{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:54:10Z","timestamp":1790056450089,"version":"4.0.1"},"reference-count":77,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T00:00:00Z","timestamp":1563494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Dysfunctional psychological pain responses, namely fear\u2010avoidance (FAR), including catastrophizing and helplessness, as well as endurance\u2010related responses (ER), including thought suppression and overactivity, have been shown to be risk factors for persistent low back pain (LBP). Literature suggests that athletes may differ from non\u2010athletes regarding psychological responses to pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study set out to compare FAR and ER between athletes and non\u2010athletes with LBP. It was hypothesized that athletes would report less frequent FAR and more frequent ER, and that both FAR and ER are associated with LBP intensity and disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The 173 athletes and 93 non\u2010athletes cross\u2010sectionally reported how frequently they employ FAR and ER on the Avoidance\u2010Endurance Questionnaire (AEQ), as well as LBP intensity and disability on the Chronic Pain Grade Questionnaire (CPGS). MANOVA was applied to compare FAR and ER between athletes and non\u2010athletes. Hierarchical multiple linear regression models were used to determine the unique associations between FAR and ER with LBP intensity and disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Athletes reported lower frequencies of behavioural avoidance than non\u2010athletes, but no other FAR variables differed between the groups. Frequencies of ER did not differ between athletes and non\u2010athletes. Regression analysis indicated substantial associations of FAR with LBP intensity, as well as of FAR and ER with disability in athletes and non\u2010athletes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of the present study suggest that athletes and non\u2010athletes with LBP differ regarding behavioural avoidance, but overall, differences regarding pain responses are marginal. FAR and ER are both reported in athletes and non\u2010athletes and contribute to disability in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Athletes train to endure pain in the course of athletic socialization, at least in the context of exercise. However, there is sparsity of knowledge about psychological pain responses in athletes with low back pain and whether they differ from those in non\u2010athletes. The results of this comparative study suggest that endurance responses are more frequent than avoidance responses among athletes and non\u2010athletes\u00a0alike. However, both types of responses seem relevant to clinical pain management in athletes as well as non\u2010athletes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1442","type":"journal-article","created":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T19:43:34Z","timestamp":1561059814000},"page":"1649-1662","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Psychological pain responses in athletes and non\u2010athletes with low back pain: Avoidance and endurance matter"],"prefix":"10.1002","volume":"23","author":[{"given":"Hannah","family":"Gajsar","sequence":"first","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology, Faculty of Medicine Ruhr University of Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Titze","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology, Faculty of Medicine Ruhr University of Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Levenig","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Sociology, Faculty of Medicine Ruhr University of Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Kellmann","sequence":"additional","affiliation":[{"name":"Unit of Sport Psychology Ruhr University of Bochum Bochum Germany"},{"name":"School of Human Movement and Nutrition Sciences The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahan","family":"Heidari","sequence":"additional","affiliation":[{"name":"Unit of Sport Psychology Ruhr University of Bochum Bochum Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Kleinert","sequence":"additional","affiliation":[{"name":"Department of Health 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