Attachment and Adjustment in Adolescents and Young Adults With a History of Pediatric Functional Abdominal Pain
Open accessAbstract
OBJECTIVES: This study tested predictions of the Attachment-Diathesis Model (ADM) of Chronic Pain in a cross-sectional sample of adolescents and young adults with a history of childhood functional abdominal pain (FAP). ADM posits that attachment anxiety is a diathesis for poor adjustment (physical health, mental health, and functioning) in the context of chronic pain and that pain self-efficacy, pain threat appraisal, and passive coping mediate this effect. METHODS: Participants (N=261) were recruited from a database of consecutive new patients evaluated for abdominal pain at a pediatric gastroenterology clinic. Participants' mean age at the follow-up assessment was 21 years. Structural equation modeling was used to test the fit of our conceptual model to the data. RESULTS: Model fit was good (comparative fit index=0.971, the Tucker-Lewis index=0.940, root mean square error of approximation=0.067). Attachment anxiety significantly predicted poorer health in both the mental and physical domains. Model fit was consistent with our hypothesis that pain self-efficacy mediates the effect of attachment anxiety on passive coping and that passive coping, in turn, mediates the effect of pain self-efficacy and pain threat appraisal on mental and physical health. DISCUSSION: Among individuals with a childhood history of FAP, those with anxious attachment may be at higher risk for poor physical and mental health. Pain beliefs and coping may mediate the relation between anxious attachment and health outcomes and may serve as effective targets for intervention in chronic pain.
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Anxiety is positively correlated with pain sensitivity in males but not in females.
“several studies have shown that anxiety is positively correlated with pain sensitivity among males, but not females 211, 212”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [211]
Increased emotional awareness and coping self-efficacy may be two mechanisms by which secure attachment decreases stress reactivity.
“Research suggests that increased emotional awareness24 and coping self-efficacy25,26 may be two mechanisms by which secure attachment decreases stress reactivity.”
From Psychobiological factors of resilience and depression in late life (2019) · cites this paper as [25]
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- Authors
- Laird, K. T., Preacher, K. J., & Walker, L. S.
- Affiliations
- Vanderbilt University (US)
- Venue
- The Clinical Journal of Pain
- Published
- 2015-02
- Volume
- 31
- Issue
- 2
- Pages
- 152-158
- ISSN
- 0749-8047 (ISSN-L)
- PMC
- PMC4201885
- OpenAlex
- W2053022101
- Cited by
- 23
- References
- 74
- Citations by year
- 2026: 1 · 2025: 4 · 2023: 1 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 5 · 2015: 1
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK058404, P30DK058404)
- National Center for Research Resources (UL1RR024975)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30HD015052, R01HD023264)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- functional abdominal pain, attachment anxiety, chronic pain, adolescents, young adults, pain self-efficacy, passive coping, mental health, physical health, adjustment, pain beliefs
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Anxiety, Attitude to Health, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Individuality, Male, Models, Psychological, Parent-Child Relations, Surveys and Questionnaires, Abdominal Pain, Self Efficacy, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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