Adult attachment and approaches to activity engagement in chronic pain
Open accessAbstract
BACKGROUND: The way in which individuals with chronic pain habitually approach activity engagement has been shown to impact daily functioning, with both avoidance of one’s daily activities and overactivity (activity engagement that significantly exacerbates pain) associated with more pain, higher levels of physical disability and poorer psychological functioning. OBJECTIVE: To provide insight into the development of maladaptive habitual approaches to activity engagement in chronic pain by applying an attachment theory framework. METHODS: A sample of 164 adults with chronic pain completed selfreport measures of attachment, approach to activity and pain cognitions. Mediation analyses were undertaken to examine the direct association between attachment variables and maladaptive approaches to activity, and to test for the mediating role of pain cognitions (catastrophizing and thought suppression). RESULTS: Results demonstrated that higher levels of secure attachment were associated with lower levels of activity avoidance, which was fully mediated by lower levels of pain catastrophizing; higher levels of preoccupied or fearful attachment were directly associated with higher levels overactivity; higher levels of preoccupied attachment were associated with higher levels of activity avoidance, which was partially mediated by higher levels of pain catastrophizing; and higher levels of fearful attachment were indirectly associated with higher levels of activity avoidance through higher levels of catastrophizing. CONCLUSIONS: These results provide preliminary support for the suggestion that insecure attachment may be a source of vulnerability to the development of disabling activity patterns in chronic pain.
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The biopsychosocial approach characterizes pain and disability as a multidimensional dynamic interaction among physiological, psychological, and social factors that reciprocally influence each other and produce chronic complex pain syndromes.
“Collectively, the biopsychosocial approach describes pain and disability as a multidimensional, dynamic interaction among physiological, psychological, and social factors that reciprocally influence one another, resulting in chronic and complex pain syndromes7, 12.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [7]
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- Authors
- Andrews, N. E., Meredith, P. J., Strong, J., & Donohue, G. F.
- Affiliations
- The University of Queensland (AU)
- Corresponding author
- Andrews, Nicole E
- Venue
- Pain Research and Management
- Publisher
- Wiley
- Published
- 2014-01
- Volume
- 19
- Issue
- 6
- Pages
- 317-327
- ISSN
- 1203-6765 (ISSN-L)
- 1918-1523
- PMC
- PMC4273711
- OpenAlex
- W3239271
- Cited by
- 33
- References
- 98
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 4
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Pain Research and Management (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Acquire (CQUniversity) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Royal Brisbane and Women’s Hospital Foundation Scholarship
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Keywords
- chronic pain, adult attachment, activity engagement, activity avoidance, overactivity, pain catastrophizing, thought suppression, insecure attachment, preoccupied attachment, fearful attachment, secure attachment, pain-related cognitions, maladaptive coping
- MeSH terms
- Female, Humans, Male, Middle Aged, Personality, Surveys and Questionnaires, Chronic Pain
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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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