CORRESPONDING AUTHOR: Melissa F. Miller, PhD, MPH, Cancer Support Community, Fairfax, VA, 22033; melissa@cancersupportcommunity.org in 74 female and male participants, who were grouped according to gender role on the basis of the Bem Sex Role Inventory. Using sex, gender and psychological traits (catastrophizing, fear of pain), it was found that sex, but not gender, strongly predicted pain responsivity in nearly all pain measures and fear of pain was a mediator. The fear avoidance model postulates that in chronic low back pain (CLBP) a fear of movement is acquired in the acute phase, which leads to subsequent avoidance of physical activity and thereby drives the chronification of the pain syndrome. In an event-related fMRI study we investigated neural correlates of the hypothesized fear of movement. 60 women (30 CLBP patients, 15 healthy controls and 15 women with spider phobia, mean age: 46.8±9.8 years) participated. The CLBP patients were divided on the basis of the Tampa Scale of Kinesiophobia (TSK) into a high and low fear-avoidant group. They viewed 120 photographs depicting neutral and painful movements, generally fear-inducing and neutral objects from the International Affective Picture System (IAPS) and spiders while functional MRI data were acquired. For CLBP patients activations were found in brain areas commonly implicated in emotional processing (cingulate cortex, orbitofrontal cortex) for the contrast of painful > neutral movements. However, in a random effects analysis, CLBP patients with high fear avoidance did not differ from those with low fear avoidance or controls with regard to this contrast. For the contrast fear-inducing IAPS pictures > neutral pictures, CLBP patients with high fear avoidance exhibited an activation in the left anterior insula, which was not found in those with low fear avoidance. The spider phobics showed extensive bilateral activation in the cingulate cortex and the insulae for the contrast spiders > neutral pictures and the random effects analysis revealed marked differences in these areas between the spider phobics and the healthy controls.