Attachment insecurity predicts responses to an interdisciplinary chronic pain rehabilitation program
Abstract
The aim of this study was to examine the hypothesis that attachment insecurity is associated with poorer responses to interdisciplinary treatment for chronic pain. Patients (n = 235) admitted to a 4-week interdisciplinary rehabilitation program were recruited. At pre-treatment, participants completed a battery of questionnaires assessing adult attachment styles and dimensions, as well as pain intensity, disability, self-efficacy, pain catastrophizing, and depressive symptoms. The latter measures were completed again at post-treatment. Nearly two-thirds of participants (65.5 %) reported having an insecure attachment style. Attachment insecurity was unrelated to pre- and post-treatment reports of pain intensity and pain-related disability, but was significantly associated with most other clinical variables at both time points. Regression analyses controlling for pre-treatment functioning indicated that attachment insecurity was associated with less improvement in pain catastrophizing, pain self-efficacy, and depressive symptoms. Further research is warranted to investigate the processes by which attachment characteristics influence patients' responses to chronic pain rehabilitation.
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Women report using catastrophizing, behavioral activities, positive self-statements, social and emotional support, and problem-focused coping more often than men.
“compared to men, women have endorsed more frequent use of catastrophizing, behavioral activities, positive self-statements, social and emotional support, and problem-focused coping 148, 201–204.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [202]
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The role of psychosocial processes in the development and maintenance of chronic pain
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“Some researchers have demonstrated that attachment insecurity relates to poorer rehabilitation outcomes in chronic pain (Kowal et al., 2015), cancer (Adellund Holt, Jensen, Gilsa Hansen, Elklit, & Mogensen, 2016), and cardiac patients (Heenan, Greenman, Tassé, Zachariades, & Tulloch, 2020).”
Background
- Authors
- Kowal, J., McWilliams, L. A., Péloquin, K., Wilson, K. G., Henderson, P. R., & Fergusson, D. A.
- Affiliations
- University of Ottawa (CA)
- University of Saskatchewan (CA)
- Université de Montréal (CA)
- Ottawa Hospital Research Institute (CA)
- Corresponding author
- Kowal, John
- Venue
- Journal of Behavioral Medicine
- Published
- 2015-02-26
- Volume
- 38
- Issue
- 3
- Pages
- 518-526
- ISSN
- 0160-7715 (ISSN-L)
- 1573-3521
- OpenAlex
- W2063800765
- Cited by
- 36
- References
- 56
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 8 · 2017: 2 · 2016: 2 · 2015: 1
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- insecure attachment, chronic pain, interdisciplinary pain rehabilitation, treatment response, pain catastrophizing, pain self-efficacy, depressive symptoms, pain-related disability, adult attachment styles
- MeSH terms
- Adult, Aged, Cooperative Behavior, Depression, Female, Humans, Male, Middle Aged, Pain Measurement, Surveys and Questionnaires, Self Care, Cognitive Behavioral Therapy, Reactive Attachment Disorder, Interdisciplinary Communication, Young Adult, Catastrophization, Chronic Pain, Pain Management
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