Related Experiment Video
Updated: Aug 12, 2025
Investigating Pain-Related Avoidance Behavior using a Robotic Arm-Reaching Paradigm
Published on: October 3, 2020
The role of dispositional mindfulness in the fear-avoidance model of pain
Jenna M Wilson1, Ilana Haliwa2, Jerin Lee3
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, United States of America.
Objective:
The fear-avoidance model of pain posits that a painful stimulus is interpreted through pain catastrophizing, which leads to negative downstream cognitions, emotions, and behaviors that shape the experience of pain. As dispositional mindfulness is associated with less catastrophizing and pain, some researchers have suggested incorporating mindfulness into the fear-avoidance model. Across two studies, we empirically tested dispositional mindfulness as a stand-alone component within the fear-avoidance model of pain.
Methods:
Two independent, online cross-sectional surveys (Ns = 362 and 580 U.S. adults) were conducted. Participants completed validated assessments of mindfulness, pain catastrophizing, fear of pain, pain vigilance, depression, pain intensity, and pain sensitivity. Using structural equation modeling, we tested the inclusion of dispositional mindfulness in the fear-avoidance model of pain. We proposed that greater mindfulness would be associated with less pain catastrophizing, which in turn would be associated with less fear of pain, leading to less depression, and then ultimately less pain intensity and pain sensitivity.
Results:
Across both studies, the fear-avoidance model of pain did not fit the data well, with or without mindfulness included. We found that a simplified model fit the data best (Study 1: χ2/df = 1.83; CFI = .981; RMSEA = .049, 90% CI [0.019, 0.076]; SRMR = 0.031; Study 2: χ2/df = 2.23; CFI = .976; RMSEA = .046, 90% CI [0.026, 0.067]; SRMR = .031), such that greater mindfulness was significantly associated with less pain catastrophizing and, in turn, lower levels of pain intensity and pain sensitivity.
Conclusion:
Our findings suggest that a simplified model, compared to the traditional fear-avoidance model, may partly explain the experience of pain among individuals without chronic pain. Future work should examine the temporal associations among these variables to inform the employment of future empirically supported interventions for pain management.
Related Concept Videos
01:14Avoidance Learning and Learned Helplessness
Avoidance learning occurs when an organism learns that a specific behavior can prevent an unpleasant outcome. For example, a student who receives a bad grade may start studying harder to avoid future poor grades. This behavior persists even when the negative outcome is no longer present. Avoidance learning is powerful because it maintains behavior in the absence of the...
01:25Analgesia and Pain Management
01:24Primary Motives: Sleep, Sex, and Pain Avoidance
Sleep is a fundamental physiological drive that fosters a state of restfulness crucial for several bodily functions. It facilitates body restoration, the process by which the body repairs, rejuvenates, and maintains itself during sleep, including memory...
01:09Preparedness and Phobias
01:22Behavior Therapy
Exposure therapy is a cornerstone of behavioral treatment for anxiety disorders. It involves systematic exposure to feared stimuli, either in real...
01:14Frustration and Conflict: Avoidance-Avoidance, Double-Approach Avoidance