Pain-related anxiety plays a significant role in pain and disability, as it has been suggested as an influence on cognitive and coping responses to pain1. While avoidance behavior has often been shown as a response to pain anxiety, the question arises whether pain anxiety may also be associated with pain-related endurance, such as cognitions of thought suppression, humor/distraction, and task persistence behavior. The PASS-20 assesses cognitive, physiological and behavioral aspects of pain-related anxiety, such as cognitive anxiety, fear, physiological anxiety and escape/avoidance. The aim of this study was twofold: (1) To examine the factor structure and the psychometric characteristics of a German version of the PASS-20 in a sample of low back pain (LBP) patients, and (2) to examine aspects of criterion-related and content validity with a special focus on pain-related avoidance versus endurance.
