Functional Disability in Nonspecific Low Back Pain: The Role of Pain-Related Fear and Problem-Solving Skills Johanna H. C. van den Hout, Johan W. S. Vlaeyen, Peter H. T. G. Heuts, Wil J. T. Sillen, and Annelies J. E. H. L. Willen Previous studies have shown that pain disability in chronic back pain patients is closely associated with pain-related fear and avoidance. This study was aimed at rep- licating this finding in a sample of low back pain (LBP) patients with a new episode of sick leave. In addition, the supplemental value of problem solving in predicting pain disability was examined. It was further hypothesized that problem solving would moderate the effects of daily stress on pain disability. The results were partly as pre- dicted. Pain-related fear, pain intensity, pain catastrophizing, daily stress, and prob- lem solving were found to be individually related to functional disability, of which pain intensity and pain catastrophizing were the strongest predictors. Problem solving neither added predictive value regarding pain disability, nor could the moderating role of problem solving be confirmed. Surprisingly, and in disagreement with previous INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, 8(2), 134–148 Copyright © 2001, Lawrence Erlbaum Associates, Inc. Johanna H. C. van den Hout, Department of Medical, Clinical and Experimental Psychology, Maastricht University, Maastricht, The Netherlands and Institute for Rehabilitation Research, Hoensbroek, The Netherlands; Johan W. S. Vlaeyen, Department of Medical, Clinical and Experimen- tal Psychology, Maastricht University, Maastricht, The Netherlands; Peter H. T. G. Heuts, Department of Pain Rehabilitation, Limburg Foundation for Rehabilitation, Hoensbroek, The Netherlands; Wil J.T. Sillen, Department of Pain Rehabilitation, Limburg Foundation for Rehabilitation, Hoensbroek, The Netherlands; Annelies J. E. H. L. Willen, Department of Pain Rehabilitation, Limburg Foundation for Rehabilitation, Hoensbroek, The Netherlands. This study was supported by Grant No. 940-31-004 of the Council for Medical and Health Research of the Netherlands (MW-NWO). The authors thank Steven Linton, Jan Passchier, and Riekie de Vet for their helpful suggestions dur- ing the final phase of this study. Correspondence concerning this article should be addressed to Anja van den Hout, Department of Medical, Clinical and Experimental Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, NL. E-mail: anja.vandenhout@dep.unimaas.nl