This prospective, longitudinal study proposes to address the existing gaps in the research literature regarding the determinants of individual variability in pain catastrophic cognitions and pain-related fear, as well as the trajectories of chronic pain within the FAM framework. The study will also allow us to obtain empirical evidence of FAM among Chinese patients. A sample of 400 Chinese patients with chronic musculoskeletal pain will be recruited from a multi-disciplinary pain clinic in Hong Kong. Measures of the FAM components will be taken at baseline, and at 3, 6, and 12 months following baseline. Linear mixed effect modeling will be used to assess the role of personality traits in pain catastrophic cognition and the underlying mechanisms of pain-related fear. Hierarchical linear modeling and path analyses will be used to evaluate changes of the FAM components over time and the cross-sectional interrelationships between FAM components, respectively.

The results of the study demonstrated that (1) neuroticism and negative affectivity were two dispositions at the same conceptual level, and (2) pain hypervigilance mediated the relationship between anxiety sensitivity and pain-related fear. Our findings offer evidence that patients presenting with more neurotic symptom and heightened negative affect probably elicit more catastrophic thoughts about pain. These findings show demonstrate how the interdependence of dispositional factors affects pain adjustment and functioning. More importantly, results of this study add to the existing pain literature on FAM. Thus far, the studies that examined the bidirectional relationships of the key components of the FAM have all been conducted in Western populations. Findings of this study are consistent with the view that the basic premises of the FAM appear to generalize across cultures. These findings provide an important theoretical and empirical base for future research to clarify cultural similarities and differences among patients with chronic pain.

*Wong, W. S., Lam, H. M. J., Chen, P. P., Chow, Y. F., Wong, S., Lim, H. S., Jensen, M., & Fielding, R. (2015). The fear-avoidance model of chronic pain: Assessing the role of neuroticism and negative affect in pain catastrophizing using structural equation modeling. International Journal of Behavioral Medicine, 22, 118-131.
*Wong, W. S., Lam, H. M. J., Chow, Y. F., Chen, P. P., Lim, H. S., Wong, S., & Fielding, R. (2014). The effects of anxiety sensitivity, pain hypervigilance, and pain catastrophizing on quality of life outcomes of patients with chronic pain: A preliminary, cross-sectional analysis. Quality of Life Research, 23, 2333-2341.