionnaire including 11 items slightly revised from instruments designed to assess fear-avoidance beliefs in patients, and four items about treatment practices. The results indicated that these health care practitioners on the average generally held beliefs that are consistent with the current evidence, but there were also indications that some practitioners held beliefs reflecting fear-avoidance. More than two-thirds reported that they would advise a patient to avoid painful movements, more than one-third believed a reduction in pain is a prerequisite for return-to-work, while more than 25% reported that they believe sick leave is a good treatment for back pain. These beliefs were found to be related to reported practice behavior. Those with high levels of fear-avoidance beliefs were compared to those with low levels. Those with high levels of fear-avoidance belief had an increased risk for believing sick leave to be a good treatment (RR = 2.0; 90%CI = 1.02-3.92), not providing good information about activities (RR = 1.7; 90%CI = 1.19-2.45), and being uncertain about identifying patients at risk for developing persistent pain problems (RR = 1.5; 90%CI = 1.00-2.27). It is concluded that some practitioners hold beliefs reflecting fear-avoidance and that these beliefs may influence treatment practice.

Attitude of Health Personnel↗