The Fear-Avoidance Components Scale (FACS)

Randy Neblett, Tom G. Mayer, Mark J. Williams, Sali Asih, Antonio I. Cuesta-Vargas, Meredith M. Hartzell, Robert Joseph Gatchel

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Objectives: To assess the clinical validity and factor structure of the Fear-Avoidance Components Scale (FACS), a new fear-avoidance measure. Materials and Methods: In this study, 426 chronic musculoskeletal pain disorder patients were admitted to a Functional Restoration Program (FRP). They were categorized into 5 FACS severity levels, from subclinical to extreme, at admission, and again at discharge. Associations with objective lifting performance and other patient-reported psychosocial measures were determined at admission and discharge, and objective work outcomes for this predominantly disabled cohort, were assessed 1 year later. Results: Those patients in the severe and extreme FACS severity groups at admission were more likely to "drop out" of treatment than those in the lower severity groups (P=0.05). At both admission and discharge, the FACS severity groups were highly and inversely correlated with objective lifting performance and patient-reported fear-avoidance-related psychosocial variables, including kinesiophobia, pain intensity, depressive symptoms, perceived disability, perceived injustice, and insomnia (Ps<0.001). All variables showed improvement at FRP discharge. Patients in the extreme FACS severity group at discharge were less likely to return to, or retain, work 1 year later (P≤0.02). A factor analysis identified a 2-factor solution. Discussion: Strong associations were found among FACS scores and other patient-reported psychosocial and objective lifting performance variables at both admission and discharge. High discharge-FACS scores were associated with worse work outcomes 1 year after discharge. The FACS seems to be a valid and clinically useful measure for predicting attendance, physical performance, distress, and relevant work outcomes in FRP treatment of chronic musculoskeletal pain disorder patients.

Original languageEnglish
Pages (from-to)1088-1099
Number of pages12
JournalClinical Journal of Pain
Volume33
Issue number12
DOIs
StatePublished - 1 Jan 2017

Fingerprint

Fear
Musculoskeletal Pain
Somatoform Disorders
Chronic Pain
Moving and Lifting Patients
Sleep Initiation and Maintenance Disorders
Statistical Factor Analysis
Depression
Pain
Therapeutics

Keywords

  • FACS
  • chronic musculoskeletal pain disorders
  • depression
  • disability
  • fear-avoidance
  • functional restoration program
  • insomnia
  • lifting capacity
  • the Fear-Avoidance Components Scale

Cite this

Neblett, R., Mayer, T. G., Williams, M. J., Asih, S., Cuesta-Vargas, A. I., Hartzell, M. M., & Gatchel, R. J. (2017). The Fear-Avoidance Components Scale (FACS). Clinical Journal of Pain, 33(12), 1088-1099. https://doi.org/10.1097/AJP.0000000000000501
Neblett, Randy ; Mayer, Tom G. ; Williams, Mark J. ; Asih, Sali ; Cuesta-Vargas, Antonio I. ; Hartzell, Meredith M. ; Gatchel, Robert Joseph. / The Fear-Avoidance Components Scale (FACS). In: Clinical Journal of Pain. 2017 ; Vol. 33, No. 12. pp. 1088-1099.
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Neblett, R, Mayer, TG, Williams, MJ, Asih, S, Cuesta-Vargas, AI, Hartzell, MM & Gatchel, RJ 2017, 'The Fear-Avoidance Components Scale (FACS)', Clinical Journal of Pain, vol. 33, no. 12, pp. 1088-1099. https://doi.org/10.1097/AJP.0000000000000501

The Fear-Avoidance Components Scale (FACS). / Neblett, Randy; Mayer, Tom G.; Williams, Mark J.; Asih, Sali; Cuesta-Vargas, Antonio I.; Hartzell, Meredith M.; Gatchel, Robert Joseph.

In: Clinical Journal of Pain, Vol. 33, No. 12, 01.01.2017, p. 1088-1099.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Williams, Mark J.

AU - Asih, Sali

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AU - Hartzell, Meredith M.

AU - Gatchel, Robert Joseph

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Neblett R, Mayer TG, Williams MJ, Asih S, Cuesta-Vargas AI, Hartzell MM et al. The Fear-Avoidance Components Scale (FACS). Clinical Journal of Pain. 2017 Jan 1;33(12):1088-1099. https://doi.org/10.1097/AJP.0000000000000501