Cited by 260Musculoskeletal pain and rehabilitationAttachment and Relationship DynamicsPsychosomatic Disorders and Their Treatments

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The relationship of attachment style to depression, catastrophizing and health care utilization in patients with chronic pain

Ciechanowski, Paul, Sullivan, Mark, Jensen, Mark, Romano, Joan, Summers, Heidi·2003·Pain

DOI 10.1016/s0304-3959(03)00120-9

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Abstract

Attachment theory and research suggest that patterns of interpersonal relationships may be important determinants of illness behavior, care seeking, and treatment response in individuals with chronic health problems, including chronic pain. Attachment styles have been shown to be associated with psychological adjustment in the context of chronic illness, but little research has been conducted so far examining these relationships in patients with chronic pain. We assessed 111 patients with chronic pain participating in a multidisciplinary pain treatment program to determine if attachment style is associated with pain, depression, catastrophizing and physical disability at pre-treatment and 12-month follow-up, and with change in health care utilization pre-treatment to follow-up. At both pre-treatment and follow-up, fearful attachment style was associated with significantly greater depression and catastrophizing, and secure attachment was associated with significantly lower levels of depression. Preoccupied attachment style was associated with greater than weekly pain-related visits at 12 months follow-up, even after controlling for depression, catastrophizing and pre-treatment pain-related health care utilization. The findings suggest that attachment style may be a useful construct for examining factors affecting adjustment and treatment response of patients with chronic pain.

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Authors: Ciechanowski, P., Sullivan, M., Jensen, M., Romano, J., & Summers, H.
Affiliations: University of Washington (US)
Corresponding author: Ciechanowski, Paul
ORCID: Ciechanowski, Paul
Sullivan, Mark
Jensen, Mark
Romano, Joan
Summers, Heidi
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-08
Volume: 104
Issue: 3
Pages: 627-637
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/s0304-3959(03)00120-9
OpenAlex: W2029650441
Cited by: 260
References: 60
Citations by year: 2026: 1 · 2025: 6 · 2024: 6 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 10 · 2019: 13 · 2018: 18 · 2017: 13 · 2016: 13 · 2015: 17 · 2014: 19 · 2013: 13 · 2012: 17
FWCI: 5.78
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Neurological Disorders and Stroke (R01NS031638, R01 NS31638)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: attachment styles, chronic pain, depression, pain catastrophizing, health care utilization, fearful attachment, secure attachment, preoccupied attachment, multidisciplinary pain management, physical disability, psychological adjustment
MeSH terms: Adult, Chronic Disease, Depression, Female, Humans, Male, Middle Aged, Object Attachment, Pain, Patient Acceptance of Health Care, Logistic Models

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The relationship of attachment style to depression, catastrophizing and health care utilization in patients with chronic pain

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