**5. Conclusions**

The results in this study indicate that the association between fear-avoidance and pain intensity differs between men and women. For men, no association between these variables was found, whereas for women, an increase in fear-avoidance was associated with a (slight) increase in pain intensity. Affective experiences, however, did not confound the association between fear-avoidance and pain intensity in either men or women. Our findings support research highlighting the importance of sex differences in pain experience, which may be important for clinicians to consider for a more personalized pain management approach in chronic pain patients. Nevertheless, further research with a larger sample and equal numbers of sexes is needed to confirm these findings and their clinical implication.

**Author Contributions:** Conceptualization, N.d.M., B.B., C.L., R.L. and E.M.M.J.; methodology, N.d.M., B.B., R.L. and C.L.; formal analysis, S.M.J.v.K., S.W. and E.v.D.; investigation N.d.M., S.M.J.v.K., S.W. and E.v.D.; resources, N.d.M., B.B., C.L., R.L. and E.M.M.J.; data curation, S.M.J.v.K. and S.W.; writing—original draft preparation, E.v.D., S.W., S.M.J.v.K., N.d.M. and B.B.; writing—review and editing, E.v.D., S.W., S.M.J.v.K., N.d.M., B.B., R.L., C.L. and L.V.; visualization, S.W.; supervision, J.v.Z.; project administration, N.d.M.; funding acquisition, N.d.M. and B.B. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Institutional Review Board Statement:** The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of METC azM/UM (protocol code 2018-0955 and 19 January 2019).

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study.

**Data Availability Statement:** All data relevant to the study are included in the article. Data can only be obtained by contacting the corresponding author.

**Conflicts of Interest:** The authors declare no conflict of interest.
