The role of fundamental fears in the engagement in health protecting behaviour and the use of health care services

  • J.J.S. Pepels


Introduction Fundamental fears have been found to contribute to the engagement in health protective behaviour and the use of health care services before. These behaviours are proposed to contribute to the development of chronic pain. In order to validate these results, anxiety sensitivity (AS), injury/illness sensitivity (IS), and fear of negative evaluation (FNE) were tested in regard to these behaviours and general health concerns. Method Measures of fundamental fears, health protecting behaviour, use of health care services and perceived health were administered online to 121 participants. Correlations were tested with Pearson correlation tests. Predictive values of the fundamental fears were calculated with linear regressions. Results IS correlated positively with all behavioural measures and was the best predictor for all three behavioural measures. AS only correlated with perceived health. FNE showed a trend with perceived health and somewhat predicted health protecting behaviour. Discussion Results partially replicate previous findings, but also contradict other findings. This study further confirms the notion that fundamental fears are involved in pain-related behaviours and recommends further investigation in these relations.


Asmundson, G. J., & Norton, G. R. (1995). Anxiety sensitivity in patients with physically unexplained chronic back pain: a preliminary report. Behaviour research and therapy, 33(7), 771-777.

Asmundson, G. J., Norton, P. J., & Norton, G. R. (1999). Beyond pain: the role of fear and avoidance in chronicity. Clinical Psychology Review, 19(1), 97-119.

Asmundson, G. J., & Taylor, S. (1996). Role of anxiety sensitivity in pain-related fear and avoidance. Journal of behavioral medicine, 19(6), 577-586.

Carleton, R. N., Park, I., & Asmundson, G. J. (2006). The illness/injury sensitivity index: an examination of construct validity. Depression and anxiety, 23(6), 340-346.

Carleton, R. N., Thibodeau, M. A., Osborne, J. W., Taylor, S., & Asmundson, G. J. (2014). Revisiting the fundamental fears: Towards establishing construct independence. Personality and Individual Differences, 63, 94-99.

Chen, V., & Drummond, P. D. (2008). Fear of negative evaluation augments negative affect and somatic symptoms in social-evaluative situations. Cognition and Emotion, 22(1), 21-43.

Keogh, E., & Asmundson, G. (2004). Negative affectivity, catastrophizing and anxiety sensitivity. In G. Asmundson, J. Vlaeyen, & G. Crombez (Eds.), Understanding and treating fear of pain (pp. 91-115). New York: Oxford University Press.

Leary, M. R. (1983). A brief version of the Fear of Negative Evaluation Scale. Personality and Social Psychology Bulletin, 9(3), 371-375.

Lilienfeld, S. O. (1996). Anxiety sensitivity is not distinct from trait anxiety. In R. Rapee (Ed.), Current controversies in the anxiety disorders (pp. 228-244). New York: The Guilford Press.

Norton, P. J., & Asmundson, G. J. (2004). Anxiety sensitivity, fear, and avoidance behavior in headache pain. Pain, 111(1), 218-223.

Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11(2), 141-153.

Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behaviour research and therapy, 24(1), 1-8.

Taylor, S. (1993). The structure of fundamental fears. Journal of behavior therapy and experimental psychiatry, 24(4), 289-299.

Vancleef, L. M., Peters, M. L., Gilissen, S. M., & De Jong, P. J. (2007). Understanding the role of injury/illness sensitivity and anxiety sensitivity in (automatic) pain processing: An examination using the Extrinsic Affective Simon Task. The Journal of Pain, 8(7), 563-572.

Vancleef, L. M., Peters, M. L., Roelofs, J., & Asmundson, G. J. (2006). Do fundamental fears differentially contribute to pain related fear and pain catastrophizing? An evaluation of the sensitivity index. European Journal of Pain, 10(6), 527-527.

Vlaeyen, J. W., Kole-Snijders, A. M., Boeren, R. G., & Van Eek, H. (1995). Fear of movement/(re) injury in chronic low back pain and its relation to behavioral performance. Pain, 62(3), 363-372.

Vlaeyen, J. W., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain, 85(3), 317-332.