{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T20:14:19Z","timestamp":1769631259031,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T00:00:00Z","timestamp":1611619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Biased interpretations of ambiguous bodily threat situations characterize youth with chronic pain, and have been associated with functional disability for this population. Despite predictions by the fear\u2010avoidance model of chronic pain, that fear and avoidance of pain explain the association between threat perceptions and disability, this has not yet been explored in youth with chronic pain. This study aimed to address this gap by investigating these proposed relationships, in addition to the association between bodily threat interpretations and daily aspects of disability (as well as social, and emotional impairments).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Sixty\u2010eight adolescents aged 11\u201318\u00a0years old with a clinical diagnosis of chronic pain completed an extended version of the Adolescent Interpretations of Bodily Threat task to assess interpretations of bodily and social threat situations, alongside measures of disability and fear and avoidance of pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using mediation analysis, fear and avoidance of pain statistically accounted for the relationship between negative bodily threat interpretations and functional disability. Significant associations were also demonstrated between negative bodily threat interpretations and adolescent\u2010reported impairments in daily, emotional and social impairments. Data revealed a significant relationship between negative social interpretations and daily functional disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings indicate the clinical relevance of bodily and social threat interpretations, and fear and avoidance of pain, for this population and raise further questions regarding the content\u2010specificity of threat interpretations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Psychological theories of pain\u2010associated impact and disability point to fear and avoidance of pain, as well as information\u2010processing biases. Here, we present novel data showing the clinical relevance of bodily and social threat interpretations in explaining pain\u2010related disability amongst youth with chronic pain, potentially by shaping fear and avoidance of pain. Longitudinal designs will be required to assess these temporally sensitive mediation pathways.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1724","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T06:40:40Z","timestamp":1609915240000},"page":"1031-1040","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Associations between biased threat interpretations, fear and avoidance of pain and pain\u2010linked disability in adolescent chronic pain patients"],"prefix":"10.1002","volume":"25","author":[{"given":"K.","family":"Atkinson\u2010Jones","sequence":"first","affiliation":[{"name":"Oxford Institute of Clinical Psychology University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Oxford Centre for Children and Young People Oxford University Hospitals Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8220-3618","authenticated-orcid":false,"given":"J.Y.F.","family":"Lau","sequence":"additional","affiliation":[{"name":"Psychology Department King's College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781412986427"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.04.010"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2005.12.002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2005.08.025"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011259"},{"key":"e_1_2_9_7_1","volume-title":"Discovering statistics using IBM SPSS statistics","author":"Field A.","year":"2013"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsu008"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/120632"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/820407"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.12.021"},{"key":"e_1_2_9_12_1","first-page":"1","article-title":"Relationships among social anxiety, self\u2010focused attention, and experiential distress and avoidance","volume":"11","author":"Glick D. 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