Perceived psychosocial stressors and coping resources in chronic low back pain patients as classified by the avoidance-endurance model.

The study used a cross-sectional design, so it cannot prove that these coping styles cause the reported stress levels or vice versa. The sample had low to moderate pain and disability levels, which may not represent patients with severe chronic pain. Interviews were not recorded, relying only on written notes, which may have limited the depth of data collected. The classification of patients into coping groups varied slightly depending on whether a cluster analysis or cut-off scores were used. Many of the significant differences between groups had small effect sizes.

The authors declared no conflicts of interest. The study was approved by the ethics committee of the city of Vienna.

Do not assume that patients with fear-avoidance or distress-endurance coping styles have more external life stress. The study found no significant difference in the overall quantity of work or family stressors between the groups. The difference lay in their internal mental suffering and their lack of identified coping resources.